Dr. Ashley Bourgeois joins us for a candid discussion about caregiver fatigue and its wide-ranging effects on individuals. Dr. Andy Roark and Dr. Bourgeois share how the lessons they’ve learned have impacted their careers.
You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Dr. Ashley Bourgeois: https://thedermvet.com/about
Dr. Ashley Bourgeois on Instagram: https://www.instagram.com/thedermvet/
Dr. Ashley Bourgeois on LinkedIn: https://www.linkedin.com/in/ashley-bourgeois-dvm-dip-acvd-9169208/
Leadership Essentials Certificate: https://unchartedvet.com/certificates/
Uncharted on the Road: https://unchartedvet.com/on-the-road/
Charming the Angry Client Course: https://drandyroark.com/charming-the-angry-client/
Dr. Andy Roark Swag: https://drandyroark.com/store/
ABOUT OUR GUEST
Dr. Ashley Bourgeois is a board-certified veterinary dermatologist passionate about providing practical knowledge to general practitioners to help itchy pets! She completed her bachelor’s degree at Iowa State University and graduated from the University of Missouri’s College of Veterinary Medicine in 2010. She then completed a one-year small animal internship at Purdue University. Upon finishing her internship, she accepted a residency position with the Animal Dermatology Clinic’s Tustin, California location in 2011. She became a Diplomate of the American College of Veterinary Dermatology in 2014. Dr. Bourgeois moved to Portland, Oregon in 2016 to help expand the company. She is an owner within the company and on the board of directors. She has a strong interest in autoimmune skin diseases, allergies, cytology, and otology. In her leisure, Dr. Bourgeois enjoys outdoor activities, traveling, and watching sports. She and her husband stay busy with their daughter, son, and rescue Lab/Boxer/Pit mix. Dr. Bourgeois is passionate about educating veterinarians in dermatology and work/life integration through her podcast, lecturing, and social media presence (The Derm Vet).
EPISODE TRANSCRIPT
Dr Andy Roark: Welcome everybody to the Cone of Shame veterinary podcast. I am your host, Dr. Andy Roark. Me and my allergies are here.
With the one and only Dr. Ashley Bourgeois, she is amazing. I tell a story about this episode when we get started. This is on caregiver fatigue and Ashley’s had a lot going on in her life and she talked candidly about that on this episode, which is really fascinating. And basically we were talking about what does hardship do to our ability to empathize?
What does having our own hardship teach us about being better caregivers? Caregivers, how do we let the personal burdens that we carry spill over into our professional life? How much is just unavoidable? We can’t we’re not two different people we’re not a we’re not a professional human being in a personal life human being and the two don’t intermingle That’s not realistic either.
And so we talk a lot about just about about carrying weights. We talk a lot about carrying weights in this episode. We talk about Ashley’s son’s battle with leukemia. We talk a bit about my wife’s battle with breast cancer. We talk about this at the end. And in both cases, things look good.
I don’t want you to think this is a sad episode. It’s definitely not. This is a life lessons learned episode. And I think it’s a really good one. I hope you guys will enjoy it. 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. Ashley Bourgeois:. Thanks for being here.
Dr. Ashley Bourgeois: Thank you so much for having me. I’m so excited.
Dr Andy Roark: You can’t still be excited. you’re on this podcast. I’ve had you so many times on the podcast because you’re just, you’re so lovely. And I always just enjoy you. And it’s funny the last time that you were on the podcast, you know, we were going along and we were talking and you were talking about fluorescent light energy FLE and that was just as I really appreciate it was something I reached out to you about and then You know at the end of the episode I’m always fascinated in what people like you who are doing so many things I’m always interested in what you’re interested in, you know, and so it what are the things I’ve learned in running a podcast is The best podcasts don’t come from me having an idea and reaching out to people.
They come from hearing people talking and saying, well that’s something that person has going on in their life, or that’s something they have real expertise or real passion about. And I’d much rather engage people in what they’re passionate about because you just learn so much more and you can just tell that it’s what, it’s sort of, I don’t know, it’s, where they’re heads at and kind of, kind of what their experience has been.
And so I was talking to you last time we were together and I said, you know, are there things that are on your radar or things that you wanted to talk about? And you kind of caught me off guard. Cause you said, well, you know, I’d be interested in talking about caregiver burden. And I thought that was really I thought that was really interesting ’cause you and I have known each other since vet school and so, I’m not gonna tell your story, but you have had you’ve had a tough road in a lot of ways, and I don’t know, most people probably don’t know that about you because they see you lecturing at, you know, you’re at all the conferences.
You, you’re traveling, you’re speaking. You’re just so well regarded. You’re writing. I’d love to have you as a guest on here and you, just do so many things, but you know, as one of your friends, I, have, I’ve. You know, known about your journey and sort of watched your journey for years. And I don’t know that most people understand sort of the weight that you kind of carry.
And so when you sort of start to talk about caregiver burden, let me just sort of pause here and kind of open it up to you and sort of say, tell me a little bit about kind of what you mean by that. And also what, what makes you say that as something that, I don’t know, that you think needs sort of more attention.
What does that look like in your eyes?
Dr. Ashley Bourgeois: Definitely. I think the idea with caregiver burden, we have to realize does we extrapolate that term from human medicine. That is something that is actually really well researched in human medicine and what caregiver burden means. It means is when you are the person that’s not necessarily getting diagnosed or going through the treatment, but you are the person that has to take care of someone going through that.
And traditionally, actually, so what has done a lot of kind of initial research into this dealing with allergic pets, and it’s something I’ve lectured on. Just through my relationship of kind of teaching about allergies and dogs. And then, you know, we’re going to talk about some of the journeys that we’ve had personally.
But when you start to talk about caregiver burden, we think about it in a different way compared to when we have to go through it. So in human medicine, we often think about this with say that your parent is elderly and you have to take care of them or if you have a child who is sick or a spouse who is sick, someone that you have to, you know, drive to the appointments, you have to advocate for them when they’re not feeling well, you have to pick up medications at the pharmacy.
Obviously there’s financial burdens associated with that. So once you really experienced having to go through that yourself, whether it is for a pet, a human. You start to realize all the different aspects that are there. It’s not just when someone’s in the exam room with you, there are so many different layers that we have to deal with when we are a caregiver for a pet, a person, whatever that looks like.
Dr Andy Roark: Well, you see it in You see it in some of the elderly pets for sure, right? You see it as far as you know, this pet has 16 different medications and a routine they have to have at the end of the day and there’s all of that sort of stuff and I think that’s I think we’ve all seen patients like that, but I think those people are sort of on the outliers.
I, I think, one of the things that I was really interested in is, you know, we look at a lot of mental health and wellness stuff in vet medicine, and people say, you know, vet medicine is so hard, vet medicine is so hard. It is a challenging profession, that’s true. But when you look at mental health, wellness, you look at depression, things like that, most of the time, Most of the underlying factors that are really, most of those conditions are multifactorial.
You know, we look at it and there’s generally an acute cause or there’s an acute pain, something that’s particularly challenging for people, but it’s usually layered on top of a number of other sort of burdens that they’re carrying in their life. And so, you know, when you look at depression, yes, professional stress is on the list, but it’s generally added on along with relationship stress, you know, medical concerns, you know, illnesses of self or others, family problems you know, genetic predisposition, all of these sorts of things.
And so when you and I started talking about caregiver burden, I think that it’s, I’m always interested in talking about what else is going on with people kind of in the background and how these things kind of layer. And so, you know, we’ve seen people. and they’re having a hard day.
So, for example, I had this client that came in and she had this golden retriever that had been hit by a car. And so I go in and see her, and it’s her and like five kids and this golden retriever, and I said to her look, you know this, back leg is broken. You know, we’re going to need to, it’s orthopedic surgery is the answer, you know, and it’s going to be 4 or 5,000, something like that.
And she just absolutely came apart. And she said, can I talk to you in the hall? And so I said, yeah. And so we stepped out into the hall and she said, listen, my husband walked out on our family. And he had all the bank accounts in his name and someone from our church gave the kids this dog as, you know, as a, to, to help them during this hard time.
And I’m the one who hit it with the car and just like, Oh my God, it was the, and I was just like the load that she was carrying sort of, behind the scenes. And yes, this dog was devastating, but it had to be a culmination of all these other things that she had on her shoulders. And like when she laid that out, you just go, Oh, I’ve got, we’ve got to figure out how to help you.
but a lot of us would just see someone coming apart and think it was about the money or something like that. And you just go, Oh man, people have a lot going on that we just can’t see. And I think that’s really important to remember.
Dr. Ashley Bourgeois: It is really important to remember, and when I, you know, discuss this topic, I like to think of all the roles that all of us have. So you know, I can speak as a mom of two young kids. You know, when you have kids and you don’t have to have kids, there’s lots of other ways you can be taking care of someone.
You could have a brother or sister who needs help. But when I just think about beyond some of the issues we dealt with our son’s health issues, you know, chauffeur, not sleeping well, you know, then having, you know, both being working parents, we all hold so many titles. You know, we, a lot of us identify as veterinarians and that is really important to us.
And it’s super important to me. I mean, that’s a huge part of my identity. But there are times where that’s not as important as being a mom. That’s times where that’s not as important as being a wife or, you know, having a parent who’s going through something or having to be a friend. But we only see people in that exam room for a finite amount of time.
And at that point in time, we really often just see them as a pet owner. And there could be so many other things going on in the background, you know, especially if you are dealing with something really traumatic in your life, like your owner was. You know, but sometimes it’s also hard to find that line of boundaries and empathy.
And that can be extremely difficult because of course we are in a challenging profession. And I can speak as a dermatologist. I think there’s some things that we obviously have a little bit easier because most of our things are not life threatening, but we’re dealing with a lot of chronic issues that add up and are expensive and are frustrating.
So it is, it can be difficult to find that line of protecting your own mental health, but being empathetic to others. Especially when you often don’t have the full story, not everyone’s as forthcoming of information like your own or what.
Dr Andy Roark: Yeah. So, you, I think, the way I remember it, and correct me if I’m wrong, I think you were at a speaking engagement when you learned that your son had cancer. Is that true?
Dr. Ashley Bourgeois: So I was at our veterinary dermatology conference. And what’s interesting about that is I was about to speak like in an hour. I was supposed to give an abstract and this was the first conference. And if you know, I know, you know, a lot of dermatologists. We are a pretty close knit group. We’re kind of a medium sized specialty.
Most of us are kind of weird, right? And I’m including myself in that top tier. We’re kind of weird. We’re kind of funky, but we talk a lot because that’s what we do all day, every day with our clients. So we’re a pretty tight knit group. And so we, this is the first conference in 2022 we had since COVID in person.
So we’re all so excited, right? We are in new Orleans. We are having a ball. We are. We are, you know, cheersing. We were having a good time. And I had found out second day into our conference, that our son was severely anemic. So luckily I didn’t find out about his diagnosis until I got home, but we found out he was severely anemic in that he needed a blood transfusion.
Which there’s lots of reasons kids need blood transfusions, but it’s scary and you have no idea why. So I pretty much had to drop everything. And what I’ll say about our community is pretty much everyone rallied around me because I just said, I just found out my son needs a blood transfusion. I am going home.
And you know, between the people, someone spoke for me, they got me into my hotel room and got me on a plane as fast as they could. And then I went straight to the hospital from the airport. And then the next morning is when we found out that our, at the time, three year old son had leukemia.
Dr Andy Roark: Yeah. Oh, man. When you sort of go through this and you’re learning these things about your son and your family, and you’re sort of coming back together what was your sort of thought about the arrangement of your life, right? So you’re a specialist, you, you’ve got all these things.
I love the fact that you’re sort of able to say, guys, I’m leaving and I, you know, and I just, and you just go. I think a lot of people who’ve had those sorts of realizations have that experience. I found out my wife had breast cancer. I was just like, all right I’m gonna go for a walk.
And no one had a problem with that. No one had a problem with that. And so it is, but I think everyone sort of has that sort of lightning strike moment.
I was sort of secondary in that this was my wife’s diagnosis. But at the beginning, you know, we didn’t know really anything about it.
And so there was this great uncertainty and wait. And it was funny, but we came back to sort of together. And we talked about it and so she sort of said, this is a diagnosis and things like that. And I said, okay, well, what are you going to do? And she’s like, well, I’m going to go to work. And I was like, okay, well, I, me too.
and we went back to work and people asked me about it. And my sort of thought was like, I didn’t know what else to do.
Hey guys on Uncharted, April is this weekend in my hometown Greenville, South Carolina guys. I am looking forward to diving into all kinds of topics on marketing and strategy and growing practices and streamlining communication with pet owners and with our team. Anyway, this is, um, this is the flagship conference of Uncharted.
It is the first conference we ever did. It is an absolutely magical experience. I am so sorry if you’re not going to be there. Uh, It’s it’s. It’s awesome. But don’t worry. I didn’t, I didn’t jump on here. Uh, to tell you bad things. I jumped on here to tell you good things. We’ve got tons of stuff coming down the pipelines at Uncharted, head over to The vet.com/events to see all the stuff we have coming.
If you live in Atlanta the Uncharted team, including me will be there next month. We will be there in May. We are doing our leadership essential certificate together in person. It’s going to be amazing. You should come, you should bring your leadership team. You should bring your team, lead your head, CSR, your head technician, uh, your, uh, your, your veterinarian, your associate vet, who might want to be a medical director.
One day, you guys should come together. You should get all the information downloaded into your brains at one time. That’s in Atlanta in may. We’ll be doing that again in Minneapolis, in June. And so come and see me. I’d love to meet you in person. It’s going to be small, intimate, boutique, deep training on everything.
You know, you need to have to lead and manage other people. So it is our leadership essentials program. It’s going to be incredible guys. Back half of the year, we’ve got our virtual summits coming up. We’ve got our practice owner summit at the end of the year. I just uncharteredvet.com/events. You’ll see all the chefs coming down the pipelines.
You don’t want to miss it. All right, let’s get back into this episode.
Dr Andy Roark: And so let me ask you that. And again, I know this may sound strange, but I’m always curious. How did you reconcile sort of the rest of your day with this thing that’s going on at home?
Did you want it to be, did you want to be away from work or did you want to go right back to it? How did you sort of square those things in your mind?
Dr. Ashley Bourgeois: Yeah, that’s a really great question, and I think the first important thing to realize it is that it is different for everybody. So, and it’s hard when you get connected to people who, so for leukemia is one of the top pediatric cancer. So it’s kind of interesting. I didn’t know anything about it, but then as you start telling people, you find a friend of a friend, you have, right.
Like you get all of a sudden these indirect connections and you get in these groups and you know, all these things, but then you realize everyone does things differently. Like the pediatric leukemia journey, at least the one that my son is currently on. Is about two and a half years of treatment. And so there are some people who completely just quit working for those two and a half years.
So what I ended up doing is there’s all these in right, kind of similar, probably to your journey. You went from knowing nothing about something to all of a sudden, almost being like a layman expert right now, like anyone who connected with the thing, be like, here’s this phase, here’s this phase, here’s this phase.
Here’s when they lose their hair. Here’s when they do this. But you don’t know any of that. Like I’m not trained in that. And so what I did was pretty much like that Saturday, we found out the first month is the induction phase, at least for what our son deal or dealt with is the most, one of the most intense.
And so he ended up going on steroids twice daily. And then a bunch of different lumbar punctures and chemo rounds that he has to go through. And so I essentially just took those initial, like that initial month, and a half off. He also ended up throwing like a clot in his arm. And so we had to give him heparin injections.
There was just a lot going on. And I very much identify with work. So it was hard, but not hard because I knew in that time, like if I was at work and our son ended up gaining a bunch of weight, couldn’t walk cause they get neuropathies from the chemo and they’re, you know, he’s three and he gained like eight pounds, which is a lot for a three year old just from all the steroid weight.
And I was like, if I’m in an exam room and someone’s mad, cause I won’t refill Apoquel, like I am not in that mindset. Like I am not there. Now I was still doing some stuff like podcasts or things I could control. Like I’d be like, this is a bad day. I’m not going to do it. But I wasn’t in the clinic for about a month and a half because I just had to, I couldn’t control that.
And I love being in the clinic, but I was still doing little things like interviews, podcasts, content. But when I needed it, when I knew I could be like, okay, I like to you, your point. A lot of walking. My dog got walked a lot during that month. But I wasn’t in the clinic cause I knew I couldn’t, I just couldn’t mentally be there.
But after that month and a half, I was also very much ready to go back. So probably a middle ground where I kind of got through that initial time, but then I needed to get my mind off of it.
Dr Andy Roark: Well, that makes sense. I really like your example of like, if a client was gonna get mad about Apoquel.
Dr. Ashley Bourgeois: I was like, I can’t.
Dr Andy Roark: Well, and I was, that’s what, that’s where I kinda wanna go with this, is started to talk to you about sort of the experience of working with people when you’re carrying a burden and working with people with the idea that they might be carrying a burden.
I, it was funny, I tell this story sometimes now because so, so. My wife came to where I was and just to talk to me in person was just like, Hey, this is the diagnosis. and, we decided that we would come back to work. She was like, well, I gotta go, I gotta go teach. And I was like, okay.
And again, everybody handles. Things are on the way and so I went back to my team and I was like, I have to go for a walk. And so I went for a walk and I walked down main street and I went to this coffee shop. And so I was like, I, you know, it’s been a hard morning. I think I would like a bougie coffee.
And so I, walked into the coffee shop and the guy was behind the counter and he had this big smile on his face and he was like, Hey man, how’s your day going? And I was just standing there and I thought I just found out my wife has cancer. How’s your day going? and of course I didn’t say that but I’ve never forgotten that and just and having that internal thought of it ain’t the best and so of course I said something like, you know, one one step at a time and then I sort of placed my order But, I’ve never had such clarity in my life that people, they’d have no idea what you’re going through.
And I have been that happy guy to be like, hey buddy, how’s everything going? And I’m sure that there is a heavy weight that other people carry. I was texting with somebody. last week, and she said, oh, I just got terrible news about my father having metastatic cancer, and I was like, oh, and I kind of carried on with the conversation thinking that she had gotten that news in the last couple of weeks, and it was like, oh, no, it’s been less than an hour, Andy, and I was like, oh, no, I’m so sorry.
But even like, I just, you don’t process and you don’t know that people are carrying sort of a burden like this. And you look at them, you, I don’t know, I always kind of imagined that you would know, but you, I don’t think that you do. And so, I just, that whole ownership of the idea that people don’t, They’re going to continue to have their own things and they’re not going to know about your things.
I don’t know. I think that’s important. I think that was sort of an eye opening realization for me. And the other thing I wanted to ask you about with this is just and it makes sense also that you would take time off. Like, I was mad for a while. Like, you know what I mean? Like, I did not want to hear.
about how other people were having a tough day because, you know, because traffic was bad. I was like, are you kidding me right now? Are you kidding me right now? And so I think that was something that I had to kind of manage was just not having a lot of patience for things that seem trivial in the light of kind of this weight that I was kind of holding.
And again, I know people have a lot worse things than I had, you know, and so I don’t know. So does any of that sort of resonate with you when you think about it? Did you feel that? I don’t know. Did you feel that? Were you frustrated with other people? Did you have less patience at least initially?
Dr. Ashley Bourgeois: You know, it’s funny as it would be very situational for me. So like, to your point, that’s kind of why I ended up taking that month off, right? Because if it was someone I know coming in saying like, Oh, I just want the antibiotic skin without cytology. I’d been like, I’m sure I would have been fine and faked my way through it, but I just didn’t need to, right?
Like I didn’t need to. I had a supportive company. We could figure it out. I didn’t need to, but where I kind of ran into were a couple things. I can be a deflector, meaning people be, I’m a very positive person for the most part. So when people, right, everyone saw, I left the meeting early. So everyone’s like, let’s go get drinks.
I’m like, I’m on my way home for some reason. My son needs a blood transfusion. I don’t know why they were still all at the conference when I found out, but I didn’t want to like call and tell everyone, like, let’s let everyone know. I’m not there cause my son has cancer. So, you know, for me, everyone was calling to check in when they got back.
I didn’t know exact cause. With our son, he couldn’t go to school for about a year. So there’s about a year because he was so immunosuppressed. He couldn’t. So basically, my husband and I kind of divided and conquered. We’re very fortunate. We could do that. So, you know, I was down to two days a week in the clinic.
He was kind of down to two, he’s an engineer. He was down to two days a week in the office. And then the fifth day we’d kind of like. Divide and conquer whatever needed to happen. And in that time period, there’s lots of appointments happening and he had to have a few more blood transfusions, bone marrow you know, ask for things like that.
So there were times that people would call and because I think I tend to be a positive person, I would just like, well, we’re very, we’re really lucky because we, you know, we caught it early. We’re very lucky because we have supportive jobs. So I would, and people would be like, You can be lucky. It could still really suck.
Like you have a child with cancer, like it’s okay to say it sucks. And I’m like, yeah, it does. But then you end up in this weird competition. Right? So like I was connected to people I knew who’s my son is what’s called standard risk with kind of medium risk. And I got connected to people who had children with high risk.
So they were having a different protocol. I ran into a lot of people, even in the last year when he’s been on maintenance now for a year and, you know. See, fairly normal kid. If you saw him, you would not know. He just got a haircut again, like, he’s crazy, he’s about to turn five, his birthday’s coming up.
Like, you would not look at him and know he’s still going through chemo. Like, he’s been pretty good for, I mean, we still have our challenges, but he’s been pretty good for about a year since he hit maintenance. But a lot of times when I talk to people, they’ll have something hard going on in their life.
And they’ll say, here’s my hard thing, but it’s nothing compared to what you’re going through. I’m like, I don’t need that anymore. Like, yes, I appreciate you want to say that, but I still want to be here for you as a friend. And I don’t have this magic. You know, trump card because I have a child with cancer.
That means you can’t go through something hard. So that’s what I’ve had to kind of explain to my friends is I love that you want to be appreciative and supportive, but like, I still want to hear about your hard stuff, but I think that is very different for people. I know people who can’t do that. They can’t.
But I’m a very external person. I’m a verbal person. I’m an external person, like to my husband’s dismay sometimes, but I’m a chatter like I want to talk through things like if you have a problem, like I want to be able to sit there and talk to you about it. And I’m okay to not be like, well, Like I, I remember my friend, his dog slipped his disc and he was like, Oh, but it’s nothing.
I’m like, no, that’s terrible. It’s terrible that you have to go to acute surgery with your dog. You know, do we have to be in a competition? But I think that is very individual on a person because I know people who kind of have to seclude themselves when they’re going through something like this.
But I’m such an external person, I almost craved not hearing about other people’s bad things, but I craved to know what was going on in the world because I knew the world didn’t stop just because I was going through something.
Dr Andy Roark: It seems like there’s sort of a switch that some people go through and maybe others don’t. There’s a part, I think. I mean, everyone’s different, as you say, but there’s a part when we’re sort of carrying a burden or we have something that happens that’s significant in our lives, where I think, it’s justifiable to look around and say, this isn’t fair.
You know, this isn’t fair. Why is this happening to me? I don’t think anyone would fault people for having those thoughts. And I think that’s justifiable. I think it’s justifiable. for a while and then I think one of the transitions that happens or it doesn’t happen is The feelings that we have of having carried this burden.
They can either transition into empathy for other people or They stay as this sort of source of frustration. You know what I mean? It feels like at some point we have the potential to make the choice. I’ve had this hardship. I had this thing that happened to me that really sucks.
And so I don’t want to hear about other people’s complaining or I’ve had this hardship. I’ve had this burden, had this bad thing that happens to me. And so I understand that other people are also struggling and I’m going to be more empathetic than I would have earlier because now I’ve, I know, that things can suck, you know, does that make sense, I guess, that sort of dichotomy of perspectives and I just, you so exemplify the second one to me and all the times I’ve talked with you and of, being someone who has never seemed angry to me, who has never seemed you have never, and let it make you sort of angry or, you know, or bitter, but in fact, it’s the opposite where you just seem you’re, you just seem so much more empathetic and more open and you’re the first one to say things like, well, we don’t know what that person’s dealing with, you know, and stuff like that.
And it’s just, I don’t know. Do you, did you. Did you feel like you had a transition in that way? Do you feel like you just from the very beginning you always sort of had This rise in empathy. Did you ever have the I don’t want to hear about your crap kind of phase or was that not a thing for you?
Dr. Ashley Bourgeois: Yeah, I don’t want to paint a picture that like the day after we found out I was just like, all’s good.
Dr Andy Roark: Yeah, mother teresa, like
Dr. Ashley Bourgeois: Right, no, I don’t want to paint a fake picture. I definitely I went through grief like anybody else. You know, I definitely went through like, why or. You know, cause when we found out we had a couple of people tell us like he looked pale and you know, I would joke about it.
Like, I’d be like, we’re not exactly the tannest of people. Right? Like I’m Norwegian German. Like, so I don’t want to definitely give a false impression that it was just like, Oh, he’s got cancer. No big deal. Not at all. But I think that you, I mean, there would be good and bad days, right? There’d be days where I would be like, Well, why?
And our son has had a couple of medical issues, like he was born with a congenital heart defect. I like to call him our English Bulldog. He is just our daughter, nothing. She’s like had nothing. Our son has been to the Children’s Hospital for a heart procedure when he was 13 days old, tubes put in his ears when he was, you know, 10 months old and now cancer.
So he saw like the Children’s Hospital for three different diagnoses before he was even like when he was three. But I think I’m also just very trusting in like medicine. So the good news is as soon we had, I will say the way that our initial oncologist told us, was wonderful. And I’ve been in situations like when we initially got told about our son’s heart defect, the communication bedside manner was not wonderful.
And that was way different as far as how I processed it. But the oncologist we had was wonderful. It was very like, here’s what we’re dealing with. Here’s exactly, I mean, there’s a roadmap. Here’s exactly what it is. Here’s the things we need to do. But then she also, and we’re very fortunate, like pediatric leukemia, the type he has is like a 90 to 95 percent cure rate.
So it’s like, this is going to be a sucky road and I’m so sorry. You have to go through this, but I just want you to know there’s plenty of options. So I think I was able to also, I’m kind of a. Tell me what needs to be done and it will happen. That is just, that is me to like a fault. Sometimes my husband would be like, we don’t have to just do everything cause you can. But so I was like, I went through grief. I went through uncertainty, right? Cause I didn’t know what our world was going to look like. He has a port in. So anytime he gets a fever, which kids, right. They always get fevers. He has to go to the hospital. Cause they have to do blood cultures just to rule out sepsis.
So it was here’s all these uncertain things. But there is a roadmap and an endpoint and I can just, I’m just, my personality can be like, tell me what needs to be done and it will happen. That can also be a fault because sometimes I have a hard time like just relaxing or, you know, being like trusting and not having to be on so much.
So I definitely had my doubts. But I just want everyone to know whatever you’re going through, like there’s not a right or wrong. Like I definitely had things I probably didn’t handle as well, but it’s just like how I identified with it. And I just tend to be very trusting in like the research and science.
And once they said, you know, there’s, a, really high chance for a cure rate, then I just had some peace with that.
Dr Andy Roark: What are some of the things that changed in your perspective or in the way that you practice based on the experience that you had? So, I mean, I can’t imagine having this experience and you get this diagnosis and it’s not delivered well, and there’s a lack of bedside manager manner.
And then you go and you have this other diagnosis and this person delivers it well and things like, surely you took things away from that, sort of influenced you and how you communicate and how you practice medicine. Like, are there things that stand out in your mind?
Dr. Ashley Bourgeois: Oh, you bet. I mean, for sure. We just had a situation where we had to ask to not see someone anymore because even two years in, when we were seeing a certain person, we didn’t have the best feeling. And that includes my husband who is like, I’m pretty nice and patient. He is like a saint compared to me. So when he was I don’t know, I was like, Oh, that’s it.
Like we need to probably just advocate that we don’t feel good about seeing that person. So I took a lot away from that delivery. Making sure, so, you know, when we were talking before we hop on, like if someone’s a couple of minutes late, of course I have boundaries, but often I understand I have been panicked because I’m a couple of minutes late for an appointment.
You know, I have been like, I cannot go to everything. I’m the more medical minded person in our family. I can’t go to every single appointment for our son over two and a half years. Like it is not like my husband’s job is a bit more flexible than mine. Like we have to balance that, you know, if he gets a fever, we have to drop everything and run in, that’s a little bit easier for his schedule.
So if someone says like, Oh, my wife sent me a list of questions, you know, historically it would be like, well, why, doesn’t she come in now? I’m like, okay, great. Show me the list of questions. You know, okay, great. Can you FaceTime them? Can you put them on speaker? Like when, you know, I used to be annoyed at people would be like, Oh, they’re on speakerphone.
And now I’m like, cool, great. Put them on. I’m on FaceTime a lot. Like, I’m just like,
Dr Andy Roark: I’m glad we made this happen. Yeah. That’s great.
Dr. Ashley Bourgeois: It just saves a lot of frustration. Cause I don’t know, to your point, I have no idea if they just had. A child that was diagnosed with something. I have no idea if the wife is the breadwinner of the family And she needs to go be the one that’s working. I don’t know that now.
I have a lot of clients who confide a lot in me because it’s dermatologists We get to know our clients a lot pretty well but I don’t know that so if I can reasonably make it happen without breaking a boundary and it’s not just because i’m stubborn In saying, well, it’s just the way that it should be.
Then I will try my best to accommodate it. Now I will have boundaries if they’re like 25 minutes late for the 30 minute appointment and they’re like, you have to see me this second. Of course I have boundaries, but I really, tried to just think about how I have felt in those situations. I also, almost every single exam.
I, even if it’s a happy, you’re doing great. You’re just here for blood work. I almost always end with what questions do you have for me? Because so many situations and I’m, you know, my texts will be like, cause I’m a talker, like you’re a couple minutes late, but I kind of know where I can make it up in my schedule at this point, practicing so long, but I like to ask that cause I’ve written so many situations in the last few years where we’ve seen many people and you just know the ones that, you know, Make you feel rushed, you know that just make you feel like oh I’m just checking off the box and moving on and of course if I like know that they’ve been taking too much time I can Say, okay.
Well great. I’m gonna do this if you have any other questions, like, you know, we can set another appointment But even if it’s just I could get in and out fast just having that question and oftentimes it’s oh not really or something quick I just feel like people feel like, Hey, you appreciated my time that I just paid you for.
So I really try to be thoughtful of that because I’ve had so many situations where they just run out and I have, like two questions I want to ask them and I never got that opportunity.
Dr Andy Roark: Yeah. Well, actually, I know people are going to want to know, how’s Carson doing now?
Dr. Ashley Bourgeois: He is doing great. He is so currently he’s about to turn five. And he has been in school now for a year and as it stands now, things go well. You know, he’s still on chemo every single day. But as it stands now in July, he is supposed to finish treatment. So my hope is he starts kindergarten this fall.
As a normal boy that gets to put all this behind him. And then we’ll just kind of keep every step of the journey, checking and making sure things stay in check. But so far, so good.
Dr Andy Roark: That’s awesome. Allison’s now well over a year post treatment. Everything is going well also. So, yeah. Some bright skies ahead. Ashley, thank you so much for being here. Where can people find you online? You have such a wonderful online presence. You do so much stuff on Instagram and just, you make educational videos and you’re just, I don’t know, you’re such a great online presence.
Where can people find you?
Dr. Ashley Bourgeois: Yeah. I mean, I try to keep things simple. Everything’s under the DERM VET, which includes, you know, some motivational stuff, some parent stuff, but mostly dermatology education, the idea just to make it really tangible and easy for general practitioners to learn. And then. You know, my own podcast, the DermVet podcast.
And I just really appreciate you having me on and being open to having this discussion. I know it’s not easy for everyone to share journeys like we feel comfortable with, but I hope people can take some stuff away from it. Cause we are a really great community, but we have things that we have to navigate as well.
Dr Andy Roark: Oh, thanks so much for being here. Guys, thanks for tuning in and listening. Take care of yourselves, everybody.
And that’s it. That’s what I got for you guys. Thanks for being here. Thanks so much to Ashley for being here and sharing her story and providing her perspective and everyone has a.
Their own personal journey and there’s no one way to feel about things but I just– I really feel like talking to people who have had experiences in practice in life and kind of understanding what their perspective was. I think it’s, I think it’s helpful in getting her own ideas straight in her own minds and kind of parsing to her own feelings So I really appreciate her coming here and just sort of sharing of herself . Anyway guys, take care of yourselves.
Be well everybody. I’ll talk to you later on. Okay. Bye
