Anxiety After Being Injured by a Patient

Dear Second Opinion,

I recently performed a wellness examination on a new canine patient and sustained a bite wound that required stiches. An assistant was providing appropriate restraint, and all protocols for a new patient examination had been followed. I immediately sought medical care following the incident and fortunately will not be left with long-lasting injuries.

 Ever since the incident, I feel anxious and fearful around my patients. I am hesitant to perform exams without the patient being muzzled, even patients I’ve been seeing for years that have never exhibited aggression. I’ve also been limiting certain aspects of the physical exam due to fear of sustaining another injury.

 The clinic staff have noticed a shift in my behavior, and I’m worried that my continued anxiety is impacting not only the staff but also the way I practice medicine. I know accidents happen in our profession, but I can’t seem to get over the incident and my subsequent fear of a repeat injury. I’m terrified I will no longer be able to practice high-quality medicine and enjoy my work if I can’t get over this.

How do I move past my injury and prevent fear from taking over my ability to practice medicine?

—Not Simply a Superficial Injury

Dear Not Simply a Superficial Injury,

We do everything possible to avoid bites, but they can happen despite our best efforts. What you are feeling is common.

A bite can feel ferocious and violent and may trigger a feeling of helplessness or victimization. We become afraid of things that did not scare us before. This stress response is part of our brain’s programming to adapt to danger and is often physiologic as well as emotional and not necessarily in proportion with the severity of the bite. Regaining a feeling of control is the beginning of overcoming our own physiology and emotions.

The first questions to ask are “How did this happen?” and “How can I keep it from happening again?” Try to understand what happened so you can formulate a prevention plan going forward. Simply engaging in this exercise can help you regain a feeling of power.

Allow yourself to feel your emotions. They are normal and typically fade over time. It can be empowering to remember your successful interactions with dogs and remind yourself of your abilities.

Forgive yourself for being afraid, and if you have to muzzle a few extra dogs to feel safe, so be it. Your staff will understand, and you can inform clients that you were recently bitten and are temporarily being extra cautious. Muzzles are not injurious, and although clients may not love their use, most will understand after you explain why it’s being used. Handling dogs in a protected (ie, muzzled) state can help you regain your confidence.

Give it time. It may take a few weeks or months, but you will start to feel like yourself again. Remember that there is no shame in speaking with a professional. Ours is a difficult career that carries a lot of emotional turmoil. We often underestimate just how heavy a psychological burden we bear as veterinarians. Creating healthy outlets and emotional connections helps protect us psychologically.

Sincerely, 

Barak Benaryeh, DVM, DABVP