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. 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, 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 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, 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 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, 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, 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 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 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. 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? 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 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, 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 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, 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 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 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 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, 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, 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. 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. 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 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 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 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 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 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 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, 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 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 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 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 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 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 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 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 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. 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 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, 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 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 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 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 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 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 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 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, 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 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, 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. 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 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 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, 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 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 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, 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 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 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 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. 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 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, 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. 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 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 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 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 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 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, 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 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 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 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 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 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 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 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 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 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 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, 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 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 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 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 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 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 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 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. 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 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 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 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 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, 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, 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 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 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 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 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 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, 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 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. 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 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 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. 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, 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 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 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 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 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 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 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 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 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 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 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 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. 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, 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 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, 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 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, 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, 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 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 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. 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? 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 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, 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 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, 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 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 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 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, 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, 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. 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. 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 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 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 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 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 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 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, 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 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 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 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 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 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 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 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 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. 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 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, 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 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 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 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 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 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 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 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, 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 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, 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. 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 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 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, 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 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 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, 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 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 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 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. 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 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, 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. 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 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 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 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 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 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, 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 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 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 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 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 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 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 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 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 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 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, 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 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 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 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 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 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 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 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. 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 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 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 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 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, 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, 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 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 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 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 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 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, 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 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. 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 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 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. 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, 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 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 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 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 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 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 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 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 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 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 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 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