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Andy Roark DVM MS

No One Cares About Your Broccoli

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Last night I burned the broccoli. 

I was grilling cheeseburgers and had a fresh bag of BBQ potato chips ready to go when I decided we needed something green on the plate. I patted myself on the back for thinking so responsibly and being such a conscientious parent. I threw some frozen broccoli in a pan, turned on the stove, and went back outside to flip the burgers.

15 minutes later, I brought the grilled goodness inside to find a kitchen filled with smoke. I’d totally forgotten about the veg and burned it black on one side.

As my wife, Alison, dressed her cheeseburger 10 minutes later, she looked at the blackened pan and asked, “What happened over there?” I informed her that I had “ruined the broccoli” in a less-than-friendly tone. Ali replied, “Well, why do you sound so upset?”

When I told her that I was disappointed that I’d messed up part of the meal and felt embarrassed about filling the kitchen with smoke she just laughed. “Andy, no one cares about your broccoli.” The kids jumped in and said “She’s right, Dad. We were kind of bummed when we saw you get it out.” 

And with that, everyone began to happily crunch chips and devour cheeseburgers as if nothing had happened. I decided to hear what they were saying and just let the whole broccoli thing go. We had a great meal together.

I wonder how often I’ve burned broccoli that no one else cared about. How many times have I pushed myself to finish something before going home when no one would have cared if I’d just done it the next morning? How many events for my kids have I beat myself up for missing when they honestly didn’t care in the slightest? How many clients have I called over and over again when they would have been completely content with a text message? How many promises have I made and struggled to uphold when the person I promised honestly didn’t give a crap?

Sometimes we push ourselves to standards no one else holds for us, and we tell ourselves that we’re a failure if we don’t succeed. I think that mentality is often the difference between feeling accomplished and feeling like a failure. We’d all probably benefit from stopping now and then to ask ourselves “Does anyone else truly want this? Is this a standard that actually matters? Does anyone care if I burn this broccoli?” If the answer to any of these questions is “no,” maybe we can just take that responsibility off our plate and feel fine about it.

Is Purpose-Driven Leadership a Double-Edged Sword?

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Josh Vaisman joins Dr. Andy Roark on the Cone of Shame Veterinary Podcast to talk about positive psychology and purpose driven leadership. Together they look at both sides of purpose, how it can be motivating to a team and how it can also be weaponized. They also touch on how purpose should not be prescribed and why it shouldn’t be set in stone forever.

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Josh Vaisman on LinkedIn: https://www.linkedin.com/in/josh-vaisman-mappcp-pgd-8371877

Flourish Veterinary Consulting: https://www.flourish.vet/

Lead to Thrive Book: https://www.barnesandnoble.com/w/lead-to-thrive-josh-vaisman-mappcp-pgd/1143946758

Uncharted Veterinary Conference 2024: https://unchartedvet.com/uvc-april-2024/

Leadership Essentials Certificate: https://www.vetfolio.com/learning-paths/uncharted-leadership-essentials-certificate

Charming the Angry Client Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: https://drandyroark.com/store/

ABOUT OUR GUEST

Josh believes all veterinary professionals deserve to feel fulfilled by their work, each and every day. Through his company, Flourish Veterinary Consulting, he combines more than 20 years of veterinary experience, a master’s in applied Positive Psychology & Coaching Psychology, and education in Positive Leadership and Positive Organizational Scholarship and a passion for guiding leaders to cultivate work environments in which people can thrive.

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. Guys, I am here with Josh Vaisman, who You get to hear my thoughts on Josh Vaisman in just a minute. I really like him a lot. I don’t tell him that in this episode. I tell him the opposite and you’ll hear why.

But I like Josh a lot. He is a really interesting person. He’s a really deep thinker. Boy, I throw hard curveballs at him today. I asked him about motivating people. And then when he tells me that purpose is important, I tell him. What my concerns about motivating with purpose are, and then he breaks them down into things, ways that we should not motivate people with purpose or use them to drive our culture.

So we talk about weaponizing purpose. We talk about prescribing purpose and we talk about purpose and me. And so he sort of breaks out in these three different, different components and we go through it and I press him for examples and push him to see if he can convince me of his ideas and man, he does pretty darn good.

But this is something I’m really interested in so he gets the full court press in this because I really well I put him through his paces because I wanted to ask him about some stuff that I’ve tried to figure out and things that I wrestle with a little bit, you know in my own job and my own teams and so anyway, that’s it.

But he boy, it’s a great episode. So, all right guys, that’s enough from me. Let’s get into this. 

 Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark

Dr. Andy Roark: Welcome to the podcast Josh Vaisman. How are you?

Josh Vaisman: I’m doing good, Andy. How are you today?

Dr. Andy Roark: Man I am sick of your face. That’s where I am. I am so sick of you.

Josh Vaisman: Yeah. 

Dr. Andy Roark: I tried to hold it back and I just, I didn’t, I made it this far in the podcast before I have to tell you. My employees think that you are so great. They are so enamored with you.

And the number of times I have had to hear about what Josh Vaisman thinks, and what Josh Vaisman says, and what is in Josh Vaisman’s book, I just, I didn’t know that I could get through this podcast, and I can’t. I just have to tell you up front. I can’t take it anymore.

Josh Vaisman: You know, I get it. I think you need to add your name to the list of people whose nightmares include this.

Dr. Andy Roark: Josh’s face. Oh, no. It’s I– it’s one of those things I was like, ah, I have to go talk to Josh now because clearly his book is phenomenal and people like I, my employees are literally passing a copy around and like someone’s like, have you read Josh’s book? And she’s like, no, I’m going to get it when Tyler’s done.

I was like, You can have mine. Like, he sent me one. Like, he gave it to me.

Josh Vaisman: It’s true. It’s true. 

Dr. Andy Roark: And they’re like, No, I’ll wait for Tyler’s. It’s annotated now. I’m like, Oh, you gotta be kidding me. So,

I’m like, I, I write stuff, and they’re like, it’s not like Josh’s book. You don’t. And so, anyway, that’s my personal hell. I’ve heard from years, like, practice owners say, You know, I tell my team this, and then you come and say the same thing, and they listen.

I’m like, I had that experience at a staff meeting. I was like, well, guys, I, this, I really think this is what we should do. And they all sat in silence, and one of them said, That’s what Josh Vaisman says too. And they’re like, oh, okay, let’s do it. And I was like, oh, you gotta be kidding me. So, anyway,

Josh Vaisman: Andy, that could be your new in with the team. The next time that you need them to do something, you just say, well, you know what Josh suggested.

Dr. Andy Roark: You know what Josh Vaisman says? Let me, I’ll quote you, I’ll enter into the quoting Josh Vaisman contest.

Josh Vaisman: Just make up a quote and just tie my name to it. And, you know, yeah,

Dr. Andy Roark: As Josh Vaisman says, working an extra hour on the weekends is good for character. No,

Josh Vaisman: There we go. Yeah.

Dr. Andy Roark: Anyway, that’s not it. Let’s talk about your book because it’s all I hear about in my team.

It’s called Lead to Thrive, The Science of Crafting a Positive Veterinary Culture. And so, Talk to me about a little bit, lay down some background of kind of how you settled into this, what your objectives going into the book were, like, when you were like, I’m gonna, I’m gonna write a, as opposed to doing a speaking tour or a course or whatever, like, I’m gonna write a book.

What were you hoping to do with this book?

Josh Vaisman: I was hoping to somehow have the opportunity to make your every day a living hell at work.

Dr. Andy Roark: I knew it.

I knew that’s where you were going.

Josh Vaisman: I, Andy, I, gotta tell you, I often share with people, and I really do mean this, I’m, I truly am being serious here, I was a failed leader in veterinary settings. I had a wonderful opportunity to be a managing partner in a couple veterinary practices, the on site hospital director, thinking that I was showing up with great intentions and leading well.

And the reality is that I didn’t do a good job of it. In fact, I didn’t do a good job of it to the point of actually causing unintentional harm to other people and myself. And going through an experience like that, I had this sort of realization that I only could do the best that I had with the tools and the skills that I knew.

And no one had ever taught me a different way to do things, so I defaulted to what I thought I knew, and it wasn’t working. I wanted to make sure that no one else had to have that kind of experience. That no one else in a leadership position in this wonderful profession that we’re in ever had to go through the kinds of trials and tribulations that I went through.

I wanted them to have a set of tools so that from day one, they could be the kind of leader that they aspire to be.

Dr. Andy Roark: I love that. When you start sort of laying out your book, you start talking about sort of positive psychology and what it is and what it’s not. And, one of the things that I sort of picked up, I wrestled with this early on in running my team and stuff. Because a lot of things that you talk about are, I think are, real, I mean, the book is really good.

It’s a really good book. The things that you talk about, they’re absolutely important. And I have felt, sometimes in the past, like when my team talks about positive psychology, psychological safety, things like that. At some point, as the person who has to kind of make the sausage actually get made, I’m like, guys, we can’t, it can’t all be good vibes and warm, fuzzy feelings, as much as I want it to be.

Like, I am a very positive person. We’ve got a very good culture on our team, and I feel like we have for a long time. And also, there are some parts that are not fun, and sometimes people are uncomfortable, and that’s not failure. And so I wrestled a bit with this, positive psychology means that it should be good feelings, good vibes, comfortable all the time.

And you sort of start off your book talking about that sort of idea. Can you sort of lay out your thoughts on that?

Josh Vaisman: Oh, absolutely. I appreciate you bringing that up, because it’s actually a very important distinction to make. Positive psychology and this approach to positive leadership that I’m trying to convey in the book is absolutely not about happy, joyful unicorns and rainbows, feeling, you know, cuddling with kittens and puppies all day.

It should not be that way. In fact, that’s in some ways the antithesis to the message. What positive psychology and this approach to positive leadership is really about is a recognition that the work that we do in veterinary medicine, regardless of what role we’re in, whether you’re a small animal practitioner in a local general practice.

You’re a solo equine practitioner out in a truck. You work in industry. You work in pharmacy, you know, pharma. Whatever you do in this profession, you are facing daily stressors. This work is deeply purposeful, and it doesn’t always feel meaningful. Positive psychology is an approach to taking difficult things and finding ways to make them fulfilling so that even though we’re doing hard things, we still find joy and well-being in the overall trajectory of where we’re going.

Dr. Andy Roark: So, you say this profession is purposeful, but it’s not always meaningful. Par parse those apart from me a little bit.

Josh Vaisman: Sure. Yeah. So, I’ve done this activity in front of audiences where I’ll ask them, tell me what you see as the purpose of veterinary medicine. And Very quickly, people come up with things like we all know intuitively in our mind that the work that we do has a purpose to it. I have a good friend, a colleague of mine, Zach Mercurio.

He’s a researcher and a speaker and consultant out of Colorado State University. And Zach often talks about the difference between the purpose of work and the purpose in work. So the purpose of work is how people tend to respond to that. You know, I hear things, Andy, that you’ve probably heard similar things.

You know, veterinary medicine exists. To celebrate the human animal bond, veterinary medicine exists to give voice to the voiceless, veterinary medicine exists to make sure that our, you know, our food net is safe. You know, all of those things apply to veterinary medicine. There’s a why, a purpose that drew us to do this kind of work.

But there’s a thing about purpose of work. Purpose of work can get diluted over time. So you become a veterinarian. I imagine if you think back to, you know, your first day on the job in practice, it was probably a mix of excitement and terror, but you really felt like you were doing the thing that you meant to do.

You know, now I finally made it here. My why and the what I do are intertwined. And now years in, for a lot of us, what happens is that day by day, the why and the what start to separate. And the why just becomes what we do every day. It’s sort of like the water around a fish or the air around us. We don’t really notice it’s present until it’s gone.

The purpose in work, that experience of meaningfulness, so meaningfulness you can think of it as purpose activated. It’s when I have an acute experience that to me I perceive as positive, purposeful, and significant. So I’m doing something right now that feels like, wow, this is meaningful. That’s purpose activated.

That’s that why and that what slamming back together in a singular moment. So we can be doing work that is imbued with a deep amount of purpose, being a veterinarian. And it doesn’t feel purposeful in that moment. When the client is standing in front of you and they’re in a bad mood, and you feel like, you know, you’re shorthanded in the team, and you’re overwhelmed, and things aren’t really going right, and you lost a patient yesterday, or whatever might have happened, in that moment it doesn’t, you don’t feel the purpose of your work.

You know it’s there, but you don’t feel it.

Dr. Andy Roark: So, are you saying you don’t feel it because it’s not the purpose being activated, as you put it? Like,

Josh Vaisman: Yes, there are things that we can do that can activate purpose and there’s things that we can do for ourselves. But what I like to encourage people to think about– and that’s what the book is really about is– when we’re in a leadership position, we have an unbelievable opportunity, a gift, if you will, to be able to increase the opportunity for meaningfulness in work.

We can take the purpose of work and activate it into purpose in work for others. And that’s the key thing. If you think about the definition of meaningfulness, that it’s positive, purposeful, and significant, that’s significance. That’s almost always involving another human being. It’s an impact on the world, right?

If we can show people their impact in, in, you know, meaningful, intentional ways, it activates moments of purpose. It activates moments of meaningfulness for others.

Dr. Andy Roark: So, when you talk about leading with purpose, leading with meaningfulness, what I’m hearing you say is that this is a focus on activating these moments, right? To making sure that we have these expressed moments along the way. I am very much about purposeful leadership in that I always, I, have a mission, we have a higher purpose, we talk a lot about what is the mission, what are the values, what are we trying to accomplish, what does done look like, and I talk a lot about that, and I talk to people about what are their motivators, what do they care about, how do they feel appreciated, and I talk about those things a lot.

Is there a is there a double edged sword here? Is it possible that we talk to people about purpose in a way that they ultimately I know this sounds a little bit strange to say, but one of the things I’ve run into in my career at certain times is I’ve always been very good to get people to focus on the meaning and the purpose.

I have seen frustration come back when people say, well, we talk about the purpose, and now We have to meet these sales targets that are coming down from, you know, from corporate, or we have to do these other things and this is incompatible with my purpose. And for me, it’s always, it’s, as I’ve gotten older, I’ve gotten a little bit less likely to talk about purpose as directly as I used to.

In that, I still weave it into what we do, and I very much talk about it. But it also, I’m, I get a bit wary that when we, when we navigate the difficulties of practice, not every day is going to be a celebration of the bond with the pet owners. Because some days we’re just going to have angry people.

And then people go, “God, I’m here for my purpose, and I did not achieve my purpose, today was a failure.” And I go, No, it was a success in so many other ways, but we can kind of get myopic about defining this goal almost too tightly. And so I don’t know if that makes any sense when I say that, but, do you ever have that kind of balance idea of how we talk about purpose?

Can you lean so far that you’re just dogmatic about what the purpose is? And then people say, This is all that we care about, and I just, I’ve never been able to actually work in clinical practice because there’s always, it’s a mixed motive game, and, you know, the group that we work for has got motives, and I’ve got motives, the things that are important, and the client’s got motives, and so, Yeah, so I don’t know.

Do you parse that apart? Do you just continue to lean into values? I know this is sort of a hard question, but I’m really asking you to insert these are things that I struggle with is I’m on board with purpose. Don’t get me wrong, but at some point we’re playing at a very high level of motivating people in difficult challenging changing circumstances and I go how tightly do you hold the wheel on this Josh?

Josh Vaisman: Yeah, I think it’s a really important question to explore. There are 3 things that were coming to mind as I was listening to you describe that, that experience that you’ve had around purpose and, some of those other things and, especially that that, that marker that you landed on of, like, not Every day is going to feel like a celebration of the human animal bond.

And that’s just the reality of our work. So three things, I’m going to say them out loud, and then I’ll kind of come back to each of them. The first one is this idea of purpose being weaponized. it’s never helpful to weaponize purpose. The second. Yeah, I’ll come back to that. The second thing is purpose being weaponized, the, oh gosh, I just had it in my head and now it’s escaping me.

 The third one is, um, it’s, uh, purposeful to me, or meaningful to me is one thing to do. Oh, and then the second one that I was thinking was about purpose being prescriptive. We don’t want purpose to be prescriptive. And those–the second two kind of relate. So let me come back to the weaponization thing. There’s actually some really interesting research in, circles of research around purpose and meaning and work and things of that nature. Around the dark side of a calling. So, you know, we often talk about veterinary medicine, especially for veterinarians and technicians, is, you know, “I felt called to this work.”

Dr. Andy Roark: Yeah. I don’t like that. I don’t, it’s not popular, but I’ll push back against that sometimes. I feel like it puts so much pressure on people.

Josh Vaisman: A hundred percent. 

Dr. Andy Roark: If you’re called to something, you have zero exits. You know what I mean?

It’s like, it’s like the only option is come, is failure or to continue down this path.

And I go, Oh, yeah. God, why would you hem yourself in? And it’s the story we tell ourselves. But I know that some people go, no, it is a calling. And a lot of people say that to us in a very kind way. They’re like, oh, this is a calling. And I’m like, it’s really not. It’s just a job. 

Josh Vaisman: It’s just a job. 

Dr. Andy Roark: Hey guys, is your clinic slowing down? Are you having more open appointments than you had in the past? Are you wondering a little bit about what you need to do to get clients to, one, come into the building, and then, two, listen to your doctors and your staff when they get there? Well, you, my friend, might need to head over to the Uncharted conference in April.

That’s right! It’s in Greenville, South Carolina. It is April 18th through the 20th. This is the granddaddy of the Uncharted Veterinary Conferences. This is the one that we started with. This is our marketing and strategy conference back to our roots. I love this stuff! The theme of this conference is ‘Standing Out In A Sea Of Noise’

It is all about strategic communication. It is about getting heard. This is going to be a lot about your brand identity is understanding the modern consumer who is getting more price conscious because things are getting more expensive. We are going to need to up our marketing game, our communication game, our client bonding game, our trust building game, we’re going to have to turn the volume over on that stuff.

Guys, we didn’t have to do that for the last couple of years. People have been coming in, the pandemic was a surge in business. A lot of us are trying to keep our head above water. It’s not going to be that way going forward. It’s time to re-engage with our clients in a motivating, educating way to get them coming back into the building.

Guys, Uncharted is not a bunch of lectures. You are not going to come here and sit in lectures. You are going to work on your business at this conference. You are going to be surrounded by butt-kicking, positive people who love that medicine, who love pet owners, and who want to create a great experience and make a wonderful place for pets to get the care that they need.

They want to have a positive workplace. They want to have a place where people smile when they come to work and they’re working on making that happen. And so if that sounds like you, or if you want to be surrounded by those people, you got to come to the April conference. Also, this is the last time for a while that the April Uncharted conference is going to be in Greenville, South Carolina.

This is our birthplace. It’s our home base. It’s our nest, this is kind of a big deal for me, at least. I, you know, I, I have loved this conference in Greenville. I still love it in Greenville. I think Greenville will always be our home, but guys, we’re spreading our wings. We are going to be moving out and doing new things and going to new places.

And it is going to be amazing. But if you want the original Uncharted experience, if you are like, man, I’ve heard so many people talk about Uncharted in downtown Greenville and how the conference just fits into that community and how amazing it is, this is your chance. You want to be here. Also, if you have been an Uncharted member, if you’ve come to our conferences before, if you loved it, you always thought there’d be a chance to come back to the old Westin Poinsett and downtown Greenville you should grab a spot.

I think that there will probably be a chance in the future, but it won’t be for a while. I think there’s going to be a lot of people coming back because they want to do it one more time at the Westin before we move on and check out some new places and do some new stuff.

So I do expect this event will sell out. Guys, go ahead, head over to UnchartedVet.com and grab your registration spot right now. I’ll put a link down in the show notes. Again, you do not want to miss it. This is an investment in yourself and in your practice and your future. It is an investment in skills that you will have and use again and again, and it’s an investment in connections.

You are the average of the people you spend time with and you’re about to be surrounded and spend time with some really amazing people. Anyway, let’s get back into this episode. 

but it’s just a job. And I have, I’ve gotten more and more willing to say that. not to pet owners who are being nice, but to our colleagues. Cause I really, I don’t think that’s good headspace for us.

Josh Vaisman: I completely agree with you. There’s a veterinarian here in Colorado. She’s a friend of mine and she’s been advocating for exactly what you just said. She is on a lifelong mission to encourage people in our profession to embrace the phrase as a positive. It is just a job.

Dr. Andy Roark: It’s just a job. Yeah. 

Josh Vaisman: Her name is H. Howells, by the way and H is shout out to H. She’s doing some really, great stuff out there in the world. 

Yeah. You know, when there’s a risk to viewing work as the sore, the sole source of your identity or the sole source of your sense of purpose or meaning in the world, there’s a risk because it can become exploitative.

Whether people intend it to be or not, so the research that I’m referencing here was on zookeepers and what they found was that there seemed to be a very strong relationship between their sense of calling, how they thought of their work as a zookeeper as a calling, and all sorts of deleterious outcomes like burnout, overwork, all those kinds of things.

So we never want to weaponize purpose. We never want to make purpose these, like, a thing that we’re using to coerce or manipulate Others. We got to be very careful 

Oh. So, so, so let me give you an example here. So it sounds like what you’re saying is The old, I mean basically it’s the old, If you really cared, you would do this for free, or I thought you loved animals. How could you charge me money for this surgery that you know have? And that’s very much weaponizing purpose and uh, they’re guessing about what your purpose is, but if they’re right, boy, they’re, that, but that’s why vets get so upset about that particular barb is because it is weaponized purpose. You know, it is, it is, weaponized morality. And so, it,

it really, it hurts. It stings.

Another version of that may be a bit unexpected. It’s certainly a bit more subtle when you referenced those days where like, listen, it was just a shit day. Everybody was mean to us. Nothing really went well. We’re all ragged and overwhelmed and feeling a bit crusty. If I walk into that space as the leader in that practice, the medical director, the lead technician, the practice manager, and I say, “Hey guys, I know today was tough, but let’s talk about how we lived our purpose today.”

That can also feel like weaponization. That can feel dismissive to people. That can feel like Not always, but there are times where

Dr. Andy Roark: Tell me more about that. So, okay. Yeah. Paint, paint me a more clear picture of this, Josh. So, so, so it’s been a crap day and I walk in, I say, guys, today was a bad day, but hey, we really lived our value, we really pursued our purpose today. Tell me why you don’t like that.

Josh Vaisman: I’m not saying I don’t like that. I’m saying that we need to be cautious about how and when we use that. So an example I’ll give you, you’re married, you have a wife, your wife, you come home from work and your wife starts telling you about all of the things that were bad in her day. And your first response is, well, something must’ve gone well today.

Tell me what went well. How is she going to respond to that?

Dr. Andy Roark: I Get that. Yeah, that’s like the old I love the phrase choose happy and I have a hundred percent seen choose happy used to dismiss people of well You got to choose happy Like at some point you’re like I got screamed at they look spittle on my face and “well, you should choose happy” 

Josh Vaisman: There’s a reason for that. 

Dr. Andy Roark: Like okay.

Are you serious? Okay. I got ,now I’m on board with this. Okay, I got 

Josh Vaisman: Yes. So when we walk into a space where our team is completely downtrodden from a terrible day, and our immediate reaction is to try and pull the purpose back to make them feel better or to make them see that what they’re doing is meaningful, you can’t force purpose on somebody.

You, you have to, there’s an in between phase that we call empathy. And that has to happen first, right? Before you can start tying it back. So that’s one of the, I mean, there’s, very clear examples of weaponizing purpose and where we literally exploit people. But there’s less subtle ones that we need to be aware of.

There’s also the prescriptive side that we have to be cautious of. Your purpose is not what I tell you it is. I don’t get to prescribe that for you, right? I don’t get to, I don’t get to go in my little back office and decide, okay guys, these are going to be your values now. Now go live them.

It has, there has to be some sort of communal you know, collaborative effort to activate purpose.

I can’t tell you that things were purposeful. I have to show you that what you did was purposeful. That’s different. That means I have to understand what you talked about earlier. What are your motivations? What are the things that really seem to matter to you? When do you light up and how can I tie what you’ve done to that?

For you, because sometimes we can’t do it for ourselves. So we got to be careful about it being prescriptive.

What was the third one? I forgot what the third one was now.

Dr. Andy Roark: Purposeful to me. 

Josh Vaisman: Purposeful to me. Yes. Thank you. Sometimes the experience of meaningfulness is not actually activated through that quote higher purpose that we think of in our work.

Sometimes it’s simply through human impact. So there’s a tool you’ve probably actually heard of this. I would be willing to bet because I know you well enough that you probably already do this on a regular basis. But there’s a feedback tool that we often try and teach folks. The acronym for it is SBI.

Maybe you’ve heard of it. Situation Behavior Impact.

Dr. Andy Roark: Yeah.

Josh Vaisman: Sometimes that tool is used for corrective feedback, but often it’s a really, yeah, often it’s actually a really nice way to meaningfulness in somebody. Andy, when You asked me the question about purpose and how I think of it from my book, right?

So that’s the situation and your behavior. Gosh, it really made me feel like you really did actually take some time to read through what I wrote and you took it seriously and so seriously that you put some thought into it and threw me a question that actually made me think. Gosh, what an impact that had on me.

Thank you for doing that.

Dr. Andy Roark: I did not do that, I’ve just a book that’s been quoted at by members of my team and until I know it, I just know it. I can quote pages to you. 

Ah, right. 

I did. But no, I love it. We teach a very similar model at Uncharted the company I run, which is basically an engagement sort of question or statement.

Dr. Andy Roark: And then the behavior statement of this, we. when you behave this way, when you said this, is what the outcome was. And the last thing is, what would I like you to do with that? Would you keep that up? Thank you very much. Or, could we do that differently in the future? But yeah, it’s, but it’s, you’re right, on it.

It’s very much about that, you know, I would say, you know, people are simple animals and I don’t care how many degrees you have. And we know how training works and it’s generally positive. And it’s about being clear about the behavior that you see and that you’re trying to recognize and reinforce.

And so, anyway, I just think, I think that’s, I think people, when they think about feedback, they immediately think of negative feedback. And I’m like, but why? We don’t, that’s not how we, that’s not how we do training.

Josh Vaisman: So, so I think of that day that you mentioned, that day where it doesn’t feel like anything tied to our purpose of, you know, celebrating the human animal bond. It was that horrible day. Now, imagine that I walk into that space and I say, guys, today was awful. And I gotta be honest with you, I don’t know that

I felt at times that I was going to make it through the day, but you know, Andy, earlier, when you jumped in with that cranky client, when you could see that I was like at a loss for words, and you jumped in and you made those two statements that you made, not only could I see the impact it had on the client, but gosh, that actually made me in that moment feel like maybe I can get through today.

So thank you for doing that. That is activating meaningfulness. That’s showing that Andy, that thing that you did in this God awful, horrible day, it was positive, purposeful, and significant for me. So thank you for that.

Dr. Andy Roark: Oh, I, love that. This, fits into, you know, one of the things, the reason I always love talking with you is because there’s a lot of practices that I’ve come up with or that we’ve come up with Uncharted and we use. And then I’ll talk with you and you sort of lay down the science behind them.

I’m like, oh, that’s, I love it. I knew, I know it works. We’ve done it, you know, for years and hundreds of times. So one of my big things, I’m not a big mission statement guy. For, just logistical reasons mostly, but I am a huge core values guy, and so I, I love core values from teams, and and I love for a team to come together and say these are our values, and then one of my favorite, in order for, to make core values work, they have to be real, because talk is

cheap, and so one of my favorite things is the example exercise, where I say, you know, we we’ve got our core values painted on the wall today was hard, you 

And I’m wondering if any of you saw anyone on our team living our values.

And then somebody says, well, I saw integrity as our core value. 

And I saw this person talking to a pet owner who was trying to sort of be manipulative and she was very kind, but she did not bend the rules. She said, this is how we do things. And to me, that’s acting with integrity. And it’s just,

it’s this beautiful thing, especially if you take it to the team, because then they’re reinforcing each other. And

Josh Vaisman: Yes. 

Dr. Andy Roark: I don’t want to build a culture where the culture is the leader, Andy the leader is amazing. And so that’s why we’re here. that’s not a culture. That’s like a cult, you know, and like I want them to appreciate each other and to create that experience for each other.

So I really love how you kind of laid that out. But to me, those examples of values, I think are kind of right, right in line. Let me ask you this. I know we’re gonna, we’re sort of running short on time, but, this is something I’m just really curious. So one of the things I’ve sort of come to believe is that one of the things you have to do if you want to have a team that runs on values is you have to hold those values kind of loosely and be open to recreating them as the team changes.

And so what I do so I’ll say I, I don’t have a problem putting the words on the wall. But I still think you have to be willing to paint over those words and paint new words every couple of years because my, what I have seen is exactly what you were saying is if I bring people in and I say this is our culture, to some degree that works, especially it works if it’s one new person coming in and they sort of integrate into that culture.

But over time, if I have people leave and I have new people come in, which is not failure, by the way, that’s just. That’s growth and development and life and how things 

go is the 

Josh Vaisman: Agreed. 

Dr. Andy Roark: impermanence of our world. And so they come in at some point, it’s probably good. I think to step back and say, let’s take a blank slate here and let’s come back together and talk about what we really believe in.

And I find that process of laying down the values is such a bonding process for the group. I’m not interested in having, you know, the, holy values and purpose that don’t change because that’s not really what the, what everybody’s feeling. And so, so to me, I’ve just kind of bought into the idea of everybody can hold this up, but also know that this is going to change as we change and the world changes.

So let me pause there and just ask you that question, Josh, when you think about the purpose and you think about getting the team on board. How permanent is that purpose in your mind? How, how sacrosanct is that? How untouchable is it versus this thing’s play dough. And I don’t think we want to change our values every week, but I, but anyway, I’ll just, so let me stop talking there and just to say, how does that mesh with sort of your thoughts?

And you could feel free to tell me, I think you should push harder to keep your values, Andy. I don’t know. What are your thoughts?

Josh Vaisman: No, I don’t think I’m going to do that. In fact, I’m going to ask if I can come work with you so that I can also join in quoting my book on a regular basis. No, I really love this. What you’re talking about is a sense of community around why we’re here. So, you know, one of the things that we often ask when we’re working with organizations is, you know, when we’re trying to do this sort of organizational identity work, like really define who are we and who do we want to be in the world, right?

There are questions that need to be, ah, that need to be answered to really get to that. and we’ve tried to sort of simplify it into three questions. Why us? Why now? Why here? Right. And if you, those questions, you’re, you may have very different answers to those questions five years from now than you have right now.

And it’s actually worth consistently revisiting those questions. Culture, organizational identity, core values, purpose, mission, vision, all of those things should be as organic as we are. They should be as shifting as we are. They should change over time if we change over time. And the only way that we’re going to know if they have to change is to ask the questions.

Hey guys, you know, a year ago we sat down, we had this conversation and this was the conclusion that we all came to. Does this conclusion still work for us today? What doesn’t work anymore? What do we need to evolve? Where do we need to pivot? What do we need to renovate? But that word renovation is something I’ve been playing with a lot lately.

I think about like, you know, in this house, my wife and I have lived in this house that I’m sitting in right now talking to you from for 15 years. And every couple, three years, my wife gets an itch. She looks around at something that we’ve, you know, that we did a couple, three years ago, move some furniture around or painted the cabinets or something.

She says, you know, I think we could do that better. And then we launch some new renovation project in the home. That’s kind of the reality of living in a home. It’s very uncommon that we move into a space and keep it exactly the same for 50 years. Something changes over time. Our workplace environments should be the same and we should be able to evolve that.

So I love that you do that and I love that you include your team in that effort.

Dr. Andy Roark: Well, it’s just something, so first of all, if you want to motivate your team, you want them to own the purpose and the values.

Josh Vaisman: Yes. Yes. 

Dr. Andy Roark: It’s funny the number of people who come to me and say, Andy, I have a purpose. Help me to indoctrinate the team into this, they don’t say it that way, but that’s what it is.

It’s how do I bring the stone tablets to the team in a way that they’ll. Pick them up and honor them, and I’m like, I don’t know, buddy, I’ve been doing this 20 years, and I’ve never been able to pull it off I, but I’m pretty good at getting the community to come together, circle up, and we can hammer, you know, some cool stuff into some tablets together, and then it’s their tablets, and they’ll, be all about it.

But we can do that. But I just think that’s sort of a fundamental thing. And so if you buy into that, I’m not bringing the tablets down the mountain. We’re gonna circle up and create our own guidelines. I think you have to buy into the ideas. If you believe in that, 

then you probably also have to believe in the fact that it’s not Once you make it, it’s not permanent.

You’re going to have to make it and remake it. There’s also sort of the It’s almost well, what have you done for me lately? Idea, too. We’re just because we were all excited about this purpose five years ago. Maybe that’s not what we’re feeling today, you know, and we should have a different purpose.

But anyway, I don’t know I really enjoy these conversations. I think it’s fun to just think about what we’re doing and what really matters But I think that’s

something that We need more of in that medicine. It’s so funny because we’re so innately purposeful. Like we do such meaningful

Josh Vaisman: Yes. 

Dr. Andy Roark: But we just don’t talk to our people enough about like hey, what are you really doing?

Maybe I don’t know if you think about what you think about this but maybe it’s because we make assumptions about what people’s purpose are

Because such a strong purpose. You know, we’re like, you’re here for the human animal bond. And like, I don’t know, maybe they’re not here for that.

Maybe they’ve got other reasons. So, anyway, Josh Vaisman, thanks so much for being here. I don’t care what my team says. I still think you’re okay.

Um, Just okay. 

And, uh, your book, Lead to Thrive, The Science of Crafting a Positive Veterinary Culture, I’ll put a link down in the show notes for that.

Where can people find you online? Where can they follow your adventures and learn more from you?

Josh Vaisman: Before I respond to that question, you know me enough by now to know that I have to leave with some sort of complimentary remark. 

Dr. Andy Roark: Are you Canadian? 

Josh Vaisman: No, but I’ve 

Dr. Andy Roark: Honorary Canadian.

Josh Vaisman: Yes, I’ve been to Canada. So, I feel like I absorbed a little asmotic. Andy, I You and I had a conversation before this episode started, and then we’ve gotten to talk for the last 25 or 30 minutes in this episode.

And you know, one thing that is really emerging to me is you have this beautiful way of being very confident in your beliefs, but also being open to revising them. And that is a very special mix. That I think back now in my career in vet med and just watching you and in the work that you’ve done, and I think you’ve actually had that mix for a long time.

And you’ve sort of set the stage that this is possible in our profession. That really means a lot. And I really appreciate you sort of opening those doors for the rest of us to walk through to be able to do that as well. So thank you.

Dr. Andy Roark: Oh, you’re very kind. Thank you.

Josh Vaisman: Where folks can find me flourish.vet is our website. That’s where you can find Flourish Veterinary Consulting.

We’re pretty active on Facebook and Instagram as well. And then I personally like the sound of my own voice a lot in written form on LinkedIn. So if people want to read my musings, that’s a good place to find me as well.

Dr. Andy Roark: That sounds great. Thanks a lot for being here. Guys, thanks for tuning in everybody. Have a great day.

And that’s our show. I hope you guys enjoyed it. Thanks to Josh for being here. Gang check him out. If you’ve not picked up a copy of his book, I’ll link it up in the show notes. Definitely go and grab it.

I’m not kidding when I say my team loves it, and they quote it, and they talk about it, and they kick it back and forth, and it’s just it has been something that they have really liked, and it Pushed me to go back and I get, everybody sends me books. When people in vet medicine write new books, they generally send me a copy and I love it.

But I get a lot of books and his has absolutely stood the test of time and it has been brought up again and again. And so, anyway, if you are looking for something to read and you like positive psychology, like the idea of running healthy, productive teams, there’s a whole lot worse resources you can find than that.

So anyway, maybe take a look at it. I’ll link it up for you. Take it easy guys. Talk to you later. Bye.

How to Reinvent Yourself

by

Dr. Sarah Boston returns to the Cone of Shame podcast, this time to discuss her career journey, which includes major pivots from academia to comedy. Between slaying dragons, climbing ladders, and dealing with expectations, Dr. Sarah Boston and Dr. Andy Roark provide great insight into reinventing yourself.

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

Dr. Sarah Boston & Comedicine Podcast: https://www.drsarahboston.com/

Lucky Dog: https://www.amazon.com/Lucky-Dog-Being-Veterinarian-Saved/dp/1770893512

Uncharted Roadshow in Atlanta: https://unchartedvet.com/product/on-the-road-atl/

Leadership Essentials Certificate: https://unchartedvet.com/uvc-april-2024/

Charming the Angry Client Course: https://drandyroark.com/charming-the-angry-client/

Dr. Andy Roark Swag: https://drandyroark.com/store/

ABOUT OUR GUEST

Dr. Sarah Boston is a veterinary surgical oncologist who is an ACVS board certified small animal surgeon and an ACVS Founding Fellow of both Surgical Oncology and Oral & Maxillofacial Surgery. She practises with VCA Canada in the Toronto area. Up until recently, she has spent most of her career in academia as a tenured faculty member at both the University of Guelph and the University of Florida. Dr Boston is also a best-selling author of the book, Lucky Dog: How Being a Veterinarian Saved my Life and one of the creators of The Cageliner, a satirical online newspaper for veterinary professionals that she is currently woefully neglecting. She is also a stand up comedian and in spring 2023, she graduated from the Humber College Comedy Performance and Writing Program. She is the host of the podcast Comedicine, where she interview healthcare professionals who are also comedians. She is a nerd. She believes that we all need to laugh more.

EPISODE TRANSCRIPT

Dr. Andy Roark: [00:00:00] Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. I am back on with one of my favorite people in the world, Dr. Sarah Boston. Dr. Sarah Boston is a surgical oncologist. She has been a faculty member at more than one college of vet medicine. She is Lecture all over the world and she’s been to comedy school. She does stand up comedy I recently saw her at VMX doing the talent show where she has lectured as a surgical oncologist many times and I have watched her and she was there not lecturing doing talent show doing stand up comedy And so I talked to her about self identity I think it’s fascinating to watch someone who has the accolades that Sarah does just doing things that aren’t vet medicine at all.

And I’ve been thinking a lot about what ties us into our chair, what makes us stay where we are, what defines us in a way that we don’t feel like we can go do something else [00:01:00] because we’re too invested in this image of who we are. And that’s what we talk about today. And man is a really good conversation.

I took a lot of stuff away from this. It’s just anyway, I’m going to stop talking about now. Check out this conversation with Sarah Boston. I hope you’ll enjoy it. I think it’s really fun. I think she’s amazing Anyway, let’s get into this episode 

Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast. Dr. Sarah Boston. How are you?

Dr. Sarah Boston: I’m great. It’s great to be here.

Dr. Andy Roark: It’s great to have you. You were my first guest.

Dr. Sarah Boston: I know!

Dr. Andy Roark: You are, you were the first. I was like, I have this crazy idea. And I was like, who is not going to care if I never publish this? And I was like, Sarah Boston didn’t care. Like, she doesn’t care. And so I, [00:02:00] invited you to come and talk.

And I was also like, who do I have a lot to talk about with? And it was you. And so, You’re, you have been and always. You still don’t care that

Dr. Sarah Boston: And I still have a lot to talk about with you.

Dr. Andy Roark: Exactly! And so, here we are. For you, you have been and always will be the first podcast guest that I ever had. Yeah. I think I called the episode, Are We Bad People?

And I think that’s how it all No, it didn’t. It was about, it was not, that was a later one that you did. You’ve been on the podcast many times. Okay, for those who do not know you, you are a veterinary surgical oncologist by training. You have been a faculty member at at more than one veterinary school.

You are a stand up comedian. You you are an author. You have a book called Lucky Dog, which we’ll talk about a little bit in a minute. And you have just generally done a lot of things at very high levels. And so I was sitting back and kind [00:03:00] of reflecting here towards the early part of the year.

And I was thinking about sort of, I don’t know, I was thinking about my career. I was sort of thinking about where we go and how life changes. And it’s funny, my, my oldest daughter is 16 now. And so she’s driving around and I was thinking about how I identify as I still say I have little girls. And I do not have little girls.

I have six, I have teenage girls, which are very different, but I still say it like if, like, when I, if I don’t catch myself, then that’s what I, that’s what I think. That’s still how I identify. And, you know, I’ve just been, I’ve been thinking about life and how life kind of comes in phases. And so you, I look at you and you’ve done all of these different things. Your book, Lucky Dog, is it’s a great book. It is it’s, there’s not a lot of people who can write funny books about cancer. But, you wrote a, yeah, you wrote about, you, you wrote about practice and your time with thyroid cancer. And and sort of put that out [00:04:00] into the world, and it was, really good.

And then And then your surgical skill is great. And then you, were a college professor for, I mean, a vet school professor. And then I recently saw you at VMX in Orlando and you were in the talent show doing stand up comedy in front of like thousands of people. And you’ve been to clown college and you’ve just, you’ve done so many things. I was I was talking to this veterinarian recently and she was talking about her job and she was like, you know, I worked three days a week, which I know is not a lot I work only three days a week is the way she put it and it’s I get paid well And you know, I work with a great team and I’m just bored.

I’m just bored. Like, she’s like, I don’t like practice. I just, I don’t want to do this. And I was like, well, why don’t I get it? And she felt really guilty because she was like, I should be really happy, but I’m not. And I said, well, but, you’re not, you know, why do you feel [00:05:00] like you have to keep doing this thing the same way that you’ve always done it and she was well, it’s just kind of who I am, you know, like, I don’t know what else to do or what else to be and I’ve really been kind of rolling that around in my head as we get this, sort of self image, this self identity of kind of who we are and I’ve, I think I’ve Wrestle with it a lot in my career of what who am I and what am I trying to be and anyway?

I wanted to ask you your thoughts about that as someone who has sort of reinvented herself kind of over and over again

Dr. Sarah Boston: Yeah, I

Dr. Andy Roark: you ever yeah?

Dr. Sarah Boston: I strongly associate with what she’s saying though, because I think a lot of veterinarians feel that way. Like, I’m a surgeon, I’m a veterinarian, I’m a clinical veterinarian. And this inability to see being something else. And I actually think the further you go into specialization, like the harder that is to see.

So like, I’m still practicing as a surgical oncologist. And I love a lot of aspects of that. But I [00:06:00] definitely sort of think, Oh, like, should I do something different? Or, you know, what would that be like? But ultimately. I think I’m very pigeonholed and I think a lot of veterinarians are very pigeonholed and it’s great and it’s also not great at the same time.

Like it’s great to have that identity and something that anchors you and you can feel connected to, but I think it also, it’s restrictive and I’ve always had that. Like, cause I’m the person who wanted to be a vet when I was six and I’m from an artistic family. I’m from a family of creative people.

And that was not for me, like it, it just was like, no, she’s going to be a vet, like she’s going to do science. That’s what, she does, you know? And, again, it was great because I had a path and I had a focus and I was like, I got into vet school pretty quickly. Didn’t get a residency that quickly.

That’s okay. That’s fine. But like I was just on a path, you know, and then I think you can stay on that path and it was like, oh, now I’m boarded surgeon. Now I’m doing a fellowship. Now I’m faculty. Now I’m going to get tenure. [00:07:00]Then I changed universities. Then I had to do tenure again. Don’t recommend that, but it’s like, it all just, now you’re an assistant professor, now you’re associate professor.

I didn’t stay on long enough to be a full professor, but that was the. I was sort of on that track. I think it’s hard to get off that track. That was probably the biggest, as far as a transition of how I see myself or identify the change from being an academic, because I loved a lot of things about academia, to being like in private practice.

That, I think that has like, that’s a bit of an identity switch. Even if other people don’t see that, I see that, you know, I feel that. So. So I totally, I understand why veterinarians feel that way. I mean, I think the fact of the matter is though you can reinvent yourself, but I think there’s always a part of you that sort of hangs on to something.

So maybe that veterinarian is going to become a locum and explore other things or, you know, there’s ways you can do that. I still work 60 percent is what I work. And I, actually, I take issue with people saying I just worked three days a week or just two days a week, because I think. [00:08:00] Have I told you this?

I don’t want to talk about this, but like, it’s enough. Like,

Dr. Andy Roark: Yeah.

Dr. Sarah Boston: it’s hard. It’s not about how many hours you’re working. It’s my, I’m calling it my Peloton theory. It’s like, well, how fast were you pedaling and what was the resistance? It’s not about like, oh, I was on the bike for 20 minutes. No, like if you work 24 hours and you were like running around like a headless chicken all day, and there was a lot of emotional drama that always happens in a vet clinic and it was physically hard and it was, you had a lot of difficult cases.

It was like. I’m just saying, that’s enough. That’s enough work. And then, because if you do that 40 or 50 hours a week. Like I’ve done it. There’s nothing left. There’s nothing left at the end of that. But you don’t have energy for your partner. You’re, I don’t have kids. I wouldn’t have energy for them. I wouldn’t have any like for your dog, for your hobbies, like to do comedy, to do writing, to do anything, exercise, eat properly, all those things, like even basic stuff, I think a lot of veterinarians, they don’t [00:09:00] even have time to like eat a healthy meal, get eight hours of sleep.

So, yeah, I don’t know. I think full time for veterinarians should not be full time. Like, I think it’s just different and I think we need to look at it differently.

Dr. Andy Roark: No, like 

Dr. Sarah Boston: has nothing to do with what you asked me, but I just, I’ve been thinking about that a lot because I just, but I think it is a bit of identity because most veterinarians I know who don’t work full time, in quotations, they apologize.

Dr. Andy Roark: Yeah, I’m not or they wrestle with like I’m not a real vet And it’s like, oh, I know I’m not a real vet because I only work two days a week. I’m like, no, okay.

Dr. Sarah Boston: Oh, yeah. What else are you doing? Right? Like, and maybe you’re just. I’m just being an amazing parent. Awesome. important. Like that’s so important. And that, you know, I’ve seen colleagues who have kids and the time will slip away from them. Right. I mean, you, your little girls are, they’re not little girls.

And so, yeah, take some time out and do something. But, and so for me, it wasn’t children, but it was comedy. Just writing the book, writing a funny book about cancer, realizing that I love that part of myself. [00:10:00] And just wanting to explore it, but I wouldn’t like, I think people, what people think of me, if they know me or don’t know me probably more is like, Oh, that’s just so easy to do.

It’s not right. Because you think about, well, what? Okay. Probably the answer is nothing or it’s positive, but you will think, what do people think about me? Like I was an academic surgical oncologist doing all the things right. Doing all the papers and, all that. And now I’m like, I’m in a comedy club.

Dr. Andy Roark: You literally went to clown school.

Dr. Sarah Boston: I literally went to Humber college for, yeah, I literally went to comedy school for two years.

Don’t regret that at all. It was great. I actually just had this experience, this like a retired professor who I used to work with at Guelph. She really wanted to come see me do comedy. And that’s awesome. Right. I don’t, you know, but she’s older and I, she was emailing me a lot. She was like, Oh, I really want to come see you.

And so there’s a show that was like kind of nearby. It was like, I live in Guelph, which is outside Toronto. And this was like about 20 minutes away. She was really wanting to come see me. And so I was going to say like, [00:11:00] Oh, like it may not be for you.

Because it was like a real, like, stand up comedy show and there was a burlesque act.

There was a lot going on. I’ll just say a lot going on. It wasn’t like Sarah doing stand up at VMX, which is going to be clean corporate comedy, or Sarah doing stand up at a veterinary conference, which honestly isn’t always clean, but I try to keep in mind it’s corporate and I have to like, be ca This was me just actually working out a pretty dark set.

But I was like, should I change that for her? And I was like, well, no, that doesn’t make sense. So, and I almost said, don’t maybe, Oh, maybe you won’t like it. But then I thought, well, I shouldn’t discourage people from going out. What I want, who, what, I don’t know what she likes. So she came out, the host talked about, kind of did a monologue about addiction and a story about addiction.

Then someone came out and was like talking. I don’t know if I can say this on your podcast even, but. Oh, well, you’ll just edit it out, I guess, if I can’t, but she was talking about that she’s polyamorous and pansexual and talking about, uh, oh, dildos, I’ll just say that she [00:12:00] was talking about that. That was her act.

And then I did my fairly dark act. And then the next act was someone doing burlesque with a lightsaber to Star Wars. Like, Oh, you know, and then I was like sitting above her and her husband and a student that came with her. And like, I saw her husband get up and I was like, Oh, maybe he’s going to the bathroom.

And then it was like clockwork, like two minutes later. The student left and then two minutes later, she left and she had emailed me probably 12 times leading up to the show about getting tickets and she’s going to see me and all this. I have heard nothing. It’s been two

Dr. Andy Roark: was it. Like, like, she got up and left during the show and that was the last communication that you had.

Dr. Sarah Boston: And I’m like, Oh, I don’t even know what she thinks. Right. And I was like, well, I don’t know what to do with that. You know? I’m like, well, it’s stand up. Like, I don’t know. Anyway, that’s just a warning to anyone who comes and sees me like, it may not be your cup of tea. It’s different. It’s not like, it has nothing to do with veterinary medicine.

And, people, you know, this, like people do the comedy, like it’s totally a different world. [00:13:00] And sometimes I don’t like it. And sometimes I like it. Sometimes I’m like, what am I doing here? You know, like I am like, not, I’m in a comedy club and like the stuff people are talking about, sometimes I’m embarrassed to be on the same show, but I’m just like, it’s just is what it is.

So yeah, I. Anyway, that’s it was kind of like it did kind of make me think I wonder what she like thinks. And like what is she saying to people like Sarah Boston has completely lost her mind, you know Because it’s so has nothing to do with My life as a veterinarian, but I like that. Yeah. 

Dr. Andy Roark: I guess I think that gets to the point of what we’re talking about, right? Like so so this goes another way, too. There’s a multiverse, you know setting where Sarah Boston doesn’t do comedy , because you’re doctor Sarah Boston boarded veterinary oncologist you know, former faculty member, blah, blah, blah.

And, I can’t be associated with this, or I can’t go and do these things because I don’t want [00:14:00] people to see me that way. And I think a lot of people that carry that fear, I think the reason I wanted to talk to you specifically about this topic today is because you’re the person who is like, I’m going to go up there after the woman with her sexual history on display and you know and before the burlesque show And I’m gonna talk about you know stuff that I’m kind of working through that doesn’t really have anything to do with my clinical practice And so I but I think a lot of people would not make that call or They would be really conflicted about it And so that actually strikes at the heart of kind of what I wanted to talk to you about So this is exactly my point.

It’s like usually people would come to me and they would say I am thinking about I’m thinking about doing stand up comedy, but I’m worried that my clients will see it and I won’t be able to do this. And I would say something to them like, well, what’s the worst thing that could happen? Like, it’s what happened to you, is that they would actually get up and leave.

Dr. Sarah Boston: Someone that you respect, like a well respected specialist who probably [00:15:00] everyone here knows gets up and leaves. Yeah. And never communicates with you again. Yeah.

Dr. Andy Roark: It really is kind of about picking your poison, isn’t it, though? Like, if that’s the cost of doing the thing that you really want to do, really, you’ve only got two options. You could either, I mean, I don’t know, maybe you could have been more heavy handed about, look, really, do not come to this.

But, I don’t know. I agree with you, too. It’s, at some, you know, I think about that when I see stand up comics on Netflix, and they’re talking about stuff where I’m like, Oh, I wonder what their parents think when they see that. And again, that’s,

Dr. Sarah Boston: This was like exactly like that. So yeah, it was like a parent who wasn’t. Didn’t like it and left and never spoke to you again. You know, yeah, no, I, it’s weird because I, but I, do think first of all, pretty much everyone I tell that I do comedy, like they start laughing.

That’s a common thing. They’re like, really? Like at VMX, I’m like, Oh yeah, I’m in the talent show. You know, cause most [00:16:00] people saw me at VMX and were like, Oh, you’re speaking here. And I was like, no, I’m doing comedy and that was kind of weird for me. Like, honestly, it felt a bit weird. Cause I’ve only ever been to VMX as a speaker.

Because I’m not a primary care veterinarian, so I don’t, go to that conference as an attendee. I’ve gone as a speaker and then I went and I was like in a talent show and it did mess with my head. I will be honest. Like, it wasn’t like I was like, Oh, I feel like totally awesome here about this.

Like it, it, kind of was like, I was like, Oh, but then I, just was like, well, I’m here, like, I just, I’m going to go for it. And it went great. Like I, I came in second. And it was a. Such a fun night. And by the way, like if you’re a comedian coming in second is like, it’s like first. 

Dr. Andy Roark: it. Yeah, that’s

Dr. Sarah Boston: It’s the same. I mean, the woman who won was like absolutely amazing singer, but the people I met in the talent show were incredible.

Like shout out to any of them. If they’re listening, they’re amazing. Mostly women, but they had [00:17:00] amazing stories. They were, I was so happy to just be with them and meet them. and so I had so much fun. So. Yeah, so then you just kind of go, well, I would have never had that experience, right? Like if I had sort of got stuck in myself and been like, no, I just, I speak at conferences and I’m a surgical oncologist and I’m there to teach people things.

And I was like, no, I’m there to spit some jokes. 

Dr. Andy Roark: I am so proud to unveil the biggest project I have ever worked on. This is a partnership with NAVC’s Vetfolio and Uncharted, which is the veterinary conference that I started and run for 15 years. I have worked with people on being effective as communicators and making their practice better places to be.

Now, I am so thrilled to be launching the Leadership Essentials Certificate with Uncharted and Vetfolio. Guys, these are the seven courses that I believe, really believe anyone who’s leading other people in vet medicine should have. This is vision and value setting. This is basic [00:18:00] strategic planning. It is understanding different communication styles, and I have my friend, Stephanie Goss, uh, helping teach that session is, uh, getting the team to buy in to new ideas and initiatives.

It is how to coach and give. feedback. It is how to set priorities. It is how to delegate effectively. It is how to do time management. It is the talks and the stories that I am probably most well known for giving. My red dot talk is in here. My GPA talk is in here. Everything about the north stars, everything that I Layout where I’m like, this is just so essential to managing people.

It’s, it’s the trust game. It is everything about building and maintaining trust with your team. I think that this is something that I would recommend for anyone who is a practice owner. Uh, it’s anyone who’s definitely who’s becoming a new practice owner. It is for anybody who has especially gotten promoted up into management.

It is huge for our team leads. We take people who are CSRs, we take people who are technicians, and we make [00:19:00]them lead techs or lead CSRs, and we give them zero leadership or management training. There’s no excuse for that anymore. This is, this is on demand whenever you want. It’s broken up. It’s eight hours.

It’s got race CE. It has the. Uncharted vet folio certificate with it is it is there is accessible I I really hope that people will take this and put it to work I I went really hard on this. It has been years in the making and refining to get this content down and right So it is it is really for is everybody who is leading and managing other people in vet medicine I hope you will check it out.

I’m so proud of it. I’m so glad to be partnering with nabc on it Anyway, guys, i’ll put links in the show note. I hope you’ll have a look. Let’s get back into this episode

Like, let’s think about this for a second. You literally went to a veterinary conference, which is like the biggest vet conference in the world, and you have lectured there. I have seen you lecture there. I’ve sat in your lectures and taken notes as you lecture there.

And then [00:20:00] you came back and literally just did stand up, and you had to know that people who were there were anticipating that you would be teaching surgical oncology, and then you weren’t. Talk to me a little bit. I think what I want to get into this is, at some point, Sarah Boston, you clearly had a decoupling of your veterinary identity and then what you wanted to be going, forward, or you just decided I’m going to have this duality, but at some point you let go of, I am Sarah Boston, the surgical oncologist that people know, you know, who is, it’s, I don’t know, has done all these things, and I’m going to have a different personality.

I’m gonna have a different identity that’s going to be mine. And I think what I would really like to try to tease out of you today is, what does that look like, Sarah? is that a separate sort of is that a second identity that you sort of feel like you have? Or do you feel like you had to morph into this sort of new thing of, yes, I do [00:21:00] practice, you know, 60 percent of the time, but I’m also really passionate about these other things and that’s kind of the complex person that I am and I think I’m really interested in when did you let go of I am ladder climber, Sarah Boston, who went to vet school and then practice and then did a residency and then joined academia so I could teach and educate and lecture and then I stepped off the ladder.

And went back to comedy school. Like, how did you, pry your fingers off and allow yourself to move to the next place? Because I think a lot of people are metaphorically in the faculty seat, holding on tight, going, this is the highest pinnacle I can climb to. And the idea of getting off this ladder now is just seems like nonsense.

Dr. Sarah Boston: Well, it is nonsense to give up tenure twice. Just ask my mom. It’s absolute nonsense. Why would anyone do that? I don’t [00:22:00] know. I think I will always be a bit of a ladder climber. Like I, I don’t know if I love that about myself or not, but like, I’m on a, just on a different ladder now and I don’t even know what it looks like.

Like I, I don’t, do comedy to be mediocre at comedy. Like I wish I could be that person who’s like, Oh, I don’t really care where it goes, that’s just not me. I care. I want to be good. Like I want this to be part of what I do that may or may not happen. And I think one thing I struggle with is the great.

People at comedy, they do it full time. It’s not, it’s hard. It is work. Like it doesn’t look like it. People think Robin Williams just got up there and was funny. He went to Juilliard. He worked. Jerry Seinfeld worked. Like the great comedians, like that was their full time job and they focused and they worked, which I can do, but I’m not doing that right now.

So I think that’s actually more of my struggle is like, now I feel like I’m on two little ladders.

Dr. Andy Roark: Oh, 

Dr. Sarah Boston: There’s a, definitely a duality for me. Like it is a duality, but now I’m, and I think though, I mean, I think about people who are parents who. Our veterinarians and probably [00:23:00] more women than, like, I don’t want to offend any men, but, or maybe I don’t know, but more, it’s a more of a, historically more of a gender based struggle, I’ll just say, maybe that’s changing, but there’s a lot of women have told me through the years that they don’t feel like they’re succeeding at home and they don’t feel like they’re succeeding at work because they’re trying to do You’re trying to do two jobs, like being a parent is a job.

It’s a kind of a full time job. It’s more than a full time job, right? And I mean, I don’t know that. It’s just what I observe. So you’re trying to be the best parent and I guess that isn’t gendered, but you’re also trying to be the best veterinarian. And you probably can’t actually, like you, you probably can’t.

You can be really good sometimes and other times, but like sometimes your kid’s sick and you need to leave early. And That’s not great, but that is just the world we live in. Right. And you just have to be like, well, today I’m not the best veterinarian. I’m the best I could be. I have to go. So, yeah, I think that, anyway, I think for me, there will always be a duality.

I’m not letting go of being a veterinarian. I don’t know if I [00:24:00] could, to be honest, I don’t think I want to, I mean, I guess I could, if I wanted to, I don’t think I want to. And I had some ups and downs during the pandemic where I was like, I. Don’t like this.

I don’t know if I want to keep doing this. And that was sort of like just different circumstances.

I was in I’m at a really nice hospital right now. I like the people I work with. The main reason I decided to sign there, cause I was locuming in clown school was literally cause I liked the people there.

Dr. Andy Roark: yeah,

Dr. Sarah Boston: it. It was like, I was like, these are nice people. I like everyone in this hospital. I’m going to go work there.

That was the whole, that was my decision making, which I think is actually good because other

times I’ve 

Dr. Andy Roark: think that’s great.

Dr. Sarah Boston: yeah, I think that will sustain you more than, I don’t know, a fancy, whatever, like that’s at the hospital, so maybe I’ve learned something, but anyway, yeah, to answer your question, I think it’s more of a duality, but now I think.

I still want to be really good at comedy and I still really want to be, you know, doing the best [00:25:00] job I can for my patients and my clients. And as a surgical oncologist and still like, you know, I always joke about like, if I’m just language languishing and obscurity now, because I’m not like as active doing research and mentorship and stuff like that.

Maybe I am, I don’t know, but that is a letting go for sure. You know,

Dr. Andy Roark: So there’s two things I heard you say that I want to kind of go back to so the first one is let me put forward a Theory about you. I think this idea that you said you talked about I’m climbing a different ladder That idea that I’m not I am moving upward and when you step off of, because you went from being in the faculty basically to really going into comedy, right?

Didn’t that happen around the same time if I remember sort of our conversations and relationship?

Dr. Sarah Boston: not so seriously. And then there was the pandemic, so it’s a bit mushy, but I kind of, and I didn’t. I, it wasn’t conscious, like they kind of happened simultaneously, but not consciously. It wasn’t like, Oh, I’m leaving faculty and now I’m [00:26:00] doing comedy. It was like, I left, I came back to the Toronto area.

It was easier to do comedy in this area and I pursued it. So it wasn’t like, I think if I’d been faculty somewhere where there was comedy, it would have just happened there too. And in some ways I wish it had, cause I would really love to teach comedy to veterinary students. Like I, I think that would be amazing.

Dr. Andy Roark: I have always seen myself as a dragon slayer, meaning I’m not happy unless I have a sword in my hand chasing a dragon down, like I am going to go and slay this dragon. And I don’t care what dragon it is all that much, I tend to pick eclectic dragons to chase down. But like, as long as I’ve got a sword in my hand chasing a dragon, I’m happy.

When you talked about I’m climbing a different ladder now. To me that kind of resonated and sort of said, I, kind of feel like Sarah’s sort of in that same boat. For me, I’ve been able to change what I do in my career because it has never been a, Ooh, do I really want to leave this behind? It’s more of a shiny object over there that I feel like I have to [00:27:00] run after.

Is 

Dr. Sarah Boston: Yeah, 

Dr. Andy Roark: would you say that sort of sums up

Dr. Sarah Boston: Yeah, I definitely feel that I think the Dragon Slayer, like that analogy, maybe better than a ladder because the ladder almost has this like negative connotation. It’s just like, Oh, I want to do that. And I think something I really valued and loved about academia was it changed all the time, right?

Like when we come on clinics, when we come at a conference lecturing, when we come doing research, I’m mentoring, like, so, and I, you know, I don’t know if I got bored. Like, you know, you talk about that clinician you talked to who said, I’m bored. I’m like, 

Dr. Andy Roark: Yeah, 

Dr. Sarah Boston: yeah, I think I was a bit bored too being in private practice.

And every week is the same, like every Monday you do this, every Tuesday you do this. So now like I’ve got sort of 60 percent that, but then I’m, doing other things during the rest of the time. And it’s, it is actually like, I’m just trying to work it out. It is challenging to balance it all. Like, doing standup in a club at night, it’s late, I’m old.

And then I have to work the next day. I’m like. to figure that out, how that’s all going to work [00:28:00] is challenging, but it’s not more challenging than what anyone else is doing. Right.

Dr. Andy Roark: Yeah, I can’t believe you do that. I’m, you know, 

Dr. Sarah Boston: Oh

Dr. Andy Roark: night and I’m like, ooooh, I don’t know. Let’s, can I just let you, can we just, can it be a game time decision? Do I have to commit?

Dr. Sarah Boston: I’ll probably be in bed then.

Dr. Andy Roark: Cause I’m gonna totally bail and I just want to say that I’m not gonna do it, but.

But, if I have insomnia then I’ll come, but that’s it. All right. the other thing I want to talk to you a little bit about, which I think is interesting is, so here you are and you sort of pushed in and you’re doing comedy, you’re doing this other thing. You’re sort of chasing this other dragon.

And just in our conversation, you mentioned your mentor who got up and left. Doesn’t talk to you. And. You mentioned your mom who was like, what are you doing? And so clearly important people in your life have pushed back a little bit maybe about some of the sort of recreation of [00:29:00] yourself. do you feel that way?

Does that bother you in a meaningful way? Or were you just like, I don’t care. Like, how do you get your head around that?

Dr. Sarah Boston: I would say the things that, I mean, the, thing that happened with my previous faculty member mentor I’ve been a bit embarrassed about it, but I also find it hilarious. And I

Dr. Andy Roark: Oh, it is hilarious.

Dr. Sarah Boston: One way that comedy has been a gift for me, and I had felt this shift, like after going to comedy school for two years, like there’s things that would have, really upset or annoyed me.

And now I just find it hilarious. Like things like that is hilarious. I’m sorry.

embarrassing. it’s, just hilarious. So like, yes, to feel a bit cringy, but even the cringy things like, so. I do, I really value that about comedy because I think it, it helps me as a clinician. It helps me in my life.

Like I can just look at things that are absurd and I can just, things that used to upset me and now I just look at it and I’m like, that’s absurd. And actually that’s hilarious. Like let me write that down. So that is a positive. I think, I mean the most, I guess the most important person in my life is as far as [00:30:00] their opinion is my husband.

He’s just like, Always supportive. Like, you know, he’s like, yeah, go for it. And, we kind of have that, our relationship, like, we’re just like, we have this pact, this is really dumb, but we’re like, you can quit your job. You don’t even have to phone me. Like, it’s just like, that’s our pact. Right. I mean, we probably…

Dr. Andy Roark: You’ve discussed it, you’ve been like, Would you be okay if I quit my job and didn’t let you know?

Dr. Sarah Boston: Yeah. We don’t, we just, that’s, it’s never happened and it never would. But I think the freedom of like, you do, you will figure it out is really important. So I’ve never felt that from him. Like I’ve always felt that. And then I guess. The other thing about comedy that is just really weird is it’s just, it just drives me.

I don’t even know why. Like sometimes I am driving to downtown Toronto to go to Yak’s comedy set and I am just like, I have no idea why I’m doing this. It doesn’t make any sense, but I keep doing it. Why did I go to comedy school? I don’t know. And people like I’ve had surgeons, like they’ve said, like, what’s your plan?

Dr. Andy Roark: Yes, what is the plan? What is the plan, Sarah Boston? Like, how does this strategically [00:31:00] take you to a higher place on the ladder? I do, I like ladder because there’s such a hierarchy to it and we all are like, I move to this level and then up to this level and then up to this level. And so there’s,

Dr. Sarah Boston: I 

Dr. Andy Roark: I can 100 percent 

Dr. Sarah Boston: have no plan, 

See 

Dr. Andy Roark: people saying are you making a play to be the surgical oncologist to the stars? I mean, what do you, I don’t, even know what that means, but

Dr. Sarah Boston: I wish I had, if someone has one and they could, maybe they could put comments or let me know. I don’t know how to, I’m trying to like put this together in a little like thing that’s like, oh, that’s the perfect job for her clearly with her background in comedy and surgical oncology.

I, don’t know. I don’t know.

Dr. Andy Roark: Perfect mixture of skills, for this mission 

Dr. Sarah Boston: No No one, one, yeah, like no one’s contacted me on LinkedIn asking for that. You know, I’ve not, I’ve yet to see that, but I feel like it’s just going to happen. Is that crazy? Like, I feel like it’s just, it’s gonna like, I don’t know. I, maybe it’s not, 

I don’t care. 

care I wish that [00:32:00] things made sense when I looked out the the windshield, but they don’t. They only make sense in the rear view. Like, if you look at my career in the rear view, I’m like, Oh man, I went here, and then here, and then this happened, and this came together. But, do I know where I’m going?

Dr. Andy Roark: I’m just, nope, I’m just driving. And, it all seems to come together behind me for some reason.

Dr. Sarah Boston: Your career looks more, your career looks strategic, but I know it’s, it wasn’t, but it looks like it is.

Dr. Andy Roark: It definitely, it looks really well put together. And I’m like, no, it was 

me. It was me figuring out what, I, love to do and tried to do more of it and figure out what I didn’t like to do. And I tried to do less of it. And then it all just, it looks very strategic.

Dr. Sarah Boston: Yeah. So I, yeah, I don’t have a, I have no plan. Like, you know, I’m just doing things.

Dr. Andy Roark: Is the, ability to kind of just shake it off. And like, you were like, you know, I just laugh at this stuff. Are you saying you think that’s a learned skill? I mean, is that something that you went to accommodate? Tell me about 

Dr. Sarah Boston: I a hundred percent think that I don’t,

Dr. Andy Roark: you think you learned that skill? 

Dr. Sarah Boston: I think I always had that. Cause I’ve always had my sense of humor. [00:33:00] And I, you know, when I wrote my book, my funny book about cancer, like that just happened. Right. And when I lecture, there’s jokes in my lecture, like, you know, and I always felt like that was important.

So that’s always my ability to see the humor in things. But I think the ability to be like, what’s funny about that? Because I heard another comedian talking about this, so I might be taking there, but it resonated with me. It was like, you know, they talk about comedy is tragedy plus time, but comedians are always trying to be like, what’s funny about that.

And when people are laughing, you know, when I don’t know if you have family get togethers my husband’s family is really good for this cause it’s a really big family and they will look back on something. Kind of disastrous that happened, everyone’s laughing, right? Like, I don’t know. I’m just, I don’t even, I don’t know.

I can’t think of an example. Nothing where people got hurt, but like a whole meal got ruined or dinner got burnt or whatever. Like just, you know, but everyone is like. Crying they’re laughing so hard about this thing that happened and like that’s comedy, right? But if you’re a comedian [00:34:00] you can speed that up and be like, well, what’s why is that funny now?

Whatever that thing is. It seems a bit crappy What’s funny something about it will be is funny now and I think we need to do that as veterinarians and you know, I, this is where the plan, here’s the plan people, here’s the plan. I think it’s sort of my wellness. I always say that my, my comedy is my wellness.

So like, you know, veterinary medicine, we talk about wellness now, which is great. Cause that wasn’t invented when I graduated from vet school, that was not a thing, but my wellness is not like I do yoga and I do this and I do this and all the things that we’re supposed to do is just, I, you know, if you saw me at work, you would be like, she’s a fraud because I don’t do those things at work.

I don’t eat properly when it’s my two day work week, but they’re long days and I’m running around. But my wellness is my ability to see the humor and my wellness is like doing comedy and seeing what’s funny. That is my wellness. And I would love to try to figure out like, how do I [00:35:00] like bring that back to the profession?

So I do like, that is the only thing that’s kind of a, if I have a plan, that’s the only plan I have and it’s not well thought out, but I’m like. You know, can I teach veterinarians about improv? Can I teach veterinarians about comedy? Can I show veterinarians what is funny about what they perceive as stress and, horror sometimes, some things that people get so upset about, but I’m like, yes, and kind of funny too.

Like, yeah. So, and I think I laugh at things that I won’t even talk about on here because people get mad at me, but I laugh about things now that I’m just like, that’s actually kind of funny. Yeah.

Dr. Andy Roark: You know, one of the reasons, and it’s so funny that you’re saying this, I’m remembering how I met you and sort of my first impressions of you, and you, one of the things I’ve always admired about you so much, even from before I really knew you, but I would see you lecture and you would be talking about surgical oncology, like [00:36:00]heavy stuff and scary stuff.

And you’re talking about doing procedures that I would be terrified to have waded into with a scalpel. And you were very candid about, well, you know, and then this goes, and, yep, that’s how this gets messed up. And and then you would say something that was really funny, and you just sucked this innate fear out of the audience about it, because everyone’s watching your talk and they’re going, Oh, my God, we are dangling, you know, we are walking on the blade of the knife here and you’re yep, and that’s what happens and it just, it’s amazing how we can be permeated with fear and stuff, especially around surgery. But you would use humor to diffuse that fear and then make, just make the whole, I don’t know, the whole experience just felt much more approachable because you’re the one who did the surgery, and it went badly, and you laughed about it, and everything turned out okay.

And it just, it made it all feel much more accessible [00:37:00] to me than if you had been like, look, you really can’t mess this up. And, it went badly for me, but I waded in and did it. this thing. And I would have been like, Oh, well, I’m never going to go into that neighborhood. And so I don’t know. I just, it’s always something that I’ve admired.

And I think you do that really well. So if I had to sort of say, how have I seen comedy and humor weave into the very specific niche high level thing that you do? I think that’s something you’ve always had. Sarah, your book, Lucky Dog is great. I recommend it for people who are interested in reading something about that medicine and also an individual’s cancer journey.

I think it’s really wonderful. You have a podcast called co medicine. Do you wanna talk about that for a second?

Dr. Sarah Boston: I would love to you have been on it, so thank you. So yeah, another concept of mine, just meeting people who are healthcare professionals, so not just veterinarians who also do comedy and like every time I meet someone like that I’m like, I must talk to them about this very specific area on the venn diagram and what we have in common.

And it’s been a blast. I, we are in [00:38:00] season two working towards season three and I’ve had, I just interviewed a paramedic, so we’ve had a paramedic, a nurse physicians, dentists, physiotherapists. Veterinarians. I’m still waiting for my veterinary Oh no. A veterinary technician. Yes. I have veterinary technicians.

So, yeah. I need a physiotherapist. I’m talking to a physiotherapist. So, yeah, at really any healthcare professional who does improv or comedy or acting comedic acting and it’s been amazing. Like I. I already knew you, but it was great to have you on. But I’ve met some really cool people and yeah, it’s just been a ton of fun.

Dr. Andy Roark: That’s awesome. Well, guys, you can get co medicine wherever you get your podcast. Sarah, thanks so much for being here. Guys, thanks for tuning in and listening. Take care of yourselves, everybody.

Dr. Sarah Boston: Thank you for having me.

Dr. Andy Roark: And that’s it. That’s what I got. I hope you guys enjoyed it Thanks to Sarah for being here guys.

I took a number of things away from this episode I didn’t want to say at the beginning because I didn’t want to kind of spoil kind of where the conversation goes but I think the idea about switching ladders and that it’s the idea that Sarah [00:39:00] is doing something that she Plans to be good at and that she’s serious about I think that’s important I think that as I look back at my own career, I don’t think I’ve ever stopped and said ooh What is this going to mean for my identity?

I’ve always just found another ladder that I was excited about climbing and just Climbed it and I didn’t worry a lot. I think a lot about like Am I allowed to do this? Does this fit with who I have been or with my training? I don’t know. I think there’s something to that. I’m gonna keep thinking about it, but it was just what a great conversation I really appreciate her time.

I she’s someone I so admire. So anyway guys, thanks for being here. Take care of yourselves everybody I’ll talk to you later. Bye

Beware The Chute: Lessons Learned In The Exam Room

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Yesterday, I saw an 8-year-old Doberman who had been urinating inappropriately in the house. His name is Bowser and his owner brought him in about two weeks ago for an initial examination with a different doctor. 

When Bowser first presented, his physical examination was normal and his bladder was completely empty. After a discussion about Bowser’s behavior, and given that a urinalysis was not possible at the time, it was decided that Bowser would be started on a supplement to help address the issue. His condition would be monitored. 

When my technician presented Bowser’s case to me, she made a point to mention that a urinalysis wasn’t performed during the last visit.

When I entered the exam room, Bowser’s owner also brought up the fact that a urinalysis wasn’t possible last time and that is part of what prompted him to bring Bowser back.

Well, I knew what I had to do. I did a thorough physical examination (finding nothing of significance, just like last time) and then pronounced with confidence that what we need is a urinalysis.

The owner did not react with the high-five that I was hoping for. Instead, he crossed his arms and narrowed his eyes. “Oooo-kay,” he said. “Is there any chance that we might need to look at Bowser’s blood to find an answer?”

I just stared at him for a moment as my mind jerked and shuddered like an engine that was suddenly missing gears. “Sure,” I responded. “He’s an eight-year-old doberman. He could have Cushing’s disease, diabetes, kidney disease, or a number of other conditions that would cause him to urinate more frequently or inappropriately.”

That’s when the guy hit me with his zinger. “Well, why haven’t we been talking about that?” 

I have been kicking myself ever since that face-palm appointment. This case was vet medicine 101, and I had to be rescued by the client. How could that happen? I’m sure bloodwork was discussed in Bowser’s first visit, but it didn’t catch my eye in the record.

I fell into what I like to call “the chute.” The chute happens when you pick up a case that already has momentum. I looked at the medical record and grabbed onto the lack of a urinalysis, then my technician mentioned urine, and then the pet owner said it. 

At that point, I was hurtling down a mental playground slide. The idea of stopping and asking “Is this really all I should be thinking about?” just didn’t occur to me.

I am going to be vulnerable and say that this isn’t the first time I’ve fallen into the chute. It’s easy when we’re busy to pick up a trail that’s laid out before us without questioning whether or not it goes exactly where we think it should. And there are significant drawbacks to insisting on starting every case absolutely from the beginning, especially when you work with highly competent professionals all around you. 

Still, we should all remember that there are dangers in just diving down a chute that is laid before us. We need to balance the desire to go fast with the need to keep an eye on the bigger picture. I was reminded of that yesterday in the room with Bowser.

P.S. Bowser’s CBC and chemistry came back totally normal, so at least I was spared the embarrassment of having to hear the pet owner say “Good thing I asked about blood work!”

A No BS Guide to Being Fantastic in the Exam Room

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People often ask me for my honest, best advice on how to be fantastic in the exam room. I generally don’t give it to them.

The reason is that most people want me to say something they can just decide to start doing with minimal or no additional effort compared to what they are already doing. It’s not because they are lazy. It’s just that people are busy and the idea of adding a significant outside-work commitment is generally not appealing (or even feasible).

People asking for advice are often looking for a piece of trivia that they don’t know which will unlock some new way of practicing. Advice like this might include “empathize more,” “choose happy,” or “make sure you’re leaning into active listening.” You get the picture.

Anyway, there’s nothing wrong with advice like this, and everything I listed is helpful, but let’s be honest… This kind of advice isn’t going to transform someone mediocre or inexperienced into someone really great at their job. Giving someone a piece of knowledge is not at all comparable to giving them a skill (and “giving” someone a skill is impossible).

I do find, however, that sometimes there are people who have the determination, time, and resources to actually go as hard as they can toward being the best exam room communicator they can possibly be. If you’re that person, I wrote this email for you. 

This is the honest answer to the question of my best advice for how to be fantastic in the exam room. I’ve got three immediate recommendations:

  1. Toastmasters International – Toastmasters is a non-profit organization where people come together in person and practice speaking. They have a well-tested program that teaches great skills around organizing your thoughts, being concise, and projecting confidence. They also make you actually stand and deliver under pressure. I did Toastmasters every other week for my first 3 years as a veterinarian and it was one of the best investments I ever made.
  1. Improv Comedy Classes – After Toastmasters, improv comedy classes are my favorite tool for taking your communication skills to the next level. Depending on the theater, you will generally learn fantastic skills for validating people who have ideas that are different from yours, listening intentionally and powerfully, thinking on your feet, and responding to unexpected situations. I’ve been doing improv for over 10 years and it has impacted every aspect of my life.

Just like with Toastmasters, reading about improv skills is not remotely comparable to having to stand up and demonstrate them over and over again. Most improv 101 classes last for 6+ weeks, but some intensive courses can be done in a jam-packed weekend. Google “Improv comedy classes near me” to find your closest theater.

  1. Uncharted Leadership Essentials Certificate – I put 15 years of communication and management consulting experience from working with literally hundreds of veterinary practices into creating the most concise and useful leadership course possible. The Uncharted Leadership Essentials certificate is designed for anyone who leads or manages other people, but the communication skills taught therein are invaluable.

The certificate is 8 hours of CE and covers building trust rapidly, understanding peoples’ values and motivators, giving feedback that gets heard, recognizing different communication styles, and holding people accountable – all important skills in the exam room. The Uncharted team delivers this content on-demand through VetFolio, in a hybrid learning model that includes 8 live virtual implementation sessions (coming in March for Uncharted members), and a live, in-person immersive experience (registration for our May program in Atlanta is now open, with our June program in Minneapolis are opening soon).

So there you have it. Those are my three favorite resources if you really want to get serious about radically improving your skills in the exam room. Yes, they all take time and effort outside of work. I wish there was a way around this, but I don’t think there is. Skills have to be built one way or another. Many of us grind them out in the exam room and there’s nothing wrong with that.  I truly believe, however, that if you can make any of these resources above work, they are a worthwhile investment in jumping ahead more quickly.

Lar Par, GOLPP and Our Missed Opportunities

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On this week’s episode, Dr. Andy Roark is joined by Dr. Mary Gardner to discuss one of her personal passion projects, raising awareness about geriatric onset laryngeal paralysis and polyneuropathy (GOLPP) in senior dogs. Dr. Mary Gardner shares her experience with the disease and how that’s led to her commitment to educating both pet owners and veterinary professionals on various treatment options.

You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!

LINKS

All About GOLPP Website

Dr. Mary Gardner on Instagram

Uncharted Roadshow in Atlanta

2024 Uncharted Veterinary Conference

Charming the Angry Client Course

ABOUT OUR GUEST

There is nothing better to Dr. Mary Gardner than a dog with a grey muzzle or skinny old cat! Her professional goal is to increase awareness and medical care for the geriatric veterinary patient and to help make the final life stage to be as peaceful as possible, surrounded with dignity and support for all involved.

A University of Florida graduate (AND ANDY’S CLASSMATE!), she discovered her niche in end-of-life care and is the co-founder and CIO of Lap of Love which has over 350 veterinarians around the country dedicated to veterinary hospice and euthanasia in the home.

Dr. Gardner is co-author of the textbook “The Treatment and Care of the Veterinary Patient”, co-author of a children’s activity book focused on saying goodbye to a dog called “Forever Friend”, and the author of a book dedicated to pet owners “It’s Never Long Enough: A practical guide to caring for your geriatric dog”. Dr. Gardner also won VMX Small Animal Speaker of the year in 2020!

EPISODE TRANSCRIPT

Dr. Andy Roark: Welcome everybody to the Cone of Shame veterinary podcast. I am your host Dr. Andy Roark. Guys, I am here with one of my best friends in the world, Dr. Mary Gardner. I love her to pieces. We went to vet school at Florida together. You’ll hear us talk about that a little bit. She has a passion project that she is working on.

It’s around laryngeal paralysis and GOLPP in senior pets. Some of you might remember Mary Gardner. She is the founder of Lap of Love pet hospice. She is a she is a hospice care veterinarian. She is a amazing lecturer. If you ever get a chance to see her speak, you should. You’re going to look and you’re going to be like, man, she’s doing three hours on end of life care.

That sounds really down. It won’t be, it will be riveting and you will learn an absolute ton from someone who is super easy to relate to someone who will make you laugh and smile and feel good about the work that we do. That’s Mary Gardner. So anyway, she is amazing. I am thrilled to be talking to her about this project that she’s fired up about that.

Honestly, when I first heard about it, I was like, why are we talking about that? Boy, she makes a good case. This is going to be great. Let’s get into it.

Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark. 

Dr. Andy Roark: Welcome to the podcast. Dr. Mary Gardner, thanks for being back.

Dr. Mary Gardner: Hi, Andy. I know. I think this is like our third or something like that.

Dr. Andy Roark: It’s tough being up there. Like, you’re definitely up there at the top of the people that I’ve had on the podcast again and again. It’s just because I love you to pieces,

Dr. Mary Gardner: I know 

Dr. Andy Roark: We’ve known each other forever. And every time I talk to you I get excited about what you’re doing and what you’re excited about and we just kind of feed off of that. And this was no, exception. So, you and I were together in Orlando in January, and I had looked at the program, and there was, Mary Gardner is doing a LARPAR surgery lab, and I’m like, either that’s a typo, or Mary Gardner is blossoming late in her career in ways that I did not anticipate and I talked to you and you were like I am doing the laryngeal paralysis workshop. And when I talked to you later I was like how was it and you were like I want six hours instead of four and I was like I like we have to talk about this this is not it would be like if I came to you and I was like I’m into Turkish baking and I love it.

I’m like, I just, it, talk to me about laryngeal paralysis and your love affair with this kind of odd medical condition.

Dr. Mary Gardner: It is. I know. And I always say like, I love it, but it’s weird to say that you love a disease, right? I hate it. I wish it wasn’t a disease, but you, I love it. It’s like, it’s just something that came into my, life personally and also professionally. My Doberman, you know, Duncan, he’s always a topic of many conversations, but he, when he was about 9 or 10, more, like 10, he started to clear his throat.

So he just was doing it. Which, you know, I’m like, Oh my God, that’s my Doberman coughing. I instantly went to DCM heart disease, you know, and

Dr. Andy Roark: It’s a dark, the dark place we go. Oh my god.

Dr. Mary Gardner: Right. He could have just had a little acid reflux. No, I went straight to stage 20 heart disease. I already went there. So, so I, bring him to the cardiologist. Like, I don’t even touch my stethoscope. I’m like, you’re going to the cardiologist, buddy. Right. And they’re like, no,

Dr. Andy Roark: We turn into, it’s when we turn into needy pet owners. We’re like, Oh my God!

Dr. Mary Gardner: Totally.

Dr. Andy Roark: Someone listened to this chest.

Dr. Mary Gardner: Exactly. Cause I can’t. And so I brought him in the right. No, he’s actually totally fine. And I’m like, he’s doing this weird clearing his throat. It’s not a reverse sneeze. It’s, you know, and so, turns out that then he was diagnosed with laryngeal paralysis and this is probably, gosh, I, should look at the exact dates, but it’s probably around 2014, 2015 or something like that.

Right. And yeah, probably around that. And so it was then a decision. Do I wait for him to get? worse and then end up in an emergency situation, which is what we see so much. Or do I consider or do I consider euthanasia before he gets that bad? And then, or do I consider doing the surgical option, which is the tieback.

And for me, it, he wasn’t so bad, like his breathing wasn’t horrific. It started over the next few months. So I can then see his breathing when he was sleeping. It was, you know, a little snoring, but it was like, and I’m like, nope, that’s, he’s not going to live like that. Right? So no doubt in my mind, I was going for the tie back and

Dr. Andy Roark: 10 year old Doberman, right?

Dr. Mary Gardner: 10 year old Doberman.

Yes. Yes. This, and that’s a very good point.

Dr. Andy Roark: This is an old, this is an old big

Dr. Mary Gardner: Is an old man.

Dr. Andy Roark: For a big dog, this is an old man. All right, I just wanted to flesh that out.

Dr. Mary Gardner: Totally. And he, I actually used this story in one of my lectures. And so I’m sort of doing parallel conversations here with you. So actually years later, I was telling the same story to a group of veterinarians and it was in Texas.

And I didn’t say it was my dog, I just said it was a 10 year old Doberman who here would even discuss tie-back surgery and only 2 people in a room of 80 raised their hands. So I’m like, no, let me repeat that. Like who here would just, talk, like give it as the option. And again, only two people.

And I said, why not? And they said, He’s an old dog and the risk of aspiration pneumonia is too high. And it just boggled my mind at that time that nobody would even consider it. And it was something that I had done. And then of course the reveal was it was my dog that I’m having this conversation about.

So back to 2014, I absolutely did the tie back. And during post surgery, he actually did have aspiration pneumonia because he vomited. From like morphine or whatever they had given him. So this is again, 2014 and so that, that is a risk, but he survived it and he was fine and he did great. Andy, like he was fine years, you know, a year or two later, I started to see then this neuropathy happened in the, in his backend.

And I was doing you know, I was researching all of this and that’s when I learned more about GOLPP than just LARPAR. And so he’s the thing that started my he, him having it is the reason why I love it so much because it was such a big a part of my life and treatment with him. He ended up dying of DCM years later.

So he did get DCM, but that’s why he passed.

Dr. Andy Roark: How did you feel about that? Are you like, it’s a heartbreak, or are you like, I called it. I called it really early. I was

Dr. Mary Gardner: So long ago.

Dr. Andy Roark: I had,

Dr. Mary Gardner: No,

Dr. Andy Roark: Long ago, I knew this was gonna happen.

Dr. Mary Gardner: I know. You know, it’s one of the things, you love a certain breed and you know what it comes with, right? Like, so I know, but he was 13. So I got, like, almost 3 years after a tieback with him where so many people would have, It would have been a few months and then I would have had to euthanize him.

So, that’s how it started.

Dr. Andy Roark: Well, you know, I love that you tell this story and you and I have talked about this before with your work with Lap of Love Pet Hospice and things and you and I are both we’re both on the advisory board for the Gray Muzzle Organization it says this is a group that we both care about and it’s glad we get to do this stuff together I saw this case and it was a dog had a splenic mass and he’s my neighbor’s dog.

His name is Copper. And he’s like a ten, ten and a half year old sort of coon hound dog. Not a small dog. And so I had that talk with him. You know what I mean? When you’re like, well, you know, it’s probably two thirds chance it’s going to be malignant and one third it’s benign. And, you know, this is kind of how it goes.

And, you know, kind of what do you want to do? And I guess I was kind of trying to cushion the blow. You know, if they were going to say, well, you didn’t do it and they were like, no, he’s been a great dog. We’re gonna do this thing and sure enough. It’s benign. They take it out That dog is stealing food from me at cookouts like he sees me.

He’s like that guy’s a sucker You know what I mean? And like he tell you but like boy, I mean you start thinking about you like a couple of years you know sometimes I wrote an article about it, and I called it, Sometimes It’s Worth the Risk. And it’s like, sometimes we go with it, and it’s just, sometimes it’s just worth it.

And,

Dr. Mary Gardner: It’s worth it.

Dr. Andy Roark: I think it’s easy to, like, write that off, and like, I think we kind of guard ourselves by being a little dark or cynical. But man, sometimes it’s totally worth it. Okay, so you go through this

Dr. Mary Gardner: Now, hold on. On that, I’m sorry to Like, at what point is it not worth it, right? Like, is it six months? Is it a year? If you think about chemo, how many times do we do chemo and it’s just to get a few months or you amputate a dog with osteosarcoma, like that’s to relieve the pain, but you’re not taking away his cancer.

And so is that worth it? Right? And the one thing I just say, while I’m just honest is no judgment because there’s not one right answer. So it’s okay not to, but what I don’t want to do is, you know, everyone says old age is not a disease, but old age is not an excuse. And so, like, It doesn’t mean just because he was 10 that we shouldn’t do it because if he had six great months of breathing okay but then got hit by a car or something like that.

I’d still be happy I did it

Dr. Andy Roark: I love that. I just, I think that’s an important point. I’m just glad, I was just glad to see that. I love that you had a sort of happy outcome of saying, he’s ten. Well, I mean, that’s why I sort of set it up as a ten year old Doberman, and then you go, Oh, well, we’re gonna do this thing. It’s not a small undertaking.

And then three more years, and, you know, it’s that quality of life, quantity of life thing, too, where, it’s not that he stayed alive for three years, it’s that he

Dr. Mary Gardner: He was good. Yeah, right.

Dr. Andy Roark: Sleep, and breathe, and like, that’s a significant difference. So anyway. So, so I love that.

So you go have this experience. Alright. So, so I’m looking at this. You know, I know you’re interested in quality of life. I know you’re interested in seeing your pets. So you go through this experience yourself. And then talk to me a little bit about the realization you sort of had or sort of your experience around this where you started to feel like this is something that needs more light on it.

Because that’s kind of what I got from you at VMX when you were talking about doing this workshop and things. So, so help, me get my head around like. The need you saw in the larger profession or what that kind of looks like.

Dr. Mary Gardner: Yeah. Well, I think because we laugh a lot of them and I go euthanize so many animals in their home So many are because of because of mobility issues and so many are middle sized dogs. So 60, 70, 80 pound dogs, like that’s our bread and butter, let’s say, right? It’s mobility issues, you know, large, medium, large dogs and so many I’d go to and now they’re not in the emergency situation, right?

Which what is what GP normally sees is that the dog is under emergency, but here’s a dog that has bilateral muscle atrophy. They’ve got weakness. It’s clearly neurological on the back end. They’re saying, yeah, he’s, kind of snoring more. He’s having some breathing, you know, struggling and his bark has changed.

And I’m like, this is freaking LARPAR. Like, and, I was just seeing it so much, but nobody ever talked to them about it. 

Dr. Andy Roark: Yeah. 

Dr. Mary Gardner: And then again, at the same time, I had this, you know, lecture in, in Texas where everybody’s like, it’s too old of a dog. We wouldn’t do it. And it, was just like. But we can help so many and the families want to do it.

So it was probably in 2020, maybe I I did a Facebook live with this surgeon, Dr. Bryden Stanley, who is the, like the godmother of GOLPP. And we did it for like, it was an hour long conversation. I just, I asked her everything, meds, da, and thousands of people have watched it. Hundreds of people reach out to me and these are pet owners and they send me videos of their dog and they’re like, my vet doesn’t know what it is or my, he, you know, they, say, don’t do the risk, but I think I want to do the surgery.

And you know, it’s, I of course always walk a very fine line to never throw any vet under the bus, but I always say, go, just go to a surgeon and get, you know, here’s the statistics because now I know the statistics really well. And so it’s just. Now my passion project to educate everybody in the veterinary field about it.

And I love it. So, you know, when we went to vet school, it was called idiopathic laryngeal paralysis.

And we didn’t know that actually there was a connection to the polyneuropathy. And this is where I think if a pet does even go for the tie back surgery, they need care with their veterinarian and rehab and stuff like that, because it’s more than just a tie back, it’s a whole like.

You know, big thing, and that’s where GOLPP, so that’s geriatric onset poly laryngeal paralysis and polyneuropathy has came, has come in, and that’s, so Dr. Stanley is the one who found that connection.

Dr. Andy Roark: Let’s go ahead and start to talk about let’s start to talk about GOLPP a little bit here because when we started talking about the tieback and managing these cases, you know you do not fancy yourself a surgeon unless things have radically changed

Dr. Mary Gardner: No, I’ve not blossomed, no.

Dr. Andy Roark: I was say I was like, wow, it just, you do a lot of things, you do a lot of interesting things. Surgery was not one of them that I had on my bingo card for you, but, given that you’re very interested in this, topic of like, so, so talk to me about the interface here. So, so without making this into a surgery podcast,

Dr. Mary Gardner: Oh god no, which it won’t be,

Dr. Andy Roark: Yeah, which is why the blind leading the blind in, in that regard.

Hey guys, I just want to talk to you real quick about the Uncharted Roadshow in Atlanta. I am going to be there with Stephanie Goss and Maria Parita and Tyler Grogan and we are going to be doing the Uncharted Leadership Essentials Certificate. That is, uh, it is two days, it is 14 hours of race CE. You heard that right, it’s packed in there.

It is workshop style CE. We will be doing understanding the trust economy. We’ll be doing strategic planning, vision and values. We’ll be doing communication styles, feedback and coaching, achieving team buy in, setting priorities, getting priorities done. That means holding people accountable and setting timelines and deadlines.

We’re going to be doing all of that stuff. You are going to be, uh, drinking from the fire hose and it is all about you actually getting the skills. As I said, it is very, very, very very hands on, you are not going to be sitting and getting lectured at. You are going to learn, you are going to be a different and better leader when you leave than when you arrived.

That is a Sunday and a Monday in May, as I said the 5th and 6th in Atlanta. Grab yourself a spot, they are going to sell out, um, I would love to see you there. Alright, let’s get back into this episode. 

Dr. Andy Roark: So talk to me a bit about, GOLPP. Talk to me about, surgery as a tool. And if surgery is a tool, Mary, what are the sort of the other tools in the toolbox? What does this overall management of this condition look like in your mind when it’s done exceptionally well?

Dr. Mary Gardner: Oh God, this is the most amazing question. Okay, so, 

Dr. Andy Roark: Why, thank you! know, I work hard.

I take notes ahead of time. Like I prep,

Dr. Mary Gardner: I love Prepping.

So, well actually, you know, let’s step back. I think about Duncan and his clearing of his throat, right? Everybody assumes that’s like a tickle in his larynx or something like that. That was actually because he was having, you know, regurge. So, so, you know, like almost like acid reflux.

Because that comes oftentimes in parallel with, GOLPP, with the laryngeal paralysis. So basically and this is definitely not surgery, definitely not a anatomy class here, but the a laryngeal nerve actually is what the problem is with the larynx. But it’s also all kind of connected to the esophagus.

And so they will have esophageal mobility issues. And that’s why they’ll have little acid reflux. Some of them so much that they vomit often or regurge often. And so it’s not just from the surgery or the tieback that they could have aspiration. It’s because of their vomiting. Like that’s why, because they may vomit or have that regurge or they eat too fast and they have a tieback or drink too fast.

But it’s a risk factor even for dogs that don’t have a tieback. And I don’t think people understand that we have to actually help them with their regurg also because it’s gonna, it’s gonna happen. And then what, what also happens is that they will get a polyneuropathy, neuropathy. So their back end is going to start to toe drag, get weak, all those things.

So historically, when we in GP get a LARPAR case in, it’s on emergency, right? So we are just hoping that they can breathe. We’re not doing a full neurological exam. And half these dogs are like, You know, basically unconscious. Anyway, we give him some ace. So you’re not doing a good neurological exam. So we never actually knew that the polyneuropathy was, there.

And but many already started to have a little, you know, CP deficits and things like that. So, Dr. Bryden was actually doing research on the esophageal problem with, larpar. So that’s what she was studying. And when she had all these dogs coming in that were in her case, she was doing a full neurological exam.

And she’s like, wow, all these dogs also have polyneuropathy, you know, this neuropathy in the back end. So it was because she was able to do a really good full exam is how she made this connection to it all. So really the optimal thing if you’ve got a breathing disorder is to do the tie back and a problem is that there’s not, it could be expensive for a family, there may not be a surgeon locally, there may not be a surgeon eight hours from them, right?

And so that’s, also an issue. It also may be an emergent situation where it could be something that we need to do in a day or two and not wait for five weeks to get to see the surgeon that, you know, the boarded surgeon. So then, so, so all these things are, happening of course, so regardless of surgical intervention, you will, you need to manage the esophageal problem and you also need to manage that, polyneuropathy.

And it’s no NSAIDs, it’s nothing like that. It’s, it is, you know, physical therapy is the biggest help and then environmental management and harnesses and stuff like that. So that, like in in a high level nutshell is, GOLPP and. with the surgery. So many people are nervous about recommending it because of the risk.

However, the risk that here’s the big thing is that anesthesia for the surgery is very important. Technically, this isn’t a, this isn’t a difficult surgery on the pet, right? You’re not going into the, a spay is worse, right? You’re good. It’s a soft tissue. It’s a tiny little incision. It’s soft tissue.

It’s in the neck. It’s two stitches. Close it, you know, for the tie back, then you’ve got some skin, you know, whatever sutures, an ice pack. It doesn’t need morphine. It doesn’t need all these things that, this is why there was so much aspiration after surgery is because we were over anesthetizing them. So that’s why for this workshop I did at VMX we had Sheilah Robertson, our good, you know, friend talk about anesthesia.

And, it’s only about 8 percent of a risk factor for aspiration pneumonia. And I always say it’s a hundred percent risk for asphyxiation, so I would much rather take an eight percent risk than a hundred percent risk. But and they might be a it might be a 14 year old lab. Do you do it?

Guess what? If you get six more months, like it doesn’t matter if they don’t want to do it or they want to do it, but I don’t think we should make that decision for our families. And I’ve done studies, I’ve done surveys of over 800 families and about half and half did the tie back and didn’t. And it’s about 50 percent did not get the advice of their, from their veterinarian about the tie back.

They found it on their own. And we absolutely should give the option for those families. But anyway, so that’s where I get so kind of worked up on it is because there are people that are not getting this information and they would do the tieback or then they need to learn about physical therapy and, knowing how, to, how should your dog eat?

You know, should it be a raised bowl or not? All these things.

Dr. Andy Roark: Talk, talk to me a little bit. I know we don’t have a ton of time.

Dr. Mary Gardner: I know. Sorry.

Dr. Andy Roark: But if, no, I love it. If, I was talking to a pet owner and I was like, “Hey, you know, this is, an option. This is what I’m seeing. This is kind of how it progresses. You know, there is surgical intervention.”

We sort of gracefully talk about that and kind of, you know, what does that look like for you? Is that something we want to explore a little bit? And they said, well, okay. So what is our life like? After the surgery. Talk to me a little bit about in sort of those terms sort of at the high level.

Frame up for me what the commitment for physical therapy and the environmental management would look like. How much do you share with the pet owners kind of in the moment of what that looks like?

Dr. Mary Gardner: Yeah. You know, it’s funny is, I think we recommend amputation of an osteosarc way more than we recommend a tieback, right? And,

Dr. Andy Roark: Probably true. 

Dr. Mary Gardner: right, yet 

Dr. Andy Roark: Oh.

Dr. Mary Gardner: You manage a hundred pound Rottweiler that’s just had his leg amputated, that’s difficult. Like, that’s a lot of care at home, where this is not so much.

So, there’s should we change the feeding and water habits? Yes, we need to slow them down. So there’s slow, waters water bowls. Should they feed raised bowls? Actually not a raised bowl. They should be on an incline. So that way they’re slow. That’s how they should be fed because it’s gravity, right?

Like all these things, it’s, not just a raised bowl. That doesn’t do anything. We need to get them on an incline. And then. And, you know, talk to the owner that probably the vast majority of pets will have a neuropathy, start of a neuropathy at least within a year from diagnosis. Duncan took a little longer because I think I noticed him sooner.

I was like, whoa, that’s a cough, right? Owners don’t think, we, I went a little crazy. So, within the year, you’re going to have a 60, 70 pound dog that may have trouble walking. And that means yoga mats around your house. Here’s the help them up harness. Here’s some physical therapy exercises. And it’s probably about 18 to two years out that they live, but it’s, because we’re already starting at 12.

The average pet is getting it done at 12. So you’re talking about labs that are probably going to die towards 14. Regardless, there’s a million other things that they might be getting also, so I don’t think, but the neuropathy does become a big issue and I think it’s very important to talk to owners whether or not they do the tieback that because they may have a dog that has some respiratory issues, but it’s okay. They’re managing it well. They’re in air conditioning. They’re in a cold area. They don’t, you know, exert themselves. They’re a couch potato and you know, they’re, it’s not that bad, but they’re going to get the neuropathy also. And that’s where it starts to be a caregiver burden. And it was for, I wouldn’t say a burden.

I would do it all day long for Duncan. And I just, I can’t tell you any, how many hundreds of people have emailed me about this. It’s crazy.

Dr. Andy Roark: Oh, I’m sure. I think that, I’m trying to think back to where my sort of ideas around this procedure come from? I feel like, and you, were there, we were there together in the same class, but I feel like the whole aspiration pneumonia was beaten pretty soundly into me. I don’t know if it was, I think it was one of those things where like, if I saw a test question that had laryngeal tieback, the question was going to be, or the answer was going to be aspiration pneumonia.

You know what I mean? Like it was, that it

Dr. Mary Gardner: and it was 30 percent risk then, but that’s because of like the anesthesia that they’re doing back then, right? So we could do it so much better, so much more simple. We don’t need massive pain. They don’t need to be on morphine. It’s, not that bad, right? So it’s better to have them alert and not, you know, all drugged up.

So I think you’re right. That was 100 percent when me and you were in it it,that’s what we were taught.

Dr. Andy Roark: Well, I was trying to remember why I had that thought, because I’ll be honest, like, it’s just not, it’s not a procedure that’s really kind of been on my radar. I haven’t looked at a dog that’s struggling and been like, well, I’m not gonna say anything. But I’m like, why isn’t this, why didn’t this come to my hand faster?

As I, I think that when we were going through it, the risk really was taught as being quite high. And I was like, boy, this is kind of a last resort, is how I had it filed in my mind. I think you, I’m glad you’re talking about this. I know you and I had talked earlier and you said that you’re going pretty.

pretty hard on this. You’re putting together. Talk to me about the website that you’re sort of putting together. You sort of mentioned that you were sort of putting together resources and you wanted to make this really accessible. what’s your plan with that?

Dr. Mary Gardner: it is just my passion plan. So I’ve got, it’s been totally self funded. It’s called all, all about GOLPP. So, allaboutgolpp.com and it’s for both the pet parents and the veterinarians out there. So I wanted it to be like a one stop shop of education. For the pet owners. So what is it?

What are risk factors? You know, medications. Cause there’s doxepin discussion. Like, should we use that? and, no, don’t waste your time on that. You know, things, like that. I’ve also got a veterinary section. So it’s got how to diagnose what are the signs. non surgical options. And then there’s a whole set of resources.

So there’s handouts for veterinarians. We’ve got history handout. We’ve got an oral exam handout for them. We’ve got client education handouts, all free on the website. And then the biggest thing is just these rehab videos that I made with Dr. Carolina Medina. If you remember her from UF and the acupuncture service.

And so we made about 11 different rehab videos for just exercises at home that aren’t a big struggle for, it’s not like go run agility. This is, you know, the cookie stretch and the incline stand, you know, stuff like that. So, it’s got all the resources and lists of the boarded veterinarians out there, the list of the rehab facilities.

And yeah, so it’s just, my goal is that it’s the one stop shop for people to get educated on both, pets and vets, both pet owners and vets.

Dr. Andy Roark: You know, it’s funny. I, as I’ve come along in my life, I have come to really appreciate stories and examples that illustrate who people are. And so I always think it’s this beautiful thing. If you can reach into your pocket and kind of pull out a story or an example about someone who sort of encapsulates who they are and.

One of my favorite stories about you is this one, where it’s like, you’re the person who gets excited about something that they care about, and you don’t post it on Facebook, like, you’re like, nope, we’re, and you make, you launch an empire and crusade, and you’re building, there’s gonna be a GOLPP app, that you’re gonna, like, that

Dr. Mary Gardner: Wait, yes. I would love that. Yes.

Dr. Andy Roark: I see you running across a professional sporting event with like a banner behind you before security tackles you that says “Ask your vet about GOLPP.” I mean, it’s just, 

Dr. Mary Gardner: I like that.

Dr. Andy Roark: You get these passion projects and

Dr. Mary Gardner: I do.

Dr. Andy Roark: And you go with them and you do such great stuff. And I don’t think you get enough credit for all the work that you do for our profession.

But anyway, I, love you buddy. I’m so glad you do this.

Dr. Mary Gardner: I love you too.

Dr. Andy Roark: I really appreciate you coming and sharing with us. So cool. Mary Gardner, besides the website

Dr. Mary Gardner: Oh God,

Dr. Andy Roark: and all the resources, where can people find you online if they want to follow your, if they want to follow your adventures, where can they find you?

Dr. Mary Gardner: So my, personal adventures are at Dr. Mary Gardner. So Dr. Mary Gardner, and I’m on Instagram and Facebook and I, you know, my shenanigans are out there and I will post about this in a couple of weeks when I’m you know, ready to, but it’s it’s been fun. So you can follow me there.

Dr. Andy Roark: Very nice. Cool. Take care, everybody. We’ll talk to you later.

Dr. Mary Gardner: Bye.

Dr. Andy Roark: And that’s what I got guys. That’s that’s my talk with Mary Gardner. Thank you to her for being here. Thank you to you for also being here.

Thank you to me for I’m here as well. Like we all need praise sometimes like we all want to feel appreciated and so i’m appreciating myself. Anyway, guys, if you enjoyed the podcast send it to your friends if you’re like, I don’t have any friends to send it to but I want but I really liked it you can just go and leave me an honest review wherever you get your podcast that’s super helpful as well Anyway, that’s enough. That’s enough of this. Let me let you go so you can get out there and do good in the world. All right. I’ll see you guys soon. Bye