Becoming Antifragile

Author: Holly Sawyer, DVM, Human-Animal Bond Certified, works for GuardianVets, the only after-hours teletriage/telemedicine service to be endorsed by AAHA. The mission of GuardianVets is to keep the veterinary hospital in the center of the Human-Animal Bond while supporting the work-life balance of today’s veterinary professional.

If COVID-19 has taught us anything, it is that life can be wildly unpredictable. Veterinarians tend to be tidy, structured thinkers. That’s not to say we are all compulsive neat freaks. But our chosen profession demands that we master the art of pattern recognition. “Know your normal” becomes the mantra of every lecture and clinical rotation, and the aspiration of every new grad. So we gain expertise in “normal” and work hard to maintain it—in our patients and in our lives.

Duck and Pivot
The pandemic slammed us with a reality that was anything but “normal.” Overnight, we had to launch curbside care, rely on phone consultations and telemedicine, enact social distancing, and otherwise upend our historically stable profession. Let’s face it, a time-traveler from 1950 who walked into your clinic pre-COVID would have ogled at your pretty toys, but not the structure of the appointment, physical exam, or general administration of treatment. In a world of industry disrupters like Airbnb and Uber, consumer desire for choice and convenience is clearly king. In this moment of inertia within our profession, in which we are no longer the object at rest, but the object in motion, let us stay in motion. Just as the fighter in the boxing ring will fare better with quick feet and nimble reactions, we too can capitalize on the left hook that threw us off balance and now pivot into an upper cut that transfers all of that energy against the status quo.

Change Your Perspective, Change the World
What am I talking about here? You could call it a fundamental change in thinking, a mental model that embraces stressors and unpredictability as a catalyst toward improvement instead of detriment. I am talking about becoming Antifragile. This term, coined by risk analyst Nassim Taleb[1], has been applied to systems as varied as bacterial resistance and human psychology. To understand it, we must first look at the other end of the spectrum.

Fragile systems are brittle. They have very little margin for error because they maximize efficiency of time and resources to achieve optimal outcomes. Our modern, globalized society has steadily pushed us toward this ideal. We benefit from cheap food, medical advances, and technological gadgets that rely on tight tolerances of sourcing, shipping, supply, and demand. Enter COVID, and suddenly dairy farmers are dumping milk at huge economic loss because restaurants and schools are closed, while pig farmers face euthanizing pigs before they can be sold due to meat packing plant shutdowns. In our imperfect world, even small stressors can break a system, like a porcelain plate that shatters when dropped.

Resilient (or Robust) systems have built-in redundancies to survive stress. They are the plastic food containers that bounce on the floor. The system survives in its original form despite unpredictable events, but even resilient systems will reach a failure point. NASA’s Space Shuttle Program has learned that the hard way. Twice. Antifragile systems get better with stress and volatility. They are the Hydra of Greek mythology. Lop off one head, two grow in its place. Expose a population of staphylococcus to methicillin, and soon you will have a thriving infection of superbugs. Bad for us, great for them. Likewise, the saying, “What doesn’t kill you makes you stronger,” describes the mechanism by which we ourselves become antifragile. When we succeed in the face of overwhelming odds, we tend to achieve greater feats the next time around. The opposite viewpoint “Avoid all risk at all cost”—in turn makes for a very brittle population that fears unpredictability because it doesn’t know what it can overcome. [2]

Choose Your Own Adventure
Veterinary Medicine is at a pivot point in the boxing ring right now. Instead of resisting change, let us grow through it to become better than we were before. It will take energy, patience, creativity, and a willingness to fail small in order to succeed big. Happily, our clients are particularly forgiving of experimentation right now, especially when it is for their benefit. We can establish a new and better normal if we provide our clients the care they want, how they want, when they want it, while reclaiming some work-life balance for ourselves. Offer a digital patient portal, an easy pipeline for communication to bond the client to your clinic, so you remain at the forefront of healthcare decisions before entrepreneurs with far less training fill that space. Schedule differently, cross-train staff to new tasks, and leverage your RVTs and CVTs to legally fill needs previously provided by DVMs. Treat life as an adventure instead of a race to perfection, and don’t panic when you don’t recognize the pattern ahead. That which you fear may become a game-changing opportunity.

[1] Taleb, Nassim Nicholas. Antifragile: Things That Gain from Disorder. New York: Random House, 2012.
[2] Lukianoff, Greg, and Jonathan Haidt. The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure. New York: Penguin, 2018.