April 17, 2023 • 44 mins
We’re on break, creating all new episodes for season 3. In the meantime, here’s one of our favorite episodes from the past year. See you soon.
Nobody likes to talk about pet loss… but everybody wants to talk about pet loss. What a difficult scenario that is! Veterinary oncologist Dr. Renee Alsarraf joins us to talk about grief, professionalism, and the importance of being human - on the job and off.
In this episode we cover:
- The whole truth about loving - and losing - your pets
- The terrible advice Dr. Renee Alsarraf’s grad school teacher gave her (and why she refused to listen)
- Why veterinarians and other professionals should really NOT check their human emotions at the door
- When it’s time to welcome a new love into your life (human or otherwise)
- How Dr. Alsarraf’s experience with veterinary oncology did (and didn’t) prepare her for her own cancer diagnosis
Click here for the episode webpage.
Notable quotes:
“I think we tend to see our pets - especially when they're ailing - more like our little babies, and so we want to protect them. That's our innate role. And yet we can't protect them from the inevitable. That's really hard.” - Dr. Renee Alsarraf
“You can't push emotions down and expect them to not pop back up in other places.” - Megan Devine
About our guest:
Dr. Renee Alsarraf is a veterinary oncologist, lecturer, and philanthropist. Her new book Sit Stay Heal is a moving and uplifting memoir of an esteemed veterinary oncologist fighting to save her four-legged patients while making sense of her own unexpected cancer diagnosis.
Find Dr. Alsarraf on IG @reneealsarraf and read more about her book at sitstayhealbook.com
Get in touch:
Thanks for listening to this week’s episode of Here After with Megan Devine. Tune in, subscribe, leave a review, send in your questions, and share the show with everyone you know. Together, we can make things better, even when they can’t be made right.
Have a question, comment, or a topic you’d like us to cover? Visit megandevine.co
For more information, including clinical training and consulting, visit us at www.megandevine.co
For grief support & education, follow us at @refugeingrief on Instagram, Facebook, Twitter, and TikTok
Want to talk with Megan directly? Join our patreon community for live monthly Q&A sessions. All the info at this link.
Check out Megan’s best-selling books - It’s OK That You’re Not OK and How to Carry What Can’t Be Fixed.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
I remember as again, I was a fourth year veterinary student,
and I don't remember the case, but it was something
said and the owner was there, and it was another
awkward situation, and I think I maybe wiped brushed a
tear from my eye, and the head clinician, who was
very well seasoned, he had been around for a long time.
(00:20):
He later pulled me aside and he's like, don't worry,
you know, don't worry. You know, after a while, after
you go through this a little bit, this won't affect you.
Speaker 2 (00:28):
Like your soul will deaden. It will be okay.
Speaker 1 (00:31):
And I remember thinking right there, I will never let
that happen to me, because if I do, that's when
I should hang up my Stepiscope.
Speaker 2 (00:46):
This is hereafter, and I'm your host, Megan Devine, author
of the best selling book It's Okay that You're Not Okay.
I've spent the last ten years having interesting conversations about
difficult things, and you know, I think we're all just
waiting for check Is to tell the truth about our
actual lives. So I hope this show in general, but
also this episode gives you some starting points for your
(01:08):
own conversations about difficult things in your life, be sure
to let me know how it goes. This week on
Hereafter veterinary oncologist doctor Renee al Saraf, we discuss cancer,
dogs and finding hope when you know too much about loss.
Settle in, everybody, Settle in with your dogs if you
got them. We'll be right back after this first break.
(01:35):
Before we get started, one quick note. While we cover
a lot of emotional relational territory in each and every episode,
this show is not a substitute for skilled support with
a licensed mental health provider or for professional supervision related
to your work. And one more note. Hereafter with Megan
Divine is currently on break between seasons. We'll be back
(01:56):
before you know it with a whole new season with
even more incredible guests. In the meantime, here's one of
our most loved episodes, We'll see you soon. I learned
about doctor Renee Alsarov through an email from her publicist.
It is an interesting perk of the podcast business that
(02:17):
I get the inside scoop on new books along with
offers for people to be guests on the show. It
makes my job a lot easier. Without even knowing Renee,
I said yes, which is very not typical of me.
I usually poke around a lot to get like a
bigger backstory of a potential guest before I say yes
to something. But this topic, the topic of illnesses and
(02:40):
cancer and death in pets, specifically in dogs, A lot
of people carry grief from the death of companion animal,
and it's just something we don't talk about very much.
So of course I jumped at the chance to talk
to somebody who spends their entire professional career in this
really deep emotional territory of oncology in the animal world. Now.
(03:06):
Doctor Alsaroff noticed that people didn't really talk about grief
when she was in veterinary school too. She went to
school at Michigan State University and she founded MSU's Pet
Loss Support Group services. You're going to hear about that
in our conversation today, But she basically saw that even
the professionals weren't really talking about the grief in the
room or the emotions in the room, and she wanted
(03:27):
to do something about that. She went on to study
medical oncology and dedicated her work life to the emotionally
charged world of cancer. Our conversation actually reminded me a
lot about what we focused on in season one of
hereafter that whole grief on the job and because of
your job thing. So not only do we get into
grief around pet loss in this conversation, but we also
(03:50):
talk a lot about how hard it is to do
these goodbye intensive jobs. So Renee, welcome to the show.
I am so glad you're here now. I was just
telling everybody that I jumped at the chance to talk
with you because pet loss is like a really massive
issue that we don't talk about very much. We're going
(04:11):
to get into your own story of illness and how
that intersects with your work and what the dogs have
taught you, but I would really love to start there
with that grief piece. So what's your relationship with grief?
Speaker 1 (04:22):
On a lot of levels, I deal with it all
the time. People think though, being a veterinarian oncologist is
a very sad job, and surprisingly it's the opposite. It's
a very heartwarming job because I can hopefully give a
family another couple of years with their dog, or another
(04:43):
holiday season with their cat or something, and so many
people are just so thankful and then have the time
to process their emotions and go through that with them.
And yet it's also a very emotionally draining job because
it's an off emotional job really through the highs and
the lows. I am so grateful for you having me on,
(05:06):
so thank you very much. This is a great topic
because I think a lot of times people don't feel
justified or able to voice their grief about their pet
because it was just a pet. And yet that is
so not what it is. It's a family member, it's
(05:28):
someone who loves you unconditionally. You know. You had asked
about my relationship with grief when I was in veterinary school,
and it was during my senior year until we were
in the clinics, and I saw how many people would
just the pet parents would stand alone, right and they
would try to stifle their cries, hold back their tears
(05:52):
and stand there and equally stoic was that veterinarian in
that white coat who just stood there with their by
their side. And I thought, oh my goodness, this situation
could be so different. Slight segue, I can't imagine not
hugging someone or at least putting a hand on their
(06:14):
arm or on their shoulder. But while at Michigan State,
I started Michigan State University's Pet loss support group, and
I raised a whole bunch of money and we hired
a therapist that limited her practice to bereavement, and we
opened it up to anyone. Right, it didn't You didn't
(06:36):
have to have a dog or a cat. You could
have had a horse or a ferret or any four
legged animal though I guess two legged with a bird.
And it was a really special thing for people to
come together. I believe it was a really good thing. Yeah.
Speaker 2 (06:51):
I mean when we make the space for people to
tell the truth about their experience and their feelings and
the relationship, no animal pun intended, but people flock to it.
Speaker 1 (07:02):
Correct.
Speaker 2 (07:02):
I think you're right that, like the loss of a
pet is a really diminished or devalued loss, which is
so weird to me because like, I don't know anybody
who doesn't have feelings when their companion animals gets sick
or dies, right, Like, everybody has the feelings, but we
don't want to talk about those feelings.
Speaker 1 (07:18):
Correct, And I think that there are other feelings put
on these feelings. So I will see a fair amount
of people who maybe never wanted to have a pet,
and then their spouse passed away and this was their
spouse's cat or dog, and by gosh, they don't want
to give up on this, on this animal because it's
(07:40):
their last real tie, or at least in their head,
it's their last real tie to them. And I think
that that makes it hard. And I think too, the
other reason it makes it hard is because we sometimes
feel so helpless with our pets, right, Like nobody wants
to have to go through the grief period. We all
have to go through grieving throughout life. But when it's
(08:03):
a person, sometimes we can have those long lasting conversations,
or we can make amends, or we can do what
we need to do. And I think we tend to
see our pets, especially when they're ailing, more like our
little babies, right, And so we want to protect them.
That's our innate role, and yet we can't protect them
(08:26):
from the inevitable, and I think that's really hard.
Speaker 2 (08:30):
Yeah, And there's I think there's also that helplessness in
there too, right, that they don't speak an English language
or a human centered language, and it's like there's that
extra level of helplessness in there. Having done this a
couple of times now, it's such a weird position to
be in to euthanize an animal and decide on the
(08:50):
end of their lives. I mean, we do have that
for humans with the Death with Dignity Act in some states,
but it's still it's wonderful and it's necessary, and it's
a really loving act to do, and it's also very strange.
And I feel like we don't talk about that either, right,
that it's both things. It's both things.
Speaker 1 (09:08):
It is both things. And the first thing is for
that that pet parent to decide will I make that
decision for my dog, or will I, in a sense,
let nature take its course. And most people choose euthanasia,
not as many at all decide to not do that,
(09:28):
And there is no wrong answer. It's a very personal choice.
And then in making that decision, we all have the
same fears. Nobody wants to make that decision one day
too early, right, but my goodness, you certainly don't want
to make that decision one day too late. So it's
it's trying to find that medical balance of when that
(09:52):
perfect day is and then trying to find that emotional
balance for yourself and your family to accept it and
to deal with it.
Speaker 2 (10:02):
So you mentioned in that story about when you were
in school and what you saw happening. So you said,
you know, I see the pet parents standing by themselves
trying to be stoic. I mean, we've got such a
weird aversion to big emotions of any kind in this culture.
You know, this is what I spend all of my
time talking about. But I love that you also brought
in and hear are the stoic veterinarians with their hands
(10:22):
by their sides pretending to not be human?
Speaker 1 (10:25):
Yeah.
Speaker 2 (10:25):
I mean you had a really long career here and
focusing on oncology. There are a lot of goodbyes. In
my introduction I said that you are in a goodbye
heavy profession. I guess I have two questions here, What
did you see? What do you see in terms of
the stoicism and stoicism of your colleagues, And what have
you seen over the arc of your career and the
(10:47):
practice that you've built about the change in that human
relatedness in the profession. So two questions loaded into one.
Speaker 1 (10:55):
Yes, no, and there are great questions. And thankfully as
the decades and I'm showing my age, but as the
decades have passed, that has gotten better. I think as
a veterinary profession, we are more in tune with being
(11:15):
open to expressing emotions or hopefully having some compassion. And
that's maybe not even the right thing to say, because
I think we're always compassionate, but to show that compassion
at that trying time, you know, more than just awkwardly
handing someone a fistful of cleanexes, right, but being able
(11:37):
to talk them through it. I remember as again, I
was a fourth year veterinary student, and I don't remember
the case, but it was something said and the owner
was there, and it was another awkward situation, and I
think I maybe wiped brushed a tear from my eye,
and the head clinician, who was very well seasoned, he
(11:59):
was had been around for a long time. He later
pulled me aside and he's like, don't worry, you know,
don't worry. You know, after a while, after you go
through this a little bit, this won't affect you.
Speaker 2 (12:09):
Like your soul will deaden. It will be okay.
Speaker 1 (12:12):
And I remember thinking right there, I will never let
that happen to me, because if I do, that's when
I should hang up my steposcope. That's not why we
get into veterinarian medicine or any you know, human medicine
or anything. We do it for that love, that healing,
(12:35):
that caring. But I think, as you know, the younger
generations come through, they're able to be a little more
in touch with everyone's feelings in the room.
Speaker 2 (12:45):
Yeah, I mean that really is the old school way
of doing things right. We see that in the human
medical profession as well, especially in hospitals, where you are
supposed to check your humanity at the door, you are
not supposed to show emotion. In fact, I had a
lot of dots and surgeons on the show last season
and they were like, if you show emotion, we actually
questioned your professional capacity. Wow, right, Like how terrifying is that?
(13:10):
And I think there's also there's something really interesting in
here too, like the binary in there, the we only
have two options. We can either be completely stoic and
professional or we can be a hot, weepy mess. And
I feel like, you know, it's it always reminds me
of that idea, like if I start crying, I'll never
be able to stop. And we need to be able
to do our jobs correct. Where is that middle ground
(13:35):
there between allowing your human response, your human connection, and
your professionalism, Like where do they meet?
Speaker 1 (13:42):
I actually talk a lot about this in the book
Believe it or not right because being the person that
say is actively being the one to euthanize someone's pet,
And everyone in the room has their tears just dripping
down their face and noses read and all I want
(14:03):
to do is cry as well. And sometimes it's not
because it's not for the pet, because I know medically
it is the best thing for the dog or the cat.
They're suffering, they're in pain. But to see what the
family is going through just can tear you up inside.
(14:26):
So it's not easy to sort of remember what your
job is. But you have to write. I have to
keep reminding myself in my head. I have to do this.
I have to maintain composure. But that doesn't mean that
once that final act is done that some of those
emotions don't come out. And I think two, it actually
(14:47):
builds for a more human a better relationship with that
pet parent. You know, you had talked about what some
of the physicians had said about professionalism, but I'm not
so sure that not showing a little bit of emotion
or a tear is in the definition of being a professional.
Speaker 2 (15:07):
Yeah, oh, men's is drawn that one And this is
the thing, right, And a lot of this is like
old ideas about doctors, right, that they're supposed to be
this like revered up on a pedestal. You must be
more than human. And I mean that that was the
model of the fifties, right, Like we've come a long
way here, like women can be doctors. Woo. I mean,
what a change, but that we want our providers to
(15:30):
be very skilled at what they do, and we want
to see that they're human and not automatons, right, And
I do like I agree with you. I see that
coming up through counsel or education. I see it coming
up through the medical profession and what they're getting trained in.
That we have to start talking about not leaving our
humanity at the door. It's also like, what are we
showing our clients and our patients if we're completely stoic
(15:53):
in an emotional moment, we're saying the right thing to
do is to have no feelings about this. They were
always role modeling.
Speaker 1 (16:01):
Yeah, that's very true. It's a very good way.
Speaker 2 (16:15):
Hey, it's me jumping in here before we head back
into this episode. If you're a therapist, social worker, or
other provider and you have been waiting for me to
open up a professional training program for you. That time
has officially come. Enrollment is open for my four month
online training program four months with me. With so much
(16:37):
grief in the world, it is a pretty good bet
that you are encountering it in your patients or your clients.
As we learn on this show, and as I've been
telling y'all forever, grief is everywhere, even if it's not
the identified problem that somebody brings into the room. I
developed this online training so that you can bring human
centered grief care into your practice. All of the information
(17:00):
is at Megandivine dot Co. I'm going to link to
the training registration page in the show notes, But if
you've been waiting to have some real skills and some
real conversation about doing the work of supporting grieving people
in your practice, don't miss this link in the show
notes and Megandivine dot Co. Okay, back to the show
(17:22):
you brought up. When you were talking about that vignette
in the room with the family and the emotions, you said,
if you're the one administering the Euthanasian medicine, it reminded
me of so years and years and years ago. I
was a volunteer at a wild bird rehab center and
they did a lot of euthanasia because they got like
the hopeless cases, right, because they were experts, and so
(17:42):
everybody who had a case that they couldn't solve, they
sent them up. And I remember the one and only
time I've directly done a euthanasia, it was for a
flicker who was so injured they couldn't come back. And
that that feeling of being the instrument of death and
knowing that being the instrument of death was an act
(18:02):
of mercy. What a mailstream of feelings inside that moment. Now,
Fortunately for me, I was working with people who had
done this forever and we were able to debrief afterwards
and talk about that. I wonder if in the veterinary industry,
or even just in your own practice, do you talk
about that sort of stuff, like do you debrief? Do
(18:23):
you talk about we have weird jobs where we, as
my mentor said, all those years ago, you're dealing death
all the time, right, how do you live with that?
Speaker 1 (18:33):
You know? I talk about it with my oncology team, right,
the nurses, technicians, sometimes the client support staff upfront. Interestingly,
and I think I want to change this. I never
really talk about it with other veterinarians, and yet they
are the ones that are actively, you know, giving the
(18:59):
drugs to end the life. And I think that would
be a very very valuable conversation, and not just one conversation,
but a continuation of it as a one on one
but even as a group.
Speaker 2 (19:14):
Yeah, I think coming together and talking about the reality
of it. Like any time you're doing highly emotional work
and you're not talking about it, it's going to take
a toll, right. I think I read somewhere that veterinarians
have a very high suicide rate, correct, which is very
similar to human doctors. Yes, right, Yeah, And there are
a lot of factors there, obviously the workload, the intensity,
the pacing of everything, but also that you can't push
(19:38):
emotions down and expect them to not pop back up
in other places.
Speaker 1 (19:42):
Correct. Yes, very true. And I cry usually I'll only
shed a couple of tears in front of a family
just because then I'm trying to counsel them and help
them with their grief. But once I go, say to
the back, I let loose and just cry, as do
(20:03):
many members on my team. Yeah, it's sort of the
only way that I can handle it, short of you know,
a big bowl of pasta, or.
Speaker 2 (20:13):
Hey, all the options in the toolbox, man, all the
options in the toolbox. Now you have your own experience
of having a cancer diagnosis. You were just saying, like,
you know, after a youth in asia or after a
tough conversation with a patient, I'll often go in the
back and just cry, and I there's a bleed through
there right between like self as patient and self as provider,
(20:34):
which you talk about in the book.
Speaker 1 (20:36):
Yes, very very true, and sometimes that's really hard. I
think it's the hardest when I'm talking to a new client,
someone that I haven't seen before, so they don't know me.
And many of my patients knew some of my backstory,
especially they knew when I was out or maybe perhaps
(20:57):
look different. But for the new patients, I wouldn't really
share that with them. It wasn't the appropriate time. But
I found that it was harder to get through telling
them about the biologic behavior of cancer, what it does,
what tests we need, and what we can do to help.
It was just too raw for me.
Speaker 2 (21:18):
That overlap, like hearing yourself deliver that news and knowing
that these very same things are happening in your own body.
Speaker 1 (21:23):
Correct. There was one time, and you can't make this
stuff up, a dog had just had abdominal surgery, and
on and on and after it was a new patient.
After they left out the door, I noticed that my
one hand was on my abdomen over my scar, which
I did just subconsciously, but I'm sure in a comforting
(21:46):
type way or needing some security. So it does play
no differently than I've always had boxers for many years,
which I love. Unfortunately, are one of the more common
breeds that get cancer, and so after you know, heaven forbid,
I had lost one of my boxers. Even though I
(22:10):
loved seeing a boxer as a patient, it was really
hard for me to see a boxer as a patient
because it was just hitting too close to home. It
reminded me too much of my own dog.
Speaker 2 (22:24):
Yeah, And I mean there's relatedness on all of those levels, right,
which I think is what we often shy away from
because it's such a big feeling and we're not really
sure what to do with it. And I love how
you describe that right, the physical hand on the belly
when you're talking to a patient who has belly abdomen things, right,
like our bodies know the relatedness is natural, yes, and
(22:44):
what's not natural? It's like squashing that relatedness and like
making it weird.
Speaker 1 (22:49):
Yeah.
Speaker 2 (22:50):
So there's a theme actually that runs through your book,
usually when you're talking about your own cancer treatment and
you write things like I know what a low white
cell count means. I know what happens with this man
or that medication. So you know a lot more about
the negative outcomes and the side effects than like a
lot of civilians probably know about things. So how do
you navigate your own sense of calm or trust or
(23:14):
optimism for yourself when you can't turn off what you
know about cancer?
Speaker 1 (23:20):
So for me, I would rather know than not know, right,
Believing that knowledge is power. I remember asking U was
a close family friend and she had had uterine surgery
as well a few years back, and there was at
the time when I had it, there were three different
ways to do it, And I said, oh, you know,
(23:41):
how did you have your you know, what procedure did
you have? And she's like, oh, I had surgery And
I'm like yea, yeah, yeah, but how did they do it?
I had surgery And I'm like, well, did they and yeah,
go through your abdomen, go through your belly button, go
through more personal area. And she had no idea, and
she was good with that. I always want to know.
(24:05):
Maybe on some level it's harder because then I have
to deal with the what ifs and the fears and
the worries. But I think for me knowing what could
be or the bad things that could be, I saw
it more of me being a warrior through all of
this instead of a warrior through all of this. And
(24:28):
so I was convinced that I could will myself into
not having side effects.
Speaker 2 (24:33):
A superpower, superpowers.
Speaker 1 (24:36):
You know, And I felt like if I didn't have
whatever some gi upset, that that was a small victory,
and so I would kind of go through it that way.
Speaker 2 (24:45):
This actually happens for like, doctors make terrible patients, right
because they they know they know a lot. Maybe they
don't know everything, but they think they do. And you know,
I wonder also about when doctors or nurses familiar with
cancer receive a cancer diagnosis for their pet, right, So
if we flip that around, you were just talking about
for your own experience with cancer, you're glad for your knowledge,
(25:08):
even about the difficult things and the side effects and
what low white cell count means, because it felt empowering
to you. If we flip that around and we have
we have a physician who works in oncology and her
her basset hound has cancer. How do you see that?
Like if we flip do you know what I'm talking
about here? Like around that knowledge? Like how does that
play out in what you see?
Speaker 1 (25:29):
So that person along with someone who has gone through it,
either as a caretaker to someone who had cancer or
if they themselves had cancer. And I'm making generalities here,
but they tend to put their own emotions into it.
They don't separate out or they sometimes don't really hear
(25:53):
what I am saying because it is different. Just like
for me to go through it, it was a little different, right,
People lose their hair in general, Dogs and cats don't
because their hair just grows to a certain point and
then it stops. It's a whole different growth pattern. And
so it's trying to persist for me in showing them.
(26:14):
But it's different. Yes, you have a lot of knowledge,
and certainly you know just the study of human medicine,
they are much more advanced than a lot of the
things we know and do in veterinary medicine, but it's
still different, and trying to get them and caretakers and
(26:35):
people who have gone through it to not put their
own emotions into it because our dogs and our cats
are clueless. They don't know what they're getting into. They
approach it with a much different attitude. They don't have
that fear that they've been thinking about it all week
before the appointment and then get that sour churning in
(26:57):
their belly as they're now in the parking lot, and
then they check in. They come in and they're eager
to see us, and they get a biscuit. You know,
perhaps if I got a piece of Godiva every time.
Speaker 2 (27:08):
So the chemo chair and.
Speaker 1 (27:09):
Gage chet exactly.
Speaker 2 (27:11):
Yeah, I mean, they don't have that. Animals don't have
that front loaded apprehension other than like I really don't
like going to this place.
Speaker 1 (27:17):
Correct.
Speaker 2 (27:18):
They don't have the body of knowledge to worry the
way that we do. And it makes me think of
like process conversations, right. A process conversation is a conversation
about how we have conversations, right, And so thinking about
that interchange, it's like, can you say this is rhetorical here,
but you know, I answer if you want, can you
say to somebody who has gone through caretaking a human
(27:38):
and now their animal has cancer and you see them
loading all of those emotions into this experience, like to
be able to say, I know you've had an experience
of taking care of somebody with cancer before. It's going
to be a real challenge to keep that previous experience
out of the right now experience. But I want you
to know that I see it, and here are the
(27:59):
ways that it might be different.
Speaker 1 (28:01):
Yes, And that's fantastic advice. I do and we do
do that. And there are some people though understandably just
because they've just gone through so much that they're unable
to and perhaps then for their family, treating their pet
for cancer might not be the best thing, right, especially
(28:23):
if it's a terminal cancer. It's not an easy decision,
but so many factors go into that decision.
Speaker 2 (28:32):
Yeah, and this is you know, in therapists speak, we
say meeting the client where they are right and it's
such an emotional experience. Like again, as a person who
has had sick animals and dying animals, like you can't
help but be wound up about that stuff. It takes
a lot of a lot of grounding tools and a
lot of breathing to like be able to find that
(28:55):
common enough center point where you feel like you can
make the best decision crappy situation correct.
Speaker 1 (29:02):
Yes, And that's the goal of all of this, right
to have as as little or as few regrets as possible.
Granted the outcome wasn't what they wanted. They're losing their pet,
but to make it as peaceful as possible, to make
it so that they understand everything, because I think if
(29:24):
you know, if you fully understand, to know that they've
tried everything possible and that always the number one goal
was their pets quality of life. That hopefully gives some comfort.
Speaker 2 (29:39):
Yeah, And that these decisions are an expression of love
as well, right, like that our relationships with our animals
includes their deaths.
Speaker 1 (29:47):
Yes, Yes. And you know what I've explained to my
son and many other people going through the creeping process is,
you know, I would love nothing more than for my
boxer to live twenty five years with me, and unfortunately
that's just not their lifespan. They're not meant for that,
(30:07):
you know, And so many people, when they are hurting
so much, say never again, I'm not getting another cat, dog,
I can't take this pain. And thankfully for many of them,
that softens and they realize that they're special and each
one comes into our life with a different purpose at
a different time, and that they're able to open their
heart and share their life again with another dog or cat.
Speaker 2 (30:32):
My parents have had cats forever, and their last cat
died probably, gosh, probably ten years ago, maybe even fifteen
years ago. So that's a long time without a beast
for people who really really love beasts. But their last
three cat deaths wrecked them and they were like, we're
not we're not doing it again. And I remember, you know,
I remember. So this was before my partner died, and
(30:54):
I remember the last time we visited my folks before
he died, he and I were having a conversation like,
they're they're robbing themselves of so much joy by absolutely
deciding they're never they're never risking this amount of pain again. Right,
They're just they're they're they're holding themselves back from so
much joy. And ironically enough, you know, a week later,
(31:15):
he died in an accident, and I got that in
a different way. Oh, the risk of opening your heart
to love that much again and know that you have
to say goodbye before you're ready, right, no matter how
long it's been, it's always before you're ready, always, always right.
And that decision to expand love, expand your heart and
(31:40):
include more beings human or otherwise in that net like,
that's a that's a decision that nobody else can make
for you.
Speaker 1 (31:50):
Correct, yeah, correct. And I hope that people can remind
themselves of those ten wonderful years or maybe like a
couple crazy puppy months, but the ten wonderful years and
that hopefully eventually will outweigh the pain of the last
(32:13):
few months or however, you know, whatever the situation dictated,
because they do make our lives better in a lot
of ways.
Speaker 2 (32:22):
There's a section in your book while you're in the
hospital waiting to get your blood work back before chemo,
and you wrote, my mind is racing with I hope
my blood work is okay. I hope my ears will
be fine. I hope my chemo goes smoothly. Now, if
I were giving advice to someone else, I would point
out that all of this brooding is a waste of energy.
So in that passage, you use the word hope over
and over and over again. But you call it brooding there.
(32:44):
So when is hope not hope for you.
Speaker 1 (32:48):
When it is surrounded by fear? When I'm using hope
almost like it's the center of a ball and I'm
just trying to punch out at all the fear that
is surrounding me or circling in my head, not wanting
the worst case scenario.
Speaker 2 (33:08):
In that passage in the book, you talk about it
as those are your worries, your fears masquerading as hope. Yes, right, yeah,
I love that. And this is sort of like that
vending machine hope, right, Like we're hoping for a very
specific outcome, and really what we're doing is managing our
fears while we're talking about that, and hope is maybe
(33:29):
a different thing, a different beast than those worries running around.
So this is actually a great place for my last
question here. So knowing what you know as a professional,
given the span of your career thus far, what you've
seen about the way that things have changed are around
loss and emotion and being human on the job and
(33:50):
all of these things. So knowing what you know as
a doctor and knowing what you know as a human
being living through a cancer diagnosis of your own. What
does hope look like for you right now?
Speaker 1 (34:04):
One of the things that I finally realized as I
was going through my diagnosis and the treatment and hopefully
coming out stronger and wiser and seeing what I have
seen day in and day out for thirty years with
veterinary patients is for everyone to realize that we are
(34:30):
better together. Part One of the things I wrote in
the book was that I had sort of felt a
little bit alone. I had on my mom wheels, and
I would race to work and do my job and
race home and pick up the kid and do the dinner,
and I lost touch with myself and my friends. But
(34:52):
certainly my life is better having my friends and family
front and center in it, and just that alone, for
lack of a better word, makes it better. And you know,
if you look at dogs and they're a pack animal,
their lives right are dependent on that pack and they're
(35:14):
better together. And then our lives as humans are better
because of our animals, whether it's the unconditional love, the
non judgment, the emotional support, or in the field as
a farmer, as someone who's hurting, as service dogs with
(35:36):
providing some independence for special needs people, or the work
they do with the police, things like that. I guess
my hope is to realize that we're all better together,
which affects all of our lives in every category.
Speaker 2 (35:54):
So that relatedness of the pack is our hope for
the future and our hope for her right now. And
I think this is really true. It's true for me,
and it's true for so many of the guests the
season and so many of the folks that I talk to.
That relatedness really is our hope, right that there's a
hopefulness in our connections and being allowed to be who
(36:17):
we truly are in those connections.
Speaker 1 (36:20):
Exactly, and we do better by coming together. Yeah, And
I think even a little bit as part of that.
You know, one of the reasons that we value and
cherish our pets so much is because we can fully
be ourselves. And so when you said be able to
be yourself in that group, that's another lesson from our
(36:43):
pets that we should take to heart because we're all
so similar and yet sometimes so guarded. Yeah.
Speaker 2 (36:51):
I think that's a great place to end talking about
the gift of being able to be your true self
around an animal who is not going to judge or
hold things again you or bring it back in an
argument next week. So using that sort of as a
as a north star, right for all of our relations,
how can I be more of my true self and
also recognize other people's true selves for who they are
(37:12):
exactly nice? Okay, So I think this is a great
place for us to end. Thank you for being who
you are in the world and doing the work that
you do in the world. So I'm going to link
to your website in the show notes so that people
can see where to find your new books at Stay
Heal and what else do you want people to know?
Where can people look for you and anything else you
(37:32):
want them to know.
Speaker 1 (37:33):
So I'm on Facebook and Instagram and the website for
the book. You know, the Facebook and Instagram would be
my name, and then at my website, We've already started
listing the places that I'll have, you know, appearances, book events.
Some of them are going to be really fun in
conjunction with the local shelter or you know, some of
(37:55):
the proceeds will actually be donated to help you know,
animals in need and things like that, so to do
some good as well.
Speaker 2 (38:03):
Excellent, And that website is sit Stay Heel book Correct Correct,
sit Stay Heal book dot com everybody, so be sure
to check out that website to see if there are
any events happening near you and to learn all about
Renee's work. All right, thank you so much, Renee friends,
will be right back after this break. Don't go anywhere.
(38:35):
Before we get into this week's questions to carry with you,
I want to let you know that registration just open
for an intensive training for professionals with me that begins
this December twenty twenty two. In case you're listening later.
All of the information about this training is on the
website megandivine dot co, but a very short summary. If
(38:56):
you're a therapist, social worker, nurse or other provider. During
this training, you'll meet with me every other week for
just over four months, four whole months in live sessions,
covering everything from the current state of grief support and
how the new diagnosis codes affect our work to how
you actually deal with grieving clients or patients in more
(39:17):
human centered ways. Now, this training is limited to only
fifty people this time, so that we have a human
way of connecting with each other. So check out megandivine
dot co to find the registration link, and I will
also put the direct sign up page in the show notes.
Each week, I leave you with some questions to carry
with you until we meet again. Now, this season has
(39:38):
a running theme everybody. Sometimes it is more obvious than
other episodes, but this season is all about hope, finding it,
losing it, redefining it, fighting for it in these weird
personal and collective times. You know, it really struck me
in my conversation with doctor Renee Alceraft today was the
difference between hope as a worry and hope as more
(40:03):
of like a dream or a vision that we hold.
I think that's a really interesting distinction there, Like the
ways that she described, like, you know, sitting there waiting
for my chemo treatment, I'm like, I hope I have
good scyms. I hope I have this. I hope I
have this. It's that that transactional hope, right hope for
a very specific outcome. And what she and I got
to you was that like hope, like that is really
(40:24):
just a way to manage your anxiety, manage your worries.
But that real hope, as you heard Renee say, real
hope is in our partnerships, our connections, our relatedness, our
own packs, whether that is the human animal pack or
our own communities, that hope really lives in that kind
of connection. I think that's really cool. That's sort of
(40:46):
my working definition of what or where hope might be
too right now is that it's in our relatedness and
in our connections that we find it. What about you?
What parts of this conversation stuck with you today? What
parts made you think or cry or feel just the
tiniest bit better about the moment that you're in. What
(41:08):
you learn about hope this time? Anything, everybody's going to
take something different from today's show, but I hope you
did find something to hold onto. Hope really is a
crowdsourced community action. There are lots of ways to open
these conversations on grief and survival and connection and hope,
and we definitely want to hear from you on all
(41:29):
of this. What kind of conversations are you starting in
your life about these difficult things? Check out Refuge and
Grief on Instagram or here after pod on TikTok to
see video clips from the show and leave us your
thoughts in the comments on those posts. Be sure to
tag us in your conversation starting posts as well on
your own social media accounts. When you do that, use
the hashtag here after pod all on word and hashtag
(41:52):
on all the platforms. We love to see where this
show takes you. And if you want to tell us
how today's show felt for you, or you have a
request or a question or a topic you'd really like
me to explore on the show, give us a call
at three two three six four three three seven six
eight and leave a voicemail. If you missed it, you
can find the number in the show notes or visit
(42:14):
megandivine dot co. If you'd rather send an email, you
can do that too, right on the website Megandivine dot co.
We want to hear from you. I want to hear
from you this show, this world needs your voice. Together,
we can make things better even when we can't make
(42:34):
them right. You know how most people are going to
scan through their podcast app looking for a new thing
to listen to. They're going to see the show description
for a hereafter and think, I don't want to listen
to difficult things even if cool people are talking about them. Well,
that's where you come in your reviews. Let people know
it really isn't all that bad in here. We talk
(42:55):
about heavy stuff, yes, but it's in the service of
making things better for everyone. So everyone needs to listen.
Spread the word in your friend groups, in your social
world on social media, and click through to leave a review.
Subscribe to the show, follow the show, download episodes, and
keep on listening. Friends want more hereafter. Grief education doesn't
(43:17):
just belong to end of life issues. As my dad says,
daily life is full of everyday grief that we don't
call grief. Learning how to talk about all that without
cliches or platitudes or simplistic dismissive statements is an important
skill for everyone, especially if you're in any of the
helping professions as my guest and I talked about today.
Find trainings, tip sheets, professional resources, and my best selling book,
(43:40):
It's Okay that You're Not Okay. Plus The Guided Journal
for Grief at Megandivine dot Co. Hereafter with Megan Divine
is written and produced by me Megan Divine. Executive producer
is Amy Brown, co produced by Elizabeth Fozzio, Edited by
Houston Tilly. Logistical and media support from Micah. Also moral
(44:01):
and emotional support by Micah. Music provided by Wave crush
and occasional background noise provided by the air conditioning
I remember as again, I was a fourth year veterinary student,
and I don't remember the case, but it was something
said and the owner was there, and it was another
awkward situation, and I think I maybe wiped brushed a
tear from my eye, and the head clinician, who was
very well seasoned, he had been around for a long time.
(00:20):
He later pulled me aside and he's like, don't worry,
you know, don't worry. You know, after a while, after
you go through this a little bit, this won't affect you.
Speaker 2 (00:28):
Like your soul will deaden. It will be okay.
Speaker 1 (00:31):
And I remember thinking right there, I will never let
that happen to me, because if I do, that's when
I should hang up my Stepiscope.
Speaker 2 (00:46):
This is hereafter, and I'm your host, Megan Devine, author
of the best selling book It's Okay that You're Not Okay.
I've spent the last ten years having interesting conversations about
difficult things, and you know, I think we're all just
waiting for check Is to tell the truth about our
actual lives. So I hope this show in general, but
also this episode gives you some starting points for your
(01:08):
own conversations about difficult things in your life, be sure
to let me know how it goes. This week on
Hereafter veterinary oncologist doctor Renee al Saraf, we discuss cancer,
dogs and finding hope when you know too much about loss.
Settle in, everybody, Settle in with your dogs if you
got them. We'll be right back after this first break.
(01:35):
Before we get started, one quick note. While we cover
a lot of emotional relational territory in each and every episode,
this show is not a substitute for skilled support with
a licensed mental health provider or for professional supervision related
to your work. And one more note. Hereafter with Megan
Divine is currently on break between seasons. We'll be back
(01:56):
before you know it with a whole new season with
even more incredible guests. In the meantime, here's one of
our most loved episodes, We'll see you soon. I learned
about doctor Renee Alsarov through an email from her publicist.
It is an interesting perk of the podcast business that
(02:17):
I get the inside scoop on new books along with
offers for people to be guests on the show. It
makes my job a lot easier. Without even knowing Renee,
I said yes, which is very not typical of me.
I usually poke around a lot to get like a
bigger backstory of a potential guest before I say yes
to something. But this topic, the topic of illnesses and
(02:40):
cancer and death in pets, specifically in dogs, A lot
of people carry grief from the death of companion animal,
and it's just something we don't talk about very much.
So of course I jumped at the chance to talk
to somebody who spends their entire professional career in this
really deep emotional territory of oncology in the animal world. Now.
(03:06):
Doctor Alsaroff noticed that people didn't really talk about grief
when she was in veterinary school too. She went to
school at Michigan State University and she founded MSU's Pet
Loss Support Group services. You're going to hear about that
in our conversation today, But she basically saw that even
the professionals weren't really talking about the grief in the
room or the emotions in the room, and she wanted
(03:27):
to do something about that. She went on to study
medical oncology and dedicated her work life to the emotionally
charged world of cancer. Our conversation actually reminded me a
lot about what we focused on in season one of
hereafter that whole grief on the job and because of
your job thing. So not only do we get into
grief around pet loss in this conversation, but we also
(03:50):
talk a lot about how hard it is to do
these goodbye intensive jobs. So Renee, welcome to the show.
I am so glad you're here now. I was just
telling everybody that I jumped at the chance to talk
with you because pet loss is like a really massive
issue that we don't talk about very much. We're going
(04:11):
to get into your own story of illness and how
that intersects with your work and what the dogs have
taught you, but I would really love to start there
with that grief piece. So what's your relationship with grief?
Speaker 1 (04:22):
On a lot of levels, I deal with it all
the time. People think though, being a veterinarian oncologist is
a very sad job, and surprisingly it's the opposite. It's
a very heartwarming job because I can hopefully give a
family another couple of years with their dog, or another
(04:43):
holiday season with their cat or something, and so many
people are just so thankful and then have the time
to process their emotions and go through that with them.
And yet it's also a very emotionally draining job because
it's an off emotional job really through the highs and
the lows. I am so grateful for you having me on,
(05:06):
so thank you very much. This is a great topic
because I think a lot of times people don't feel
justified or able to voice their grief about their pet
because it was just a pet. And yet that is
so not what it is. It's a family member, it's
(05:28):
someone who loves you unconditionally. You know. You had asked
about my relationship with grief when I was in veterinary school,
and it was during my senior year until we were
in the clinics, and I saw how many people would
just the pet parents would stand alone, right and they
would try to stifle their cries, hold back their tears
(05:52):
and stand there and equally stoic was that veterinarian in
that white coat who just stood there with their by
their side. And I thought, oh my goodness, this situation
could be so different. Slight segue, I can't imagine not
hugging someone or at least putting a hand on their
(06:14):
arm or on their shoulder. But while at Michigan State,
I started Michigan State University's Pet loss support group, and
I raised a whole bunch of money and we hired
a therapist that limited her practice to bereavement, and we
opened it up to anyone. Right, it didn't You didn't
(06:36):
have to have a dog or a cat. You could
have had a horse or a ferret or any four
legged animal though I guess two legged with a bird.
And it was a really special thing for people to
come together. I believe it was a really good thing. Yeah.
Speaker 2 (06:51):
I mean when we make the space for people to
tell the truth about their experience and their feelings and
the relationship, no animal pun intended, but people flock to it.
Speaker 1 (07:02):
Correct.
Speaker 2 (07:02):
I think you're right that, like the loss of a
pet is a really diminished or devalued loss, which is
so weird to me because like, I don't know anybody
who doesn't have feelings when their companion animals gets sick
or dies, right, Like, everybody has the feelings, but we
don't want to talk about those feelings.
Speaker 1 (07:18):
Correct, And I think that there are other feelings put
on these feelings. So I will see a fair amount
of people who maybe never wanted to have a pet,
and then their spouse passed away and this was their
spouse's cat or dog, and by gosh, they don't want
to give up on this, on this animal because it's
(07:40):
their last real tie, or at least in their head,
it's their last real tie to them. And I think
that that makes it hard. And I think too, the
other reason it makes it hard is because we sometimes
feel so helpless with our pets, right, Like nobody wants
to have to go through the grief period. We all
have to go through grieving throughout life. But when it's
(08:03):
a person, sometimes we can have those long lasting conversations,
or we can make amends, or we can do what
we need to do. And I think we tend to
see our pets, especially when they're ailing, more like our
little babies, right, And so we want to protect them.
That's our innate role, and yet we can't protect them
(08:26):
from the inevitable, and I think that's really hard.
Speaker 2 (08:30):
Yeah, And there's I think there's also that helplessness in
there too, right, that they don't speak an English language
or a human centered language, and it's like there's that
extra level of helplessness in there. Having done this a
couple of times now, it's such a weird position to
be in to euthanize an animal and decide on the
(08:50):
end of their lives. I mean, we do have that
for humans with the Death with Dignity Act in some states,
but it's still it's wonderful and it's necessary, and it's
a really loving act to do, and it's also very strange.
And I feel like we don't talk about that either, right,
that it's both things. It's both things.
Speaker 1 (09:08):
It is both things. And the first thing is for
that that pet parent to decide will I make that
decision for my dog, or will I, in a sense,
let nature take its course. And most people choose euthanasia,
not as many at all decide to not do that,
(09:28):
And there is no wrong answer. It's a very personal choice.
And then in making that decision, we all have the
same fears. Nobody wants to make that decision one day
too early, right, but my goodness, you certainly don't want
to make that decision one day too late. So it's
it's trying to find that medical balance of when that
(09:52):
perfect day is and then trying to find that emotional
balance for yourself and your family to accept it and
to deal with it.
Speaker 2 (10:02):
So you mentioned in that story about when you were
in school and what you saw happening. So you said,
you know, I see the pet parents standing by themselves
trying to be stoic. I mean, we've got such a
weird aversion to big emotions of any kind in this culture.
You know, this is what I spend all of my
time talking about. But I love that you also brought
in and hear are the stoic veterinarians with their hands
(10:22):
by their sides pretending to not be human?
Speaker 1 (10:25):
Yeah.
Speaker 2 (10:25):
I mean you had a really long career here and
focusing on oncology. There are a lot of goodbyes. In
my introduction I said that you are in a goodbye
heavy profession. I guess I have two questions here, What
did you see? What do you see in terms of
the stoicism and stoicism of your colleagues, And what have
you seen over the arc of your career and the
(10:47):
practice that you've built about the change in that human
relatedness in the profession. So two questions loaded into one.
Speaker 1 (10:55):
Yes, no, and there are great questions. And thankfully as
the decades and I'm showing my age, but as the
decades have passed, that has gotten better. I think as
a veterinary profession, we are more in tune with being
(11:15):
open to expressing emotions or hopefully having some compassion. And
that's maybe not even the right thing to say, because
I think we're always compassionate, but to show that compassion
at that trying time, you know, more than just awkwardly
handing someone a fistful of cleanexes, right, but being able
(11:37):
to talk them through it. I remember as again, I
was a fourth year veterinary student, and I don't remember
the case, but it was something said and the owner
was there, and it was another awkward situation, and I
think I maybe wiped brushed a tear from my eye,
and the head clinician, who was very well seasoned, he
(11:59):
was had been around for a long time. He later
pulled me aside and he's like, don't worry, you know,
don't worry. You know, after a while, after you go
through this a little bit, this won't affect you.
Speaker 2 (12:09):
Like your soul will deaden. It will be okay.
Speaker 1 (12:12):
And I remember thinking right there, I will never let
that happen to me, because if I do, that's when
I should hang up my steposcope. That's not why we
get into veterinarian medicine or any you know, human medicine
or anything. We do it for that love, that healing,
(12:35):
that caring. But I think, as you know, the younger
generations come through, they're able to be a little more
in touch with everyone's feelings in the room.
Speaker 2 (12:45):
Yeah, I mean that really is the old school way
of doing things right. We see that in the human
medical profession as well, especially in hospitals, where you are
supposed to check your humanity at the door, you are
not supposed to show emotion. In fact, I had a
lot of dots and surgeons on the show last season
and they were like, if you show emotion, we actually
questioned your professional capacity. Wow, right, Like how terrifying is that?
(13:10):
And I think there's also there's something really interesting in
here too, like the binary in there, the we only
have two options. We can either be completely stoic and
professional or we can be a hot, weepy mess. And
I feel like, you know, it's it always reminds me
of that idea, like if I start crying, I'll never
be able to stop. And we need to be able
to do our jobs correct. Where is that middle ground
(13:35):
there between allowing your human response, your human connection, and
your professionalism, Like where do they meet?
Speaker 1 (13:42):
I actually talk a lot about this in the book
Believe it or not right because being the person that
say is actively being the one to euthanize someone's pet,
And everyone in the room has their tears just dripping
down their face and noses read and all I want
(14:03):
to do is cry as well. And sometimes it's not
because it's not for the pet, because I know medically
it is the best thing for the dog or the cat.
They're suffering, they're in pain. But to see what the
family is going through just can tear you up inside.
(14:26):
So it's not easy to sort of remember what your
job is. But you have to write. I have to
keep reminding myself in my head. I have to do this.
I have to maintain composure. But that doesn't mean that
once that final act is done that some of those
emotions don't come out. And I think two, it actually
(14:47):
builds for a more human a better relationship with that
pet parent. You know, you had talked about what some
of the physicians had said about professionalism, but I'm not
so sure that not showing a little bit of emotion
or a tear is in the definition of being a professional.
Speaker 2 (15:07):
Yeah, oh, men's is drawn that one And this is
the thing, right, And a lot of this is like
old ideas about doctors, right, that they're supposed to be
this like revered up on a pedestal. You must be
more than human. And I mean that that was the
model of the fifties, right, Like we've come a long
way here, like women can be doctors. Woo. I mean,
what a change, but that we want our providers to
(15:30):
be very skilled at what they do, and we want
to see that they're human and not automatons, right, And
I do like I agree with you. I see that
coming up through counsel or education. I see it coming
up through the medical profession and what they're getting trained in.
That we have to start talking about not leaving our
humanity at the door. It's also like, what are we
showing our clients and our patients if we're completely stoic
(15:53):
in an emotional moment, we're saying the right thing to
do is to have no feelings about this. They were
always role modeling.
Speaker 1 (16:01):
Yeah, that's very true. It's a very good way.
Speaker 2 (16:15):
Hey, it's me jumping in here before we head back
into this episode. If you're a therapist, social worker, or
other provider and you have been waiting for me to
open up a professional training program for you. That time
has officially come. Enrollment is open for my four month
online training program four months with me. With so much
(16:37):
grief in the world, it is a pretty good bet
that you are encountering it in your patients or your clients.
As we learn on this show, and as I've been
telling y'all forever, grief is everywhere, even if it's not
the identified problem that somebody brings into the room. I
developed this online training so that you can bring human
centered grief care into your practice. All of the information
(17:00):
is at Megandivine dot Co. I'm going to link to
the training registration page in the show notes, But if
you've been waiting to have some real skills and some
real conversation about doing the work of supporting grieving people
in your practice, don't miss this link in the show
notes and Megandivine dot Co. Okay, back to the show
(17:22):
you brought up. When you were talking about that vignette
in the room with the family and the emotions, you said,
if you're the one administering the Euthanasian medicine, it reminded
me of so years and years and years ago. I
was a volunteer at a wild bird rehab center and
they did a lot of euthanasia because they got like
the hopeless cases, right, because they were experts, and so
(17:42):
everybody who had a case that they couldn't solve, they
sent them up. And I remember the one and only
time I've directly done a euthanasia, it was for a
flicker who was so injured they couldn't come back. And
that that feeling of being the instrument of death and
knowing that being the instrument of death was an act
(18:02):
of mercy. What a mailstream of feelings inside that moment. Now,
Fortunately for me, I was working with people who had
done this forever and we were able to debrief afterwards
and talk about that. I wonder if in the veterinary industry,
or even just in your own practice, do you talk
about that sort of stuff, like do you debrief? Do
(18:23):
you talk about we have weird jobs where we, as
my mentor said, all those years ago, you're dealing death
all the time, right, how do you live with that?
Speaker 1 (18:33):
You know? I talk about it with my oncology team, right,
the nurses, technicians, sometimes the client support staff upfront. Interestingly,
and I think I want to change this. I never
really talk about it with other veterinarians, and yet they
are the ones that are actively, you know, giving the
(18:59):
drugs to end the life. And I think that would
be a very very valuable conversation, and not just one conversation,
but a continuation of it as a one on one
but even as a group.
Speaker 2 (19:14):
Yeah, I think coming together and talking about the reality
of it. Like any time you're doing highly emotional work
and you're not talking about it, it's going to take
a toll, right. I think I read somewhere that veterinarians
have a very high suicide rate, correct, which is very
similar to human doctors. Yes, right, Yeah, And there are
a lot of factors there, obviously the workload, the intensity,
the pacing of everything, but also that you can't push
(19:38):
emotions down and expect them to not pop back up
in other places.
Speaker 1 (19:42):
Correct. Yes, very true. And I cry usually I'll only
shed a couple of tears in front of a family
just because then I'm trying to counsel them and help
them with their grief. But once I go, say to
the back, I let loose and just cry, as do
(20:03):
many members on my team. Yeah, it's sort of the
only way that I can handle it, short of you know,
a big bowl of pasta, or.
Speaker 2 (20:13):
Hey, all the options in the toolbox, man, all the
options in the toolbox. Now you have your own experience
of having a cancer diagnosis. You were just saying, like,
you know, after a youth in asia or after a
tough conversation with a patient, I'll often go in the
back and just cry, and I there's a bleed through
there right between like self as patient and self as provider,
(20:34):
which you talk about in the book.
Speaker 1 (20:36):
Yes, very very true, and sometimes that's really hard. I
think it's the hardest when I'm talking to a new client,
someone that I haven't seen before, so they don't know me.
And many of my patients knew some of my backstory,
especially they knew when I was out or maybe perhaps
(20:57):
look different. But for the new patients, I wouldn't really
share that with them. It wasn't the appropriate time. But
I found that it was harder to get through telling
them about the biologic behavior of cancer, what it does,
what tests we need, and what we can do to help.
It was just too raw for me.
Speaker 2 (21:18):
That overlap, like hearing yourself deliver that news and knowing
that these very same things are happening in your own body.
Speaker 1 (21:23):
Correct. There was one time, and you can't make this
stuff up, a dog had just had abdominal surgery, and
on and on and after it was a new patient.
After they left out the door, I noticed that my
one hand was on my abdomen over my scar, which
I did just subconsciously, but I'm sure in a comforting
(21:46):
type way or needing some security. So it does play
no differently than I've always had boxers for many years,
which I love. Unfortunately, are one of the more common
breeds that get cancer, and so after you know, heaven forbid,
I had lost one of my boxers. Even though I
(22:10):
loved seeing a boxer as a patient, it was really
hard for me to see a boxer as a patient
because it was just hitting too close to home. It
reminded me too much of my own dog.
Speaker 2 (22:24):
Yeah, And I mean there's relatedness on all of those levels, right,
which I think is what we often shy away from
because it's such a big feeling and we're not really
sure what to do with it. And I love how
you describe that right, the physical hand on the belly
when you're talking to a patient who has belly abdomen things, right,
like our bodies know the relatedness is natural, yes, and
(22:44):
what's not natural? It's like squashing that relatedness and like
making it weird.
Speaker 1 (22:49):
Yeah.
Speaker 2 (22:50):
So there's a theme actually that runs through your book,
usually when you're talking about your own cancer treatment and
you write things like I know what a low white
cell count means. I know what happens with this man
or that medication. So you know a lot more about
the negative outcomes and the side effects than like a
lot of civilians probably know about things. So how do
you navigate your own sense of calm or trust or
(23:14):
optimism for yourself when you can't turn off what you
know about cancer?
Speaker 1 (23:20):
So for me, I would rather know than not know, right,
Believing that knowledge is power. I remember asking U was
a close family friend and she had had uterine surgery
as well a few years back, and there was at
the time when I had it, there were three different
ways to do it, And I said, oh, you know,
(23:41):
how did you have your you know, what procedure did
you have? And she's like, oh, I had surgery And
I'm like yea, yeah, yeah, but how did they do it?
I had surgery And I'm like, well, did they and yeah,
go through your abdomen, go through your belly button, go
through more personal area. And she had no idea, and
she was good with that. I always want to know.
(24:05):
Maybe on some level it's harder because then I have
to deal with the what ifs and the fears and
the worries. But I think for me knowing what could
be or the bad things that could be, I saw
it more of me being a warrior through all of
this instead of a warrior through all of this. And
(24:28):
so I was convinced that I could will myself into
not having side effects.
Speaker 2 (24:33):
A superpower, superpowers.
Speaker 1 (24:36):
You know, And I felt like if I didn't have
whatever some gi upset, that that was a small victory,
and so I would kind of go through it that way.
Speaker 2 (24:45):
This actually happens for like, doctors make terrible patients, right
because they they know they know a lot. Maybe they
don't know everything, but they think they do. And you know,
I wonder also about when doctors or nurses familiar with
cancer receive a cancer diagnosis for their pet, right, So
if we flip that around, you were just talking about
for your own experience with cancer, you're glad for your knowledge,
(25:08):
even about the difficult things and the side effects and
what low white cell count means, because it felt empowering
to you. If we flip that around and we have
we have a physician who works in oncology and her
her basset hound has cancer. How do you see that?
Like if we flip do you know what I'm talking
about here? Like around that knowledge? Like how does that
play out in what you see?
Speaker 1 (25:29):
So that person along with someone who has gone through it,
either as a caretaker to someone who had cancer or
if they themselves had cancer. And I'm making generalities here,
but they tend to put their own emotions into it.
They don't separate out or they sometimes don't really hear
(25:53):
what I am saying because it is different. Just like
for me to go through it, it was a little different, right,
People lose their hair in general, Dogs and cats don't
because their hair just grows to a certain point and
then it stops. It's a whole different growth pattern. And
so it's trying to persist for me in showing them.
(26:14):
But it's different. Yes, you have a lot of knowledge,
and certainly you know just the study of human medicine,
they are much more advanced than a lot of the
things we know and do in veterinary medicine, but it's
still different, and trying to get them and caretakers and
(26:35):
people who have gone through it to not put their
own emotions into it because our dogs and our cats
are clueless. They don't know what they're getting into. They
approach it with a much different attitude. They don't have
that fear that they've been thinking about it all week
before the appointment and then get that sour churning in
(26:57):
their belly as they're now in the parking lot, and
then they check in. They come in and they're eager
to see us, and they get a biscuit. You know,
perhaps if I got a piece of Godiva every time.
Speaker 2 (27:08):
So the chemo chair and.
Speaker 1 (27:09):
Gage chet exactly.
Speaker 2 (27:11):
Yeah, I mean, they don't have that. Animals don't have
that front loaded apprehension other than like I really don't
like going to this place.
Speaker 1 (27:17):
Correct.
Speaker 2 (27:18):
They don't have the body of knowledge to worry the
way that we do. And it makes me think of
like process conversations, right. A process conversation is a conversation
about how we have conversations, right, And so thinking about
that interchange, it's like, can you say this is rhetorical here,
but you know, I answer if you want, can you
say to somebody who has gone through caretaking a human
(27:38):
and now their animal has cancer and you see them
loading all of those emotions into this experience, like to
be able to say, I know you've had an experience
of taking care of somebody with cancer before. It's going
to be a real challenge to keep that previous experience
out of the right now experience. But I want you
to know that I see it, and here are the
(27:59):
ways that it might be different.
Speaker 1 (28:01):
Yes, And that's fantastic advice. I do and we do
do that. And there are some people though understandably just
because they've just gone through so much that they're unable
to and perhaps then for their family, treating their pet
for cancer might not be the best thing, right, especially
(28:23):
if it's a terminal cancer. It's not an easy decision,
but so many factors go into that decision.
Speaker 2 (28:32):
Yeah, and this is you know, in therapists speak, we
say meeting the client where they are right and it's
such an emotional experience. Like again, as a person who
has had sick animals and dying animals, like you can't
help but be wound up about that stuff. It takes
a lot of a lot of grounding tools and a
lot of breathing to like be able to find that
(28:55):
common enough center point where you feel like you can
make the best decision crappy situation correct.
Speaker 1 (29:02):
Yes, And that's the goal of all of this, right
to have as as little or as few regrets as possible.
Granted the outcome wasn't what they wanted. They're losing their pet,
but to make it as peaceful as possible, to make
it so that they understand everything, because I think if
(29:24):
you know, if you fully understand, to know that they've
tried everything possible and that always the number one goal
was their pets quality of life. That hopefully gives some comfort.
Speaker 2 (29:39):
Yeah, And that these decisions are an expression of love
as well, right, like that our relationships with our animals
includes their deaths.
Speaker 1 (29:47):
Yes, Yes. And you know what I've explained to my
son and many other people going through the creeping process is,
you know, I would love nothing more than for my
boxer to live twenty five years with me, and unfortunately
that's just not their lifespan. They're not meant for that,
(30:07):
you know, And so many people, when they are hurting
so much, say never again, I'm not getting another cat, dog,
I can't take this pain. And thankfully for many of them,
that softens and they realize that they're special and each
one comes into our life with a different purpose at
a different time, and that they're able to open their
heart and share their life again with another dog or cat.
Speaker 2 (30:32):
My parents have had cats forever, and their last cat
died probably, gosh, probably ten years ago, maybe even fifteen
years ago. So that's a long time without a beast
for people who really really love beasts. But their last
three cat deaths wrecked them and they were like, we're
not we're not doing it again. And I remember, you know,
I remember. So this was before my partner died, and
(30:54):
I remember the last time we visited my folks before
he died, he and I were having a conversation like,
they're they're robbing themselves of so much joy by absolutely
deciding they're never they're never risking this amount of pain again. Right,
They're just they're they're they're holding themselves back from so
much joy. And ironically enough, you know, a week later,
(31:15):
he died in an accident, and I got that in
a different way. Oh, the risk of opening your heart
to love that much again and know that you have
to say goodbye before you're ready, right, no matter how
long it's been, it's always before you're ready, always, always right.
And that decision to expand love, expand your heart and
(31:40):
include more beings human or otherwise in that net like,
that's a that's a decision that nobody else can make
for you.
Speaker 1 (31:50):
Correct, yeah, correct. And I hope that people can remind
themselves of those ten wonderful years or maybe like a
couple crazy puppy months, but the ten wonderful years and
that hopefully eventually will outweigh the pain of the last
(32:13):
few months or however, you know, whatever the situation dictated,
because they do make our lives better in a lot
of ways.
Speaker 2 (32:22):
There's a section in your book while you're in the
hospital waiting to get your blood work back before chemo,
and you wrote, my mind is racing with I hope
my blood work is okay. I hope my ears will
be fine. I hope my chemo goes smoothly. Now, if
I were giving advice to someone else, I would point
out that all of this brooding is a waste of energy.
So in that passage, you use the word hope over
and over and over again. But you call it brooding there.
(32:44):
So when is hope not hope for you.
Speaker 1 (32:48):
When it is surrounded by fear? When I'm using hope
almost like it's the center of a ball and I'm
just trying to punch out at all the fear that
is surrounding me or circling in my head, not wanting
the worst case scenario.
Speaker 2 (33:08):
In that passage in the book, you talk about it
as those are your worries, your fears masquerading as hope. Yes, right, yeah,
I love that. And this is sort of like that
vending machine hope, right, Like we're hoping for a very
specific outcome, and really what we're doing is managing our
fears while we're talking about that, and hope is maybe
(33:29):
a different thing, a different beast than those worries running around.
So this is actually a great place for my last
question here. So knowing what you know as a professional,
given the span of your career thus far, what you've
seen about the way that things have changed are around
loss and emotion and being human on the job and
(33:50):
all of these things. So knowing what you know as
a doctor and knowing what you know as a human
being living through a cancer diagnosis of your own. What
does hope look like for you right now?
Speaker 1 (34:04):
One of the things that I finally realized as I
was going through my diagnosis and the treatment and hopefully
coming out stronger and wiser and seeing what I have
seen day in and day out for thirty years with
veterinary patients is for everyone to realize that we are
(34:30):
better together. Part One of the things I wrote in
the book was that I had sort of felt a
little bit alone. I had on my mom wheels, and
I would race to work and do my job and
race home and pick up the kid and do the dinner,
and I lost touch with myself and my friends. But
(34:52):
certainly my life is better having my friends and family
front and center in it, and just that alone, for
lack of a better word, makes it better. And you know,
if you look at dogs and they're a pack animal,
their lives right are dependent on that pack and they're
(35:14):
better together. And then our lives as humans are better
because of our animals, whether it's the unconditional love, the
non judgment, the emotional support, or in the field as
a farmer, as someone who's hurting, as service dogs with
(35:36):
providing some independence for special needs people, or the work
they do with the police, things like that. I guess
my hope is to realize that we're all better together,
which affects all of our lives in every category.
Speaker 2 (35:54):
So that relatedness of the pack is our hope for
the future and our hope for her right now. And
I think this is really true. It's true for me,
and it's true for so many of the guests the
season and so many of the folks that I talk to.
That relatedness really is our hope, right that there's a
hopefulness in our connections and being allowed to be who
(36:17):
we truly are in those connections.
Speaker 1 (36:20):
Exactly, and we do better by coming together. Yeah, And
I think even a little bit as part of that.
You know, one of the reasons that we value and
cherish our pets so much is because we can fully
be ourselves. And so when you said be able to
be yourself in that group, that's another lesson from our
(36:43):
pets that we should take to heart because we're all
so similar and yet sometimes so guarded. Yeah.
Speaker 2 (36:51):
I think that's a great place to end talking about
the gift of being able to be your true self
around an animal who is not going to judge or
hold things again you or bring it back in an
argument next week. So using that sort of as a
as a north star, right for all of our relations,
how can I be more of my true self and
also recognize other people's true selves for who they are
(37:12):
exactly nice? Okay, So I think this is a great
place for us to end. Thank you for being who
you are in the world and doing the work that
you do in the world. So I'm going to link
to your website in the show notes so that people
can see where to find your new books at Stay
Heal and what else do you want people to know?
Where can people look for you and anything else you
(37:32):
want them to know.
Speaker 1 (37:33):
So I'm on Facebook and Instagram and the website for
the book. You know, the Facebook and Instagram would be
my name, and then at my website, We've already started
listing the places that I'll have, you know, appearances, book events.
Some of them are going to be really fun in
conjunction with the local shelter or you know, some of
(37:55):
the proceeds will actually be donated to help you know,
animals in need and things like that, so to do
some good as well.
Speaker 2 (38:03):
Excellent, And that website is sit Stay Heel book Correct Correct,
sit Stay Heal book dot com everybody, so be sure
to check out that website to see if there are
any events happening near you and to learn all about
Renee's work. All right, thank you so much, Renee friends,
will be right back after this break. Don't go anywhere.
(38:35):
Before we get into this week's questions to carry with you,
I want to let you know that registration just open
for an intensive training for professionals with me that begins
this December twenty twenty two. In case you're listening later.
All of the information about this training is on the
website megandivine dot co, but a very short summary. If
(38:56):
you're a therapist, social worker, nurse or other provider. During
this training, you'll meet with me every other week for
just over four months, four whole months in live sessions,
covering everything from the current state of grief support and
how the new diagnosis codes affect our work to how
you actually deal with grieving clients or patients in more
(39:17):
human centered ways. Now, this training is limited to only
fifty people this time, so that we have a human
way of connecting with each other. So check out megandivine
dot co to find the registration link, and I will
also put the direct sign up page in the show notes.
Each week, I leave you with some questions to carry
with you until we meet again. Now, this season has
(39:38):
a running theme everybody. Sometimes it is more obvious than
other episodes, but this season is all about hope, finding it,
losing it, redefining it, fighting for it in these weird
personal and collective times. You know, it really struck me
in my conversation with doctor Renee Alceraft today was the
difference between hope as a worry and hope as more
(40:03):
of like a dream or a vision that we hold.
I think that's a really interesting distinction there, Like the
ways that she described, like, you know, sitting there waiting
for my chemo treatment, I'm like, I hope I have
good scyms. I hope I have this. I hope I
have this. It's that that transactional hope, right hope for
a very specific outcome. And what she and I got
to you was that like hope, like that is really
(40:24):
just a way to manage your anxiety, manage your worries.
But that real hope, as you heard Renee say, real
hope is in our partnerships, our connections, our relatedness, our
own packs, whether that is the human animal pack or
our own communities, that hope really lives in that kind
of connection. I think that's really cool. That's sort of
(40:46):
my working definition of what or where hope might be
too right now is that it's in our relatedness and
in our connections that we find it. What about you?
What parts of this conversation stuck with you today? What
parts made you think or cry or feel just the
tiniest bit better about the moment that you're in. What
(41:08):
you learn about hope this time? Anything, everybody's going to
take something different from today's show, but I hope you
did find something to hold onto. Hope really is a
crowdsourced community action. There are lots of ways to open
these conversations on grief and survival and connection and hope,
and we definitely want to hear from you on all
(41:29):
of this. What kind of conversations are you starting in
your life about these difficult things? Check out Refuge and
Grief on Instagram or here after pod on TikTok to
see video clips from the show and leave us your
thoughts in the comments on those posts. Be sure to
tag us in your conversation starting posts as well on
your own social media accounts. When you do that, use
the hashtag here after pod all on word and hashtag
(41:52):
on all the platforms. We love to see where this
show takes you. And if you want to tell us
how today's show felt for you, or you have a
request or a question or a topic you'd really like
me to explore on the show, give us a call
at three two three six four three three seven six
eight and leave a voicemail. If you missed it, you
can find the number in the show notes or visit
(42:14):
megandivine dot co. If you'd rather send an email, you
can do that too, right on the website Megandivine dot co.
We want to hear from you. I want to hear
from you this show, this world needs your voice. Together,
we can make things better even when we can't make
(42:34):
them right. You know how most people are going to
scan through their podcast app looking for a new thing
to listen to. They're going to see the show description
for a hereafter and think, I don't want to listen
to difficult things even if cool people are talking about them. Well,
that's where you come in your reviews. Let people know
it really isn't all that bad in here. We talk
(42:55):
about heavy stuff, yes, but it's in the service of
making things better for everyone. So everyone needs to listen.
Spread the word in your friend groups, in your social
world on social media, and click through to leave a review.
Subscribe to the show, follow the show, download episodes, and
keep on listening. Friends want more hereafter. Grief education doesn't
(43:17):
just belong to end of life issues. As my dad says,
daily life is full of everyday grief that we don't
call grief. Learning how to talk about all that without
cliches or platitudes or simplistic dismissive statements is an important
skill for everyone, especially if you're in any of the
helping professions as my guest and I talked about today.
Find trainings, tip sheets, professional resources, and my best selling book,
(43:40):
It's Okay that You're Not Okay. Plus The Guided Journal
for Grief at Megandivine dot Co. Hereafter with Megan Divine
is written and produced by me Megan Divine. Executive producer
is Amy Brown, co produced by Elizabeth Fozzio, Edited by
Houston Tilly. Logistical and media support from Micah. Also moral
(44:01):
and emotional support by Micah. Music provided by Wave crush
and occasional background noise provided by the air conditioning
Host
Megan Devine
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