When our golden doodle died a few weeks into the Covid lockdown, my wife and I grieved in isolation. Norm Stillman rescued us from despair. At the time, the Plymouth veterinarian owned Court Street Animal Hospital, which he opened in April 2005 and sold in December 2020. He tirelessly tended to pets and their owners with acute skill and a reservoir of compassion. On that crushing day in April 2020, he met us with his wife, Diane, in the parking lot behind the clinic, one leg in a cast because of Achilles heel surgery. He couldn’t excise our pain, but he did help us find perspective. “Licorice won,” he said of our precious dog’s long life and – in retrospect – mercifully quick passing. “Most of us won’t get to die that way.” Stillman gave similar comfort to thousands of people during his time at the Court Street clinic.
Since officially leaving the hospital more than a year ago, Stillman, 53, has been on a sabbatical. The reasons for stepping away from his vocation are compelling and complicated. Today, he’s at a life intersection, reflecting on lessons from past and contemplating next steps. This personal period of introspection – accompanied by creeping restlessness – comes as the pet care industry is in crisis. Since the pandemic, there are more pets than ever – two-thirds of U.S. households have at least one. Correspondingly, spending on pet care is rising. It reached almost $137 billion in 2022, up nearly 11 percent from the year before.
But there are not nearly enough veterinarians to tend to all these household companions. Nationwide, there are fewer than three dozen veterinary schools.
Vets are often overwhelmed and underpaid, burdened by the staggering debt of their medical training. Many are worn down by the unrelenting workload and rising expenses. And then there’s a grim reality: Given the life span of animals compared with humans, the job routinely involves dealing with euthanasia.
It’s no wonder that many vets struggle with their mental health. A November Psychology Today story detailed a study that found about 80 percent suffer from clinical depression at some point, and half are unhappy with their career. Even worse, veterinarians are two to four times as likely to die by suicide than the general population, according to a 2019 Centers for Disease Control and Prevention study.
In a long and wide-ranging conversation – I think it’s worth your time – Stillman spoke candidly about why he isn’t practicing on a regular basis, but also about the privilege he’s felt as caregiver to animals, and the fulfillment that comes from such work.
This interview has been edited for clarity and length.
A cliched question, but did you know at an early age that you wanted to enter the veterinary field?
No, but I always loved animals. My parents are both physicians. From a young age, they kind of guided me towards being a physician, which I did not resist.
Where were you living then?
I was born in Tucson, Arizona. It was an interesting city to grow up in. The nice thing about Tucson in those days was that it was small city, like the way Plymouth is now. I lived there until I was 12 and then we moved to Auburn, Massachusetts.
You were guided, not pressured towards becoming a doctor?
My parents never officially said to me, “You’re going to be a doctor.” But our dinnertime conversation was always medical stuff. We hung out with other doctors. My friends were the kids of other doctors. It didn’t even seem like a decision. It seemed like a natural thing to do. I just kind of went on that course, but in college (Colby, in Maine) I decided I was going to be an English major because I liked English. But I was also taking a lot of science courses. In my junior year, I thought I ought to get some practical experience before I began applying to medical schools.
You didn’t do pre-med as an undergrad?
That’s the most common route, but I never took the common way. I had enough room in my schedule that I could take all the prerequisites and still be an English major. I figured I’d have a fallback, and I wanted a broader educational experience. So I went to career services and I asked them to set me up with a surgeon to shadow for a month during the January intersession. I went to a surgical hospital in New York City and the head of surgery was a Colby alumnus and he agreed to take me on. He introduced me all around and then just set me free in the hospital. I saw some amazing things, but also began to think I didn’t really like it that much.
I didn’t like their lifestyle. I didn’t like that they spent so little time with patients. They’d come in, make a quick assessment, and get out. They didn’t want to know their patients. They didn’t want to talk to their patients. They were all in a bad mood. They were working 5 a.m. till 10 p.m. every day. They were making a ton of money, and they had no time to spend it. Their families were all living in mansions on Long Island and they were living in crummy little apartments in Manhattan.
Towards the end of the month, I began to be very disillusioned. I thought, “I’ve spent a lot of time preparing myself for this and now I have this dream internship and I don’t like it.” I went back to college at the end of my junior year and saw my advisor. He was a very wise guy and he said, “Let me get this straight. You want to spend time talking with people, you want to be part of their lives because you love medicine and surgery, but you don’t want to be rushed all the time.”
How did you know you loved surgery at that age?
I was a very tactile kid. I was always like taking apart machines and building models.
Please tell me you weren’t doing surgery on the neighborhood squirrels.
No, not officially. [Said with a smile.]
What did your advisor end up telling you?
He said, “You want to be a veterinarian.” I was like, “What? You are crazy.” Then he said, “No, I’m right, and you’re going to spend some time with my friend the veterinarian.” I didn’t want to do that, but he said I owed him. And I did. He had done me a lot of favors. Right on the spot he called up his veterinarian friend. I went over there the next day and within like an hour, I knew he was right – I did want to be a veterinarian.
Almost immediate. I realized this is exactly what I wanted to do.
Did you have pets growing up?
I did have a dog.
I’m just trying to make the connection between your childhood and this college-age epiphany.
Well, I was the kid that was always turning over logs, looking for lizards and snakes. I loved to go to the zoo, and I was constantly reading about animals. I didn’t have a pet until we moved from Tucson. I didn’t know we were moving. My dad had a private practice, and he didn’t want to let it get known that he was leaving. I showed up at the house one day after school and there was a moving truck in front. I was like, “Hey, what’s going on?” A few days later, there was I was in Worcester in November. I’d left behind all my friends, and it was cold. I sat in my room all day. I’m sure I was clinically depressed.
My parents came into my room one day and said, “We’re really sorry we did this to you. What can we do to make it up to you? I said I wanted a dog. My parents, who hated animals, said, “Isn’t there anything else? How about a nice video game system or something? I said, “No, I want a dog. To their credit, they immediately went and adopted a dog for me.
A black Cocker Spaniel. He came with the name Flaps – it was too late to change it. He immediately turned my life around at 13 years old. We’d go on 10- mile walks out in the forest. He slept on my bed every night.
Even then, you saw the psychological and physical benefits for the owner as well as the dog?
It was symbiotic. I realized how he had enriched my life. It was very formative for me.
OK, now we can return to your school story.
I was almost done with college, but the prerequisites for veterinary school are different than medical school. There was a lot that I was missing. Right after I graduated, I drove home on a Monday and unpacked. On Thursday, I began taking post baccalaureate classes at Clark University and UMass Amherst. That took a little over a year. Then I applied to veterinary school, and that’s another four years. I was eligible for Tufts because I lived in Massachusetts and because my prerequisites matched up with what they required. And while I was in college, my parents moved to Virginia. Because I was still leeching off them at the time, I became an automatic Virginia resident, even though I’d never set foot in the state. I also applied to Virginia Tech. I got into both, but at the time Tufts was about $36,000 a year and Tech was $6,000, so I went there. This is about 1994.
The day after I graduated, I packed my car. Meantime, I had married my girlfriend and my parents had moved again, from Virginia to Philadelphia. I was the only prospect for grandchildren for my parents, so they begged me to come live near them. Being a good son, I did. We lived there for six years, but I really missed being in New England. My wife is from Hanover and we had two little kids, four and two. I was 33. We thought that if we were going to move somewhere, we should do it before they would resent us for moving. Then we thought that if we were going to live that close to the ocean we should try to live right near the ocean. One day we got off at what was then exit 6 [on Route 3]. We took a right into downtown and immediately we knew it was our town. We stopped at [a] real estate agency on Court Street. I told the agent we were looking for a commercial property and she said, “Oh, I’ve got a place a few doors down.” We bought it. And there I was, a solo practitioner, which I never foresaw. We opened in April 2005.
Backing up, there are three things about veterinary school that we hear a lot about: how competitive it is, how it’s more difficult than medical school because you must learn about so many species, and that it’s expensive.
I think it was easier to get in when I went. School itself was very difficult. It was a miserable time in my life. I had to keep my eyes on the prize the whole time because it’s easy to get lost in the drudgery of it. The language of medical terminology is not intuitive and it’s not part of our vernacular. They spend the first year teaching you a new language and acquiring some basic medical knowledge, the most basic parts of physiology, biochemistry, and anatomy. Once they’ve established this foundation, they begin to teach you increasingly more interesting and difficult concepts.
When I said it’s harder than medical school, you kind of shook your head.
I don’t think veterinarians learn medicine to the depth that physicians do. Having parents who are physicians and watching my daughter go through medical school, I think that in exchange for learning a much greater breadth of knowledge, veterinarians relinquish some depth. But then you’re right, you have to learn a lot of different species and they’re not always analogous to one another.
The interesting thing that people don’t know about veterinary medicine is that most veterinarians do not do a residency. In human medicine, it’s requisite. You’re not qualified to practice medicine when you graduate from human medical school. You have to do some additional training, whether it’s going to be one year of training for family practice, or seven years of training for brain surgery. Most veterinarians do not do that. In essence, your first job is your residency. New graduates make a kind of a deal with the devil. They take a job at an animal hospital, and the deal is this: You are going to teach me the day-to-day practice of veterinary medicine, and in exchange I’m going to work long hours for cheap money. That’s what I did. On the day I graduated from vet school, I could have told you the classification of every drug. I knew the name of every artery and vein and nerve and bony protuberance, but I could not have treated an ear infection or made diarrhea go away to save my life. Those are the things I learned from watching other experienced vets. For another three or four years, I learned how to be a vet.
Did you come out of school with a lot of debt?
My parents paid for college, for which I am eternally grateful. I had enough saved up to pay for the first two years of my school outright. At the end of my sophomore year, I was married, and my wife had just graduated from her nursing program. Working as a nurse in southwestern Virginia, she was able to earn enough money to pay for our living expenses and my second two years of veterinary school. I graduated debt free, which has made all the difference in my entire life – my ability to start a practice and to move where I wanted to move. I was unencumbered by debt.
It is very easy to graduate from vet school with three or four hundred thousand in debt and vets don’t always earn that much. So that’s a lifetime debt load.
Which is part of the reason we don’t have enough of them.
It’s a huge problem and it’s not going to be solved anytime soon. My daughter’s vet school, Tufts, had a family day a few months ago and I listened to their presentation. Afterwards, I was talking with the dean. I told him I was a vet and said, “What are we going to do about this shortage?” He told me that couple times a year all the veterinary school deans in the country get together for a conference. “It’s pretty safe to say that that’s almost the only thing we talk about,” he said. “We don’t know what to do about it, either.”
Let’s say the average vet school class is 100 graduating students. There are 30 schools – we’ll just round down. That’s 3,000 vet students graduating every year. Half of those are either going to go into specialty medicine to become ophthalmologists or dermatologists or something. Or maybe they’re going to go into large animal medicine. Or they’re going to become researchers. That leaves 1, 500 general practitioners, being generous, per year. For 50 states, that’s 30 veterinarians per state. We could use 10 in this town right now. The dean told me that it’s not a lack of qualified applicants. We accept a hundred per year, he said, but we turn away hundreds of equally qualified applicants. “We could easily double the size of our class and not relax our standards at all,” he said “But to do that, we would have to double the size of our faculty. And faculty members are specialist veterinarians. They’re dermatologists and surgeons and ophthalmologists, too. We can’t find any of those people” willing to leave high-paying private practices.
Covid compounded the crisis by increasing the pet population.
Everybody wanted a pet. And the demand for high quality veterinary services is also increasing. I don’t want to demean the average consumer. They love their pets very much, but they don’t really understand what’s going on with their pets. They don’t understand what’s involved in treating pets. And because of that, for a long time, a lot of substandard vets were able to get by and keep their practices open.
Once a technician picks up your dog and walks out of the exam room, you don’t really know what’s going on back there. You don’t know whether they’re just giving your dog a shot and putting him in a cage or whether they’re doing some testing and trying to get to the bottom of it. There is a wide spectrum of veterinary care available, even in this town.
Some vets have not cracked a journal in 30 years and they’re practicing medicine the same way they did in 1970. Other vets are going to continuing education every weekend, acquiring new skills, buying new equipment, and keeping themselves on the cutting edge of technology. But the average person couldn’t tell the difference between those two practitioners very well up until now. Because of media and access to the Internet, people understand better now than they did before what’s involved in really good veterinary care – and they want it. The days of just giving a dog a shot and sending them home with an envelope full of pills are gone. People want to know what’s going on. They want a diagnosis. They want a targeted treatment, and they want to understand the whole thing. And who could blame them? I want that, too. But it’s hard to do those things and it’s expensive.
Let’s rewind to when you just had opened the hospital on Court Street in 2005. What were those early years like?
Scary. One of the things I liked about that building was that I could live in it because I could not afford to buy a house and a practice. I needed a building where I could live with my family – it had an apartment upstairs.
That also meant no separation between your home and work lives.
That was a bonus for me in those days. I started that practice with zero clients. If someone called at midnight and said, “My dog’s scratching his ear,” I’d say, “Come on over, I’ll see you.” I had bought this building. I had filled it with a bunch of expensive equipment. I had some staff members that I’d hired and I had no cash flow. I was living on savings and a loan. Fortunately, the town of Plymouth was very kind to me and pretty quickly word started to get out. After a couple years, the practice was in the black. If I known what I was getting into, I might have run away from it. I chose a lovely place to live and a good location. Through that and some hard work, I made a go of it.
People really felt an affinity for you. They felt your compassion. Did you sense that?
I would describe it as gratitude. I was always so grateful to every one of my clients. I knew very well that there were a lot of choices for veterinary care in this town. I took it as a huge badge of honor and as a huge responsibility. Whenever I went on vacation, I’d always get an international plan so that they could call me. I might be in Spain or Ireland and they’d say, “My dog threw up twice,” or something. I’d walk away from my family as we were going through a museum and I would talk to them. Sometimes they’d say, “What’s going on in the background?” I’d say, “Oh, there’s a tour group going by. I’m in Ireland.” And they’d say, “Oh, my God, I can’t believe you’re answering the phone.” “Look, when disease takes a vacation, I will, too,” I told them. It’s not like I’m I’m fixing refrigerators or something. These are little people that people love.
How many hours do you think you worked on average in a week?
In the clinic, seeing patients, I’d say 40 or 50, but then maybe another 20 answering phone calls and writing notes and stuff. A lot of times I’d be at the hospital until 10 o’clock at night answering calls because people have questions and I thought that I owed them the courtesy of a response.
As a pet owner, when you look at your dog and there’s something wrong and they can’t tell you, it’s stressful. And it puts more weight on the vet because you’re asking for an interpretation of what the animal is feeling. You also have to serve as a de facto counselor when the news isn’t good.
It took me a long time to accept that as part of a veterinarian’s responsibility, and then to learn what to say in situations like that. But there is something of a therapist aspect to it.
By the nature of the lifespan of an animal, you’re dealing with more end-of-life decisions on a regular basis than a doctor who treats people.
That’s so interesting you should say that because I think about that all the time. That’s one of the major differences between human medicine and veterinary medicine. A human physician that practices for a full career might be lucky enough to meet a patient as a small child and be in practice long enough to maybe see them have their own children. Veterinarians are both blessed and cursed with guiding their patients through their entire life. I can think of hundreds of patients whom I met as puppies and kittens – newborns. I watched as their teeth fell out and they became demented. Eventually, I was given the responsibility of putting them to sleep, which is very bittersweet for me. Along with knowing those patients through their whole lives, I knew their owners through 12 or 13 or 15 or 20 years.
And the patient can’t say, “Give me another treatment, I want to go through this procedure,” or, “I don’t want you to do anything else.”
I think about that all the time, too. Animals live in the moment. Their greatest strength and their greatest weakness is that they are unencumbered by regrets for the past, and they are not burdened by fear of the future. Whatever they’re feeling at that moment is just what they feel. When I tore my Achilles tendon, even though it was a real terrible year for me, I knew that I was going to get better. I could look forward to a time when it would be healed, and I would be back to walking and back to hiking. Animals don’t have that luxury – when they’re in pain, that’s all they’ve got. They can’t comfort themselves with hopes for the future. Because of that, protecting them from pain is maybe more important for them than it is for us.
They pretty much suffer in silence, right?
Yeah, they’re not complainers. But just because they don’t complain doesn’t mean they don’t feel it. They’re just stoic. It’s very fortunate for us that we have the option to euthanize them. This is something I lie awake in bed thinking about all the time, and I have for 30 years, but it is such a good thing that we can do that for them. I’ve done it a thousand times and it hurts me just as much now as it did the first time. I remember them all. But a long time ago, I came to the realization that it’s really not about me at all. Allowing myself to put my own feelings into that situation is a luxury I can’t afford. If it hurts me to do it, it’s a small price to pay in order to allow that pet to be released from whatever suffering they’re feeling.
Is this something they talked about in school?
No, never. In fact, at the time that I went to school, they didn’t even talk about pain control. I did not have one class on pain control or prevention. And for the first few years that I was out, I’m embarrassed to admit it, I didn’t practice any, and no vet did. It was a non-issue. Then one day I went to this conference and the lecturer kept talking about analgesia and the importance of nerve blocks and pain control. Right after that, I started really getting into it, trying to learn how to address pain in animals.
Would you say you compartmentalized that part of the job?
No, I just felt it. I was never really very good at compartmentalizing, as evidenced by me taking my work on vacation. I had a very hard time drawing a line between different segments of my life. Even when I’d be sitting watching my kids’ soccer games, I’d be thinking about cases, or be on the phone. I have not experienced these feelings at all myself, but suicide’s a huge problem among veterinarians. I think that’s a side effect of the fact that we see sad things every day. We have a lot of pressure on us to do what you said – to interpret the actions of a creature that cannot speak. That’s hard. Sometimes you get it wrong.
Sometimes you, not the pet owner, made the ultimate decision by default.
Yeah. And people got angry or upset. Who could blame them? I think veterinarians take the brunt of that. The ones who can compartmentalize it are, in some ways, fortunate.
If you’d asked me how I identified back then, I would have said probably first veterinarian, second father and husband, and third American. In that order. that’s kind of partially what led to my getting out of practice for a while.
We get to the pandemic and you tear your Achilles tendon. A turning point?
It was terrible. I was feeling overwhelmed by the increased demand, but the tipping point was that the practice had grown much larger than I ever thought it would be. I hoped that maybe someday it would be a two-doctor practice. But it just kept growing beyond that.
A downside of being an excellent veterinarian.
Well, I don’t know about that, but, for better or for worse, periodically I would find myself overwhelmed. I would come to making a choice of either closing the practice to new clients or finding like-minded people to help me. Each time I reached that juncture, I chose the second option. Initially, I added another doctor and then we grew again, and then I added another doctor, and some more staff, and then another doctor. I found myself running a six-doctor practice, which is a really big practice. I was blessed to work with some great doctors but, I didn’t go to school to be a businessperson or an entrepreneur and I’m not good at it. And I didn’t really know what I was doing. I found myself having to deal with OSHA regulations and insurance.
The best part of my day was just sitting in a sunny exam room and talking with an engaged owner about an interesting topic, explaining to them how the kidneys work or how bones heal. I love that stuff. I could do it all day long. But I was doing that less and less. I was working on schedules and dealing with vendors. I couldn’t see a way out of it. I felt trapped in my practice. I was staying until 10 o’clock every night and coming back every morning at 7:30 in the morning. I felt like I was on a treadmill with no way to get off. My wife one day said, “Well, why don’t you sell it? And I was like, “Oh, no, I could never do that.” The more I thought about it, the more I thought, “Maybe if I sell it, I could just go back to being a regular vet.”
I threw out a couple of emails to some companies to see if anybody wanted to buy it. It turns out they did. I found one that I thought was a good match for me and I sold it to them – National Veterinary Associates. Their part of the deal was that they would handle all the stuff that I hated and let me go back to being the small-animal doctor that I wanted to be. They didn’t lie. I don’t have any ill feelings towards them. They started making changes because I was not maximizing the profits. I thought that as long as I could pay my mortgage and send my kids to school and have a little bit of savings, that was enough. They bought it, they could do whatever they want with it. But I wasn’t really that happy with it, and my name was still on it. Things I studiously avoided for 17 years, I didn’t want my name associated with. My intention was to go back to being an associate and working a regular schedule, but I discovered that was not a viable option. Eventually, I realized I had to leave Court Street. I took it as an opportunity to kind of remake myself a little bit and decide whether that was what I wanted to do for the next 30 years of my life, or whether there were opportunities that I had missed, goals that I had deferred that I now had the opportunity to pursue.
We’re three years past the sale and a year after you left. What kind of difference has it made in your life?
That’s really the big question. I’ve always been kind of an indecisive guy. My favorite situation has always been to have two or three options.
But if someone says, “Norm, you can have any flavor of ice cream you want, think about it for a while. I have thousand flavors here for you,” then it starts to become difficult. That’s the situation I find myself in. I could almost do anything I want to do. I could go to another country. I could learn Spanish. I could still practice medicine. I could be a per diem doctor. They come in on Monday, they work a day, and at 5:05 they walk out the door. Whatever lab work they’ve run is going to be returned by someone else tomorrow. They’re not going to stick around and make calls for two hours after the end of their shift.
That doesn’t sound like a flavor you’re going to choose.
No, I don’t want to do that. Because I really like talking with people. Nine times out of 10, when I’d walk into an exam room, I felt like I was seeing my old friend. In a 20-minute appointment we might talk about their pet for 10 minutes, and the other 10 minutes we’d talk about their kid in college or the Patriots or something like that. I kind of felt like I was a king holding court and there was this constant procession of interesting people with cool stuff to tell me. When I walked out of Court Street for the last time, I had the realization that from now on, for the rest of my career, every time I walk into an exam room I’ll be meeting a stranger for the first time. Which makes me sad.
It seems like you’re still working things out. Are you practicing at all?
I did a couple days at Court Street, and Court Street now has a sister hospital in Sandwich owned by the same company, so I did a few days there. Lately I’ve been working a few days at a new clinic that opened. But I haven’t formulated a long-term plan at all. I really don’t even know what to do with myself. I feel like I’ve been given this incredible gift. I have enough savings to support myself for the rest of my life. My kids are out of school and my house is paid off and I have no educational debts. I could do almost anything I want in the world, but what I’m mostly doing is sitting around the house, going to the gym, watching YouTube. I’m pissing it away.
Really? Or are you just recharging?
No, I think I’m pissing it away. What I need to do is to make a course and get on it. It’s been so long since I had choices. I loved Court Street. It was like one of my children, but in exchange for all the joy I got from it, I gave up a lot of choices. I knew what I was going to do every single day. And now, suddenly I’m confronted by this ocean of choices.
At every job I ever worked at, but especially at Court Street, I could not wait to get to work. I would hop out of bed in the morning and be humming to myself. I’d be standing in the shower thinking, “What interesting things am I going to see? Which of my favorite clients are coming in today?” I’d be there before everybody and I was just so happy all day, until right towards the end. I found I’d be waking up in the morning and not feeling like going to work. That was so unusual for me. At first, I couldn’t peg what was causing it. Then I realized I didn’t want to go to work. It was just a feeling probably most people have, unfortunately, when they’re going to their job.
Have you ever thought of therapy to deal with the difficult things related to your profession?
Yeah, it’s very common [among vets]. Happily for me, I haven’t had to. I have a very supportive family and I was always able to talk out my issues with my wife. You don’t keep everything inside. There’s actually an organization called Not One More Vet. It’s dedicated to preventing veterinarians from committing suicide.
I think we should wind down with a couple of less heavy questions – like are you a dog guy or a cat guy?
Dogs. But you know, I love cats too, and I have cats. A lot of people think that a cat is like a little dog, but they’re not. They’re a totally different creature with their own little things, and they’re delightful. But damn, I love dogs. They’re just amazing creatures in so many ways.
It’s hard to make generalizations about breeds, even though in our culture these generalizations always float around. My favorite dogs are mutts. I really like the look of a scruffy mutt. But, you know, I like mastiffs a lot. I like little dogs, too. The dogs I have right now are both rescues. One of them is a pit bull who’s the nicest dog I’ve ever met. They get a terrible rap and I don’t know why. The other one’s a little Boston Terrier who’s kind of a pain in my butt. But I still love her.
Mark Pothier can be reached at firstname.lastname@example.org.
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