October 17, 2022 • 43 mins
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
Announcement: want to become a grief-informed therapist? Registration is open now for Megan Devine’s 6 month grief care professional program. Details at this link.
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
Additional resources:
Grief is everywhere. Want to become a more grief-informed therapist or provider? Registration is open now for Megan Devine’s 6 month grief care professional program. Details at this link.
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? call us at (323) 643-3768 or 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 IG, FB, TW, and @hereafterpod on TT
Check out Megan’s best-selling books - It’s Okay That You're Not Okay and How to Carry What Can’t Be Fixed
See omnystudio.com/listener for privacy information.
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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 sad.
The owner was there and it was another awkward situation
and I think I'm maybe wiped brushed a tear from
my eye. And the head clinician, who was very well seasoned,
he was he was 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, Uh, this won't
affect you like that your soul will deaden. It will
be okay. And I remember thinking right there, I will
never let that happen to me, because if I do,
(00:41):
that's when I should hang up my Stepiscope, this is hereafter,
and I'm your host, Megan Divine, 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
is to tell the truth about our actual lives. So
(01:03):
I hope this show in general, but also this episode
gives you some starting points for your own conversations about
difficult things in your life. Be sure to let me
know how it goes. This week on Hereafter Veterinary oncologist
Dr Renee al Sarraff, we discuss cancer, dogs and finding
hope when you know too much about loss. Settle in, everybody,
(01:25):
Settle in with your dogs if you've got them. We'll
be right back after this first break. 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
(01:45):
health provider or from professionals provision related to your work.
I learned about Dr Renee Alsoff through an email from
her publicist. It is an interesting perk of the podcast
business that I get the inside scoop on new books
along with offers for people to be guests on the show.
It makes my job that easier. Without even knowing Renee,
(02:08):
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
cancer and death in pets, specifically in dogs, A lot
of people carry grief from the death of companion animal,
(02:31):
and it's just something we don't talk about very much.
So of course I jumped at the tence to talk
to somebody who spends their entire professional career in this
really deep emotional territory of oncology in the animal world. Now.
Dr also noticed that people didn't really talk about grief
(02:52):
when she was in veterinary school too. She went to
school at Michigan State University and she founded ms US
Pet Law 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 to do something about that. She went on to
study medical oncology and dedicated her work life to the
(03:15):
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 talk a lot about how hard it is to
do these goodbye intensive jobs So, Rennie, welcome to the show.
(03:40):
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
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 are there
with that grief piece. So what's your relationship with grief?
(04:05):
On a lot of levels, I deal with it all
the time. People think though being a veterinary 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
(04:25):
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 awfully emotional job really through the highs and
the lows. I am so grateful for you having me on,
(04:49):
so thank you very much. This is a great topic
because I think a lot of times people don't feel
justified or or 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 it's a
(05:09):
family member, It's it's 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,
(05:30):
and they would try to stifle their cries, hold back
their tears and stand there. And equally stoic was that
veterinarian in that white coat who just stood there with
their arms by their side. And I thought, oh my goodness,
this situation could be so different, slight segue. I can't
(05:52):
imagine not hugging someone or at least putting a hand
on their armor, on their shoulder. Um. But while at
Michigan State, I started Michigan State uh University's Pet Loss
Support Group, and I raised a whole bunch of money
and we hired a therapist that limited her practice to
(06:14):
bereave mint and we opened it up to anyone. Right,
It didn't you didn't have to have a dog or
a cat. You could have had a horse or a ferret,
or or any four legged animal 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. I mean when we when we
(06:35):
make the space for people to tell the truth about
their experience and their feelings and the relationship. No animal
pun intended here, but people flocked to it. And 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,
(06:57):
everybody has the feelings, but we don't want to talk
about those feelings, 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 spouses cat or dog, and by gosh,
(07:18):
they don't want to give up on this, on this
animal because it's 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 to the other reason it makes it hard is
because we sometimes feel so helpless with our bets, right,
Like nobody wants to have to go through the brief period.
(07:41):
We all have to go through grieving throughout life. But
when it's 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 little babies, right, and so we want to protect them.
(08:03):
That's our our innate role, and yet we can't protect
them from from the inevitable. And I think that's that's
really hard. Yeah, And there's I think there's also that
helplessness in there too, right, that they don't speak an
English language or or a human centered language, and it's
like there's that extra level of helplessness in there. Having
(08:24):
done this a couple of times now, it's such a
weird position to be in two euthanize an animal and
decide on the 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 it's a really loving act
to do, and it's also very strange. And I feel
(08:44):
like we don't talk about that either, right, that it's
both things. It's both things. It is both things. And
the first thing is for that that pet parents 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
(09:09):
decide to not do that, 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
(09:33):
balance of when that that perfect day is, and then
trying to find that emotional balance for yourself and your
family to accept it and to deal with it. 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
(09:55):
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 here
are the stoic veterinarians with their hands by their sides,
pretending to not be human. Yeah, I mean you had
a really long career here and focusing on oncology. There
are a lot of goodbyes. Um. In my introduction I
said that you are in a goodbye heavy profession. I
(10:17):
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 practice that you've
built about the change in that human related nous um
in the profession? So to two questions loaded into one. Yes,
(10:37):
no um, 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
open to expressing emotions or hopefully having some compassion. And
(11:04):
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 clean X is right, but
being able to to talk them through it. I remember,
as again, I was a fourth year veterinary student, and
(11:27):
I don't remember the case, but it was something sad,
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 was he 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
(11:48):
you go through this a little bit, Uh, this won't
affect you like that your soul will deaden, It will
be okay. 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 stethoscope. That's not
why we get into veterinary medicine or any human medicine
(12:12):
or anything. We do it for that love, that healing,
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. 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
(12:36):
check your humanity at the door. You are not supposed
to show emotion. In fact, um I had a lot
of doctors and surgeons on the show last season and
they were like, if you show emotion, we actually question
your professional capacity. Wow, right, Like how terrifying is that?
And I think there's also there's something really interesting in
here too, like the binary in there, the the we
(12:58):
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 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
there between allowing your human response, your human connection, and
(13:22):
your professionalism, Like where do they meet? 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 their noses red, and all I want to do
(13:46):
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 there and pain. But to see what the family
is going through just can tear you up inside. Um.
(14:08):
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 too, it actually
(14:30):
builds for a more human or 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. Yeah,
(14:50):
oh men, sister on 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 at
a pedestal. You must be more than human. And I
mean that was that was the model of the fifties, right,
Like we've we've come a long way here, Like women
can be doctors, whoo. I mean, what a change, but
that we want our providers to be very skilled at
(15:13):
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 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 in an
(15:36):
emotional moment, we're saying the right thing to do is
to have no feelings about this. We're all I mean,
we're always role modeling. Yeah, that's very true. It's a
very good point. Hey, it's me jumping in here where
(16:00):
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 months online training program four months with me. With
so much grief in the world, it is a pretty
(16:21):
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
(16:42):
of the information is at Megan Divine dot c O.
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 Megan Divine dot
c O. Okay, back to the show you brought up
(17:05):
when you were talking about that vignette in the room
with a family and the emotions, you said, if you're
the one administering the euthanasia 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 hope
the hopeless cases right, because they were experts, and so
everybody who had a case that they couldn't solve, they
(17:26):
sent them up. And I remember the one and only
time I've directly done a euthan asia, 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 of mercy. What a maelstrom of feelings inside that moment. Now,
(17:51):
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 do
you debrief? Do you talk about we have weird jobs
where we as my my mentor said all those years ago,
you're dealing death all the time, right, how do you
(18:14):
live with that? You know? I talk about it with
my oncology team, right, the nurses, technicians, sometimes the clients
support staff upfront interestingly, and 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,
(18:39):
you know, giving the the 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. Yeah,
I think coming together and talking about the reality of it.
(18:59):
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, is very similar to human doctors, right,
And there are a lot of factors there, obviously the workload,
the intensity, the pacing of everything, but also that you
can't push emotions down and expect them to not pop
(19:23):
back up in other places. Correct. Yeah, 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
(19:43):
and and just cry, as do 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 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're just saying, like,
(20:05):
you know, after a euthan asia are 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,
which you talk about in the book. Yes, very very true,
and sometimes that's really hard. I think it's the hardest
(20:27):
when I'm talking to a new client, someone that I
haven't seen before, so they don't know me. UM. And
many of my patients knew some of my backstory, especially
they knew when I was out or maybe perhaps look different.
But for the new patients, UM, I wouldn't really share
that with them. It wasn't the appropriate time. But I
(20:47):
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. That overlap, like
hearing yourself deliver that news and knowing that these very
same things are happening in your own body. Correct. There
was one time, and you can't make this stuff up,
(21:11):
a dog had just had abdominal surgery, and 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 um, which
I did just subconsciously, but I'm sure in a comforting
type way, or or needing some security. So it does
(21:34):
play no differently than I've always had boxers for many years,
which I love. Unfortunately, they 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 loved seeing a boxer as a patient, it
(21:56):
was really hard for me to see a box as
a patient because it was just hitting too close to home.
It reminded me too much of my own dog. Yeah,
and there, I mean, there's related nous 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
(22:18):
on the belly when you're talking to a patient who
has belly abdomen things, right, like our bodies know the
relatedness is natural and what's not natural. It's like squashing
that relatedness and like making it weird. Yeah. 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 out means.
(22:40):
I know what happens with this medication 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 optimism for yourself
when you can't turn what you know about cancer? So
(23:03):
for me, I would rather know than not know, right,
Believing that knowledge is power. I remember asking I 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,
(23:24):
how did you have your you know, what procedure did
you have? And she's like, oh, I had surgery. I'm
like yeah, yeah, but how did they do it? I
had surgery and I'm like, well did they? And you
go through your abdomen, go through your belly button, go
through a more personal area, and she had no idea,
and she was good with that. I always want to know.
(23:48):
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
(24:10):
so I was convinced that I could will myself into
not having side effects a superpowers, superpowers, you know, And
I felt like if I didn't have whatever some g
I upset that that was a small victory, and so
I would kind of go through it that way. This
actually happens for like, doctors make terrible patients, right because
(24:32):
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, even
about the difficult things and the side effects and what
(24:53):
low white cell out 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 Bassett
hound has cancer, how do you see that? Like if
we flip do you know what I'm talking about here?
Like completely around that knowledge? Like how does that play
out in what you say? So that person along with
(25:14):
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 what I am saying because
(25:37):
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. But it's different. Yes,
(25:58):
you you have a lot of knowledge, and sir, only
you know just the study of human medicine. Um, 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 and caretakers and people
who have gone through it to not put their own
(26:21):
emotions into it, because our dogs and our cats are
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
their belly as they're now in the parking lot, and
(26:41):
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,
so the chemo chair and get exactly 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. They don't have the body of knowledge to
(27:02):
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, answer if you want,
can you say to somebody who has gone through caretaking
a human and now their animal has cancer and you
(27:23):
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 ways that it might be different. Yes, And
(27:44):
that's fantastic advice I do and we do ye that.
And there are some people though understandably just because they've
just gone through so much that they're unable to and
and perhaps then for their family, treating their pet for
cancer might not be the best thing, right, especially if
(28:06):
it's a terminal cancer. It's not an easy decision, but
so many factors go into that decision. Yeah, And this
is you know, in therapist speak we say meeting, 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
(28:28):
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 calm enough
center point where you feel like you can make the
best decision in a crappy situation. Correct. Yes, And that's
the goal of all of this, right to have as
(28:49):
as little or as few regrets as possible. Granted the
outcome wasn't what they wanted. They're losing their their pet,
but to make it as peaceful as possible, to make
it so that they understand everything, because I think if
you know, if you fully understand, to know that they've
(29:09):
tried everything possible and that that always the number one
goal was their pets quality of life. That hopefully gives
some comfort. Yeah, And that these decisions are are an
expression of love as well, right, like that our relationships
with our animals includes their deaths. Yes, Yes. And you
(29:31):
know what I've explained to my son and and many
other people going through the grieving 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 they're not meant for that, you know,
And and so many people when they are hurting so much,
(29:52):
say never again, I'm not getting another catadog. I can't
take this pain. And and thankfully for many of them
that saw offense 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 their life again with another
(30:13):
dog or cat. 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 there 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
(30:35):
before my partner died, and 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
(30:55):
ironically enough, you know, a week later, 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
(31:17):
to expand love, expand your heart and include more beings
human or otherwise in that net like, that's a that's
a decision that nobody else can make for you. Correct, Yeah, correct.
And I hope that people can remind themselves of those
(31:42):
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 few months or however,
you know, whatever the situation dictated, because they do make
(32:02):
our lives better in a lot of ways. 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 go 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
(32:24):
and over again, but you call it brooding there. So
when is hope not hope for you 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.
(32:51):
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 and this is 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 when we're talking about that, And like,
hope is maybe a different thing, a different beast than
(33:14):
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 around loss and emotion and being human on
the job and and all of these things. So knowing
what you know as a doctor, and knowing what you
(33:37):
know as a human being living through a cancer diagnosis
of your own, what does hope look like for you
right now? 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
(34:02):
I have seen day in and day out for thirty
years with veterinary patients is for everyone to realize that
we are 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 my
mom wheels, and I would race to work and do
(34:24):
my job and race home and pick up the kid
and do the dinner, and and I lost touch with
myself and my friends. But certainly my life is better
having my friends and family front and center in it.
And and just that alone, for lack of a better word,
(34:46):
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 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,
(35:11):
or in the field, as a farmer, as someone who's
hurting as service dogs with 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
(35:34):
lives in every category. So that related nous of the
pack is our hope for the future and our hope
for right now. And I think this is this is
really true. It's true for me, and it's true for
so many of the guests this season and so many
of the folks that I talked to. That related nous
really is is our hope right that there's that there's
(35:55):
a hopefulness in our connections and being allowed to be
who truly are in those connections exactly, And we do
better by coming together. And I think even a little
bit as part of that. You know, one of the
reasons that that we value and cherish our pets so
much is because we can fully be ourselves. And so
(36:19):
when you said be able to be yourself in that group,
that's another lesson from our pets that we should take
to heart because we're all so similar and yet sometimes
so guarded. Yeah, 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
(36:39):
to judge or hold things against you or 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 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
(37:01):
doing the work that you do in the world. So
I'm gonna link to your website in the show notes
so that people can see where to find your new
books at stay here and what else do you want
people to know? Where can people look for you? And
anything else you want them to know. So I'm on
Facebook and Instagram and the website for the book. You know,
(37:21):
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, um book events. Some of
them are are going to be really fun in conjunction
with the local shelter or you know, some of the
proceeds will actually be donated to help you know animals
in need and things like that, so to to do
(37:44):
some good as well. Excellent, And that website is sits stay.
He'll book correct correct sits stay, He'll 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 nice work. All right, thank you so
much for friends. Will be right back after this break.
(38:04):
Don't go anywhere. 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
(38:26):
with me that begins this December two two in case
you're listening later. All of the information about this training
is on the website Megan Divine dot c O, but
a very short summary. If 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, for whole
(38:47):
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 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.
(39:08):
So check out Megan Divine dot c o 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 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,
(39:30):
fighting for it in these weird personal and collective times.
You know, it really struck me in my conversation with
Dr and a als Raft today was the difference between
hope as a worry and hope as more of like
a dream or a vision that we hold. I think
that's a really interesting distinction. They're like the ways that
(39:52):
she described, like, you know, sitting there waiting for my
chemo treatment, I'm like, I hope I have good skies.
I hope I have this. I hope I have this.
It's that that transactional hope, right, hope for a very
specific outcome. And and what she and I got to
was that like hope like that is really just a
way to manage your anxiety, manage your worries. But that
real hope, as you heard Renee say, real hope is
(40:13):
in our partnerships, are connections, are related nous, our own
packs um, 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
my working definition of what, what or where hope might
be too right now is that it's in our related
(40:35):
nous 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.
Don'd you learn about hope this time? Anything? Everybody's going
to take something different from today's show, but I hope
(40:56):
you did find something to hold onto. Hope really is
a prowdsourced 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
of this. What kind of conversations are you starting in
your life about these difficult things? Check out Refuge in
(41:18):
Grief on Instagram or hereafter 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 one word in hashtag on
all the platforms. We love to see where this show
takes you. And if you want to tell us how
(41:40):
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 to 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 Megan
divine dot c O. If you'd rather send an e
L you can do that too. Write on the website
(42:01):
Megan divine dot c O. 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 them right. You know how most
people are going to scan through their podcast app looking
(42:23):
for a new thing to listen to. They're going to
see the show description for 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
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So everyone needs to listen. Spread the word in your
(42:44):
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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 just along to end
of life issues. As my dad says, daily life is
full of everyday grief that we don't call grief. Learning
(43:07):
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, It's Okay that
You're Not Okay. Plus. The Guided Journal for Grief at
Megan Divine dot c. O. Hereafter with Megan Divine is
(43:30):
written and produced by me Megan Divine, Executive Producer, is
Amy Brown, co produced by Elizabeth Fossio, edited by Houston Tilly.
Logistical and media support from MICAH, also moral and emotional
support by Mega 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 sad.
The owner was there and it was another awkward situation
and I think I'm maybe wiped brushed a tear from
my eye. And the head clinician, who was very well seasoned,
he was he was 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, Uh, this won't
affect you like that your soul will deaden. It will
be okay. And I remember thinking right there, I will
never let that happen to me, because if I do,
(00:41):
that's when I should hang up my Stepiscope, this is hereafter,
and I'm your host, Megan Divine, 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
is to tell the truth about our actual lives. So
(01:03):
I hope this show in general, but also this episode
gives you some starting points for your own conversations about
difficult things in your life. Be sure to let me
know how it goes. This week on Hereafter Veterinary oncologist
Dr Renee al Sarraff, we discuss cancer, dogs and finding
hope when you know too much about loss. Settle in, everybody,
(01:25):
Settle in with your dogs if you've got them. We'll
be right back after this first break. 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
(01:45):
health provider or from professionals provision related to your work.
I learned about Dr Renee Alsoff through an email from
her publicist. It is an interesting perk of the podcast
business that I get the inside scoop on new books
along with offers for people to be guests on the show.
It makes my job that easier. Without even knowing Renee,
(02:08):
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
cancer and death in pets, specifically in dogs, A lot
of people carry grief from the death of companion animal,
(02:31):
and it's just something we don't talk about very much.
So of course I jumped at the tence to talk
to somebody who spends their entire professional career in this
really deep emotional territory of oncology in the animal world. Now.
Dr also noticed that people didn't really talk about grief
(02:52):
when she was in veterinary school too. She went to
school at Michigan State University and she founded ms US
Pet Law 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 to do something about that. She went on to
study medical oncology and dedicated her work life to the
(03:15):
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 talk a lot about how hard it is to
do these goodbye intensive jobs So, Rennie, welcome to the show.
(03:40):
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
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 are there
with that grief piece. So what's your relationship with grief?
(04:05):
On a lot of levels, I deal with it all
the time. People think though being a veterinary 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
(04:25):
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 awfully emotional job really through the highs and
the lows. I am so grateful for you having me on,
(04:49):
so thank you very much. This is a great topic
because I think a lot of times people don't feel
justified or or 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 it's a
(05:09):
family member, It's it's 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,
(05:30):
and they would try to stifle their cries, hold back
their tears and stand there. And equally stoic was that
veterinarian in that white coat who just stood there with
their arms by their side. And I thought, oh my goodness,
this situation could be so different, slight segue. I can't
(05:52):
imagine not hugging someone or at least putting a hand
on their armor, on their shoulder. Um. But while at
Michigan State, I started Michigan State uh University's Pet Loss
Support Group, and I raised a whole bunch of money
and we hired a therapist that limited her practice to
(06:14):
bereave mint and we opened it up to anyone. Right,
It didn't you didn't have to have a dog or
a cat. You could have had a horse or a ferret,
or or any four legged animal 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. I mean when we when we
(06:35):
make the space for people to tell the truth about
their experience and their feelings and the relationship. No animal
pun intended here, but people flocked to it. And 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,
(06:57):
everybody has the feelings, but we don't want to talk
about those feelings, 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 spouses cat or dog, and by gosh,
(07:18):
they don't want to give up on this, on this
animal because it's 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 to the other reason it makes it hard is
because we sometimes feel so helpless with our bets, right,
Like nobody wants to have to go through the brief period.
(07:41):
We all have to go through grieving throughout life. But
when it's 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 little babies, right, and so we want to protect them.
(08:03):
That's our our innate role, and yet we can't protect
them from from the inevitable. And I think that's that's
really hard. Yeah, And there's I think there's also that
helplessness in there too, right, that they don't speak an
English language or or a human centered language, and it's
like there's that extra level of helplessness in there. Having
(08:24):
done this a couple of times now, it's such a
weird position to be in two euthanize an animal and
decide on the 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 it's a really loving act
to do, and it's also very strange. And I feel
(08:44):
like we don't talk about that either, right, that it's
both things. It's both things. It is both things. And
the first thing is for that that pet parents 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
(09:09):
decide to not do that, 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
(09:33):
balance of when that that perfect day is, and then
trying to find that emotional balance for yourself and your
family to accept it and to deal with it. 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
(09:55):
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 here
are the stoic veterinarians with their hands by their sides,
pretending to not be human. Yeah, I mean you had
a really long career here and focusing on oncology. There
are a lot of goodbyes. Um. In my introduction I
said that you are in a goodbye heavy profession. I
(10:17):
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 practice that you've
built about the change in that human related nous um
in the profession? So to two questions loaded into one. Yes,
(10:37):
no um, 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
open to expressing emotions or hopefully having some compassion. And
(11:04):
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 clean X is right, but
being able to to talk them through it. I remember,
as again, I was a fourth year veterinary student, and
(11:27):
I don't remember the case, but it was something sad,
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 was he 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
(11:48):
you go through this a little bit, Uh, this won't
affect you like that your soul will deaden, It will
be okay. 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 stethoscope. That's not
why we get into veterinary medicine or any human medicine
(12:12):
or anything. We do it for that love, that healing,
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. 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
(12:36):
check your humanity at the door. You are not supposed
to show emotion. In fact, um I had a lot
of doctors and surgeons on the show last season and
they were like, if you show emotion, we actually question
your professional capacity. Wow, right, Like how terrifying is that?
And I think there's also there's something really interesting in
here too, like the binary in there, the the we
(12:58):
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 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
there between allowing your human response, your human connection, and
(13:22):
your professionalism, Like where do they meet? 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 their noses red, and all I want to do
(13:46):
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 there and pain. But to see what the family
is going through just can tear you up inside. Um.
(14:08):
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 too, it actually
(14:30):
builds for a more human or 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. Yeah,
(14:50):
oh men, sister on 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 at
a pedestal. You must be more than human. And I
mean that was that was the model of the fifties, right,
Like we've we've come a long way here, Like women
can be doctors, whoo. I mean, what a change, but
that we want our providers to be very skilled at
(15:13):
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 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 in an
(15:36):
emotional moment, we're saying the right thing to do is
to have no feelings about this. We're all I mean,
we're always role modeling. Yeah, that's very true. It's a
very good point. Hey, it's me jumping in here where
(16:00):
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 months online training program four months with me. With
so much grief in the world, it is a pretty
(16:21):
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
(16:42):
of the information is at Megan Divine dot c O.
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 Megan Divine dot
c O. Okay, back to the show you brought up
(17:05):
when you were talking about that vignette in the room
with a family and the emotions, you said, if you're
the one administering the euthanasia 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 hope
the hopeless cases right, because they were experts, and so
everybody who had a case that they couldn't solve, they
(17:26):
sent them up. And I remember the one and only
time I've directly done a euthan asia, 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 of mercy. What a maelstrom of feelings inside that moment. Now,
(17:51):
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 do
you debrief? Do you talk about we have weird jobs
where we as my my mentor said all those years ago,
you're dealing death all the time, right, how do you
(18:14):
live with that? You know? I talk about it with
my oncology team, right, the nurses, technicians, sometimes the clients
support staff upfront interestingly, and 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,
(18:39):
you know, giving the the 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. Yeah,
I think coming together and talking about the reality of it.
(18:59):
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, is very similar to human doctors, right,
And there are a lot of factors there, obviously the workload,
the intensity, the pacing of everything, but also that you
can't push emotions down and expect them to not pop
(19:23):
back up in other places. Correct. Yeah, 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
(19:43):
and and just cry, as do 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 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're just saying, like,
(20:05):
you know, after a euthan asia are 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,
which you talk about in the book. Yes, very very true,
and sometimes that's really hard. I think it's the hardest
(20:27):
when I'm talking to a new client, someone that I
haven't seen before, so they don't know me. UM. And
many of my patients knew some of my backstory, especially
they knew when I was out or maybe perhaps look different.
But for the new patients, UM, I wouldn't really share
that with them. It wasn't the appropriate time. But I
(20:47):
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. That overlap, like
hearing yourself deliver that news and knowing that these very
same things are happening in your own body. Correct. There
was one time, and you can't make this stuff up,
(21:11):
a dog had just had abdominal surgery, and 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 um, which
I did just subconsciously, but I'm sure in a comforting
type way, or or needing some security. So it does
(21:34):
play no differently than I've always had boxers for many years,
which I love. Unfortunately, they 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 loved seeing a boxer as a patient, it
(21:56):
was really hard for me to see a box as
a patient because it was just hitting too close to home.
It reminded me too much of my own dog. Yeah,
and there, I mean, there's related nous 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
(22:18):
on the belly when you're talking to a patient who
has belly abdomen things, right, like our bodies know the
relatedness is natural and what's not natural. It's like squashing
that relatedness and like making it weird. Yeah. 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 out means.
(22:40):
I know what happens with this medication 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 optimism for yourself
when you can't turn what you know about cancer? So
(23:03):
for me, I would rather know than not know, right,
Believing that knowledge is power. I remember asking I 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,
(23:24):
how did you have your you know, what procedure did
you have? And she's like, oh, I had surgery. I'm
like yeah, yeah, but how did they do it? I
had surgery and I'm like, well did they? And you
go through your abdomen, go through your belly button, go
through a more personal area, and she had no idea,
and she was good with that. I always want to know.
(23:48):
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
(24:10):
so I was convinced that I could will myself into
not having side effects a superpowers, superpowers, you know, And
I felt like if I didn't have whatever some g
I upset that that was a small victory, and so
I would kind of go through it that way. This
actually happens for like, doctors make terrible patients, right because
(24:32):
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, even
about the difficult things and the side effects and what
(24:53):
low white cell out 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 Bassett
hound has cancer, how do you see that? Like if
we flip do you know what I'm talking about here?
Like completely around that knowledge? Like how does that play
out in what you say? So that person along with
(25:14):
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 what I am saying because
(25:37):
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. But it's different. Yes,
(25:58):
you you have a lot of knowledge, and sir, only
you know just the study of human medicine. Um, 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 and caretakers and people
who have gone through it to not put their own
(26:21):
emotions into it, because our dogs and our cats are
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
their belly as they're now in the parking lot, and
(26:41):
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,
so the chemo chair and get exactly 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. They don't have the body of knowledge to
(27:02):
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, answer if you want,
can you say to somebody who has gone through caretaking
a human and now their animal has cancer and you
(27:23):
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 ways that it might be different. Yes, And
(27:44):
that's fantastic advice I do and we do ye that.
And there are some people though understandably just because they've
just gone through so much that they're unable to and
and perhaps then for their family, treating their pet for
cancer might not be the best thing, right, especially if
(28:06):
it's a terminal cancer. It's not an easy decision, but
so many factors go into that decision. Yeah, And this
is you know, in therapist speak we say meeting, 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
(28:28):
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 calm enough
center point where you feel like you can make the
best decision in a crappy situation. Correct. Yes, And that's
the goal of all of this, right to have as
(28:49):
as little or as few regrets as possible. Granted the
outcome wasn't what they wanted. They're losing their their pet,
but to make it as peaceful as possible, to make
it so that they understand everything, because I think if
you know, if you fully understand, to know that they've
(29:09):
tried everything possible and that that always the number one
goal was their pets quality of life. That hopefully gives
some comfort. Yeah, And that these decisions are are an
expression of love as well, right, like that our relationships
with our animals includes their deaths. Yes, Yes. And you
(29:31):
know what I've explained to my son and and many
other people going through the grieving 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 they're not meant for that, you know,
And and so many people when they are hurting so much,
(29:52):
say never again, I'm not getting another catadog. I can't
take this pain. And and thankfully for many of them
that saw offense 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 their life again with another
(30:13):
dog or cat. 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 there 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
(30:35):
before my partner died, and 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
(30:55):
ironically enough, you know, a week later, 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
(31:17):
to expand love, expand your heart and include more beings
human or otherwise in that net like, that's a that's
a decision that nobody else can make for you. Correct, Yeah, correct.
And I hope that people can remind themselves of those
(31:42):
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 few months or however,
you know, whatever the situation dictated, because they do make
(32:02):
our lives better in a lot of ways. 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 go 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
(32:24):
and over again, but you call it brooding there. So
when is hope not hope for you 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.
(32:51):
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 and this is 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 when we're talking about that, And like,
hope is maybe a different thing, a different beast than
(33:14):
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 around loss and emotion and being human on
the job and and all of these things. So knowing
what you know as a doctor, and knowing what you
(33:37):
know as a human being living through a cancer diagnosis
of your own, what does hope look like for you
right now? 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
(34:02):
I have seen day in and day out for thirty
years with veterinary patients is for everyone to realize that
we are 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 my
mom wheels, and I would race to work and do
(34:24):
my job and race home and pick up the kid
and do the dinner, and and I lost touch with
myself and my friends. But certainly my life is better
having my friends and family front and center in it.
And and just that alone, for lack of a better word,
(34:46):
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 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,
(35:11):
or in the field, as a farmer, as someone who's
hurting as service dogs with 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
(35:34):
lives in every category. So that related nous of the
pack is our hope for the future and our hope
for right now. And I think this is this is
really true. It's true for me, and it's true for
so many of the guests this season and so many
of the folks that I talked to. That related nous
really is is our hope right that there's that there's
(35:55):
a hopefulness in our connections and being allowed to be
who truly are in those connections exactly, And we do
better by coming together. And I think even a little
bit as part of that. You know, one of the
reasons that that we value and cherish our pets so
much is because we can fully be ourselves. And so
(36:19):
when you said be able to be yourself in that group,
that's another lesson from our pets that we should take
to heart because we're all so similar and yet sometimes
so guarded. Yeah, 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
(36:39):
to judge or hold things against you or 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 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
(37:01):
doing the work that you do in the world. So
I'm gonna link to your website in the show notes
so that people can see where to find your new
books at stay here and what else do you want
people to know? Where can people look for you? And
anything else you want them to know. So I'm on
Facebook and Instagram and the website for the book. You know,
(37:21):
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, um book events. Some of
them are are going to be really fun in conjunction
with the local shelter or you know, some of the
proceeds will actually be donated to help you know animals
in need and things like that, so to to do
(37:44):
some good as well. Excellent, And that website is sits stay.
He'll book correct correct sits stay, He'll 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 nice work. All right, thank you so
much for friends. Will be right back after this break.
(38:04):
Don't go anywhere. 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
(38:26):
with me that begins this December two two in case
you're listening later. All of the information about this training
is on the website Megan Divine dot c O, but
a very short summary. If 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, for whole
(38:47):
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 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.
(39:08):
So check out Megan Divine dot c o 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 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,
(39:30):
fighting for it in these weird personal and collective times.
You know, it really struck me in my conversation with
Dr and a als Raft today was the difference between
hope as a worry and hope as more of like
a dream or a vision that we hold. I think
that's a really interesting distinction. They're like the ways that
(39:52):
she described, like, you know, sitting there waiting for my
chemo treatment, I'm like, I hope I have good skies.
I hope I have this. I hope I have this.
It's that that transactional hope, right, hope for a very
specific outcome. And and what she and I got to
was that like hope like that is really just a
way to manage your anxiety, manage your worries. But that
real hope, as you heard Renee say, real hope is
(40:13):
in our partnerships, are connections, are related nous, our own
packs um, 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
my working definition of what, what or where hope might
be too right now is that it's in our related
(40:35):
nous 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.
Don'd you learn about hope this time? Anything? Everybody's going
to take something different from today's show, but I hope
(40:56):
you did find something to hold onto. Hope really is
a prowdsourced 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
of this. What kind of conversations are you starting in
your life about these difficult things? Check out Refuge in
(41:18):
Grief on Instagram or hereafter 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 one word in hashtag on
all the platforms. We love to see where this show
takes you. And if you want to tell us how
(41:40):
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 to 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 Megan
divine dot c O. If you'd rather send an e
L you can do that too. Write on the website
(42:01):
Megan divine dot c O. 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 them right. You know how most
people are going to scan through their podcast app looking
(42:23):
for a new thing to listen to. They're going to
see the show description for 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 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
(42:44):
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 just along to end
of life issues. As my dad says, daily life is
full of everyday grief that we don't call grief. Learning
(43:07):
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, It's Okay that
You're Not Okay. Plus. The Guided Journal for Grief at
Megan Divine dot c. O. Hereafter with Megan Divine is
(43:30):
written and produced by me Megan Divine, Executive Producer, is
Amy Brown, co produced by Elizabeth Fossio, edited by Houston Tilly.
Logistical and media support from MICAH, also moral and emotional
support by Mega Music provided by Wave Crush, and occasional
background noise provided by the air conditioning
Host
Megan Devine
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