June 1, 2021

#44: The C-word. With Dr Penny Thomas.

#44: The C-word. With Dr Penny Thomas.
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Season 1

Dr Penny Thomas’ career has taken her from working as a nurse in a specialist clinic while she was doing her vet degree, to a stint in mixed practise after graduating from the University of Sydney in 2011, and all the way to gaining registration as a Specialist in Veterinary Oncology in 2019.  Penny is a member of the Veterinary Cancer Society and has also obtained her Memberships of the Australian College of Veterinary Scientists in small animal medicine. She has a keen interest in haematological cancers and has published papers on multiple myeloma, anal sac cancer in cats and chemotherapy for T cell lymphoma in dogs, and is a regular participant in continuing education talks to general practitioners. 

On her journey to becoming a specialist Penny did a 2-year internship programme followed by a residency at SASH in Sydney. During her training, she spent time at Colorado State University, the University of Madison Wisconsin, The Chris O’Brien Lifehouse and the Animal Health Trust in the UK. 

And it’s this part of her career - the internship years - where we start our conversation with Penny. She talks us through the decision-making process around whether doing an internship is for you, and gives us advice on what to look for in a good internship programme, and how to choose the RIGHT internship programme. 

As usual, the conversation strays into all sorts of interesting places, like masochistic work cultures where working crazy hours is worn like a badge of honour, helping your clients make end-of-life decisions for their animals, and we talk about the risk of having pre-conceived ideas around what is best for our patients without giving our clients ALL of the options and making decisions for them.  And of course, we have to dig into what it’s like being a veterinary oncologist - all the good and all the bad and all the stuff that you probably didn’t know. 

Enjoy!

 

If you like listening to Penny then you should definitely check out the oncology series that we're doing with her over on the medicine stream on The Vet Vault Clinical. We started with a 3 part series on mast ell tumours that has answered all of the questions I’ve had for decades about these often tricky cancers, including a run-down of all the newest therapies that are becoming available to us.  

Our clinical podcasts live at https://vvn.supercast.tech/ with a free 2-week trial when you subscribe. 

 

Go to https://thevetvault.com/podcasts/  for the show notes and to check out our guests’ favourite books, podcasts and everything else we talk about in the show.

 

We love to hear from you. If you have a question for us or you’d like to give us some feedback please leave us a voice message by going to our episode page on the anchor app (https://anchor.fm) and hitting the record button, via email at thevetvaultpodcast@gmail.com, or just catch up with us on Instagram. (https://www.instagram.com/thevetvault/) 

 

Andf you like what you heard then please share the love by clicking on the share button wherever you’re listening and sending a link to someone who you know will enjoy listening.

 

And that's amazing when you can get them to feel so so much better so quickly.That's like that's what we're about.We're about having happy patients.Good evening, ladies and gentlemen.This is Gerardo Poli.And this, sorry.
I'm Gerardo Pollard.I'm you became stressed, and this is the vent valve.Hello, it falters and welcome back to another episode.I've been loving the Deep dive episodes.
We've done in two specific Specialties, I tend to have these preconceived ideas about what it must be like to be in a certain specialty.But it turns out that so far I've been mostly wrong which is why I was so excited about this conversation with a Veterinary oncologist, a career that I know very little about and I'm sure you don't either, dr.
Penny Thomas's career, has taken her from working as a nurse in the specialist, going to While she was doing a vet agree to extend, and make breakfast after graduating from the University of Sydney in 2011 and all the way to gaining her registration as a specialist veterinarian registration.
As a specialist in Veterinary, oncology in 2019, pain is now a regular participant in continuing education talks General Practitioners as well as the right here on the wait, for clinical.If you haven't heard a clinical episodes on mast cell tumors, you should definitely check them out.She has a keen interest in him at illogical, Kansas has and has published papers on multiple myeloma, Anal, Sac, cancer, and cats, and chemotherapy for T-cell lymphoma and dogs.
She's a member of the veterinary.Cancer Society is also obtained memberships in the Australia.New Zealand College of Veterinary.Scientists in small animal medicine on her way to becoming a specialist.They needed a two-year rotating internship program and then a residency at session Sydney during a training.
She spent time at Colorado, State University, the University of Madison Wisconsin, the Chris O'Brien, And life hours and the Animal Health Trust in the UK and is this part of a career, the integer part where we start our conversation with Penny, she talks us through the decision-making process around.
Whether doing an internship is for you and gives us advice on what to look for in a good internship program.And how to choose the right program for you as usual, the conversation, Strays into all sorts of interesting places like masochistic were cultures, we're working crazy hours is worn like a badge of honor a helping your Clients make end-of-life decisions for the animals about the risk of having preconceived ideas around.
What is best for our patients without giving our clients, all of the options and making decisions for them.Of course, we have to dig into what it's like being a veteran, oncologist, all the good and all the bad, all the stuff I bet you didn't know.And as we mentioned before, since recording, this interview penny has very generously donated her brain power and a time to the vet world to help us create a series of oncology episodes over on the Nicole stream, we started with a three-parter on mast cell.
Tumors that are answered all of the questions I've had for decades about those often tricky cancers, including a rundown of all of the newest therapies that are becoming available to us.Go to vvn super cast, take for a free two week trial, you can get through all of Venice episodes and a lot more in two weeks if you binge listen.
And of course it's all backed up by summarized show notes, so you don't have to worry.If you forget what you've just listened to Now back to dr.Penny Thomas and the c word.Dr. Penny Thomas Penny.Welcome to the show.I thank you for having me.
Hi, everyone.I'm here.Yes, Gerard is here as well, but it you are a you medicine specialist.I know you don't College you but I actually a medicine specialist by trade or oh God, no.I'm just an oncologist.
Just don't colleges so you're not medicine and then oncology.No.Although I Had to sit my memberships in medicine in order to specialize in oncology but that's where the sort of medicine training stopped.You got that piece of paper.Bam strange oncology.Yeah, I was like no more cancer.
Please ever been said that it really is like the quite closely related disciplines in a way to some degree.That's that's why I just presumed.I presume the one Builds on the other.Yeah.And definitely.There are a lot of Internal Medicine Specialists who end up doing a lot of oncology when they don't have a nun.
Le just nearby.So it's definitely part of internal medicine, but it is now one of those subspecialties mmm.Oh, yeah.I see.How long have you been doing it for?I have been a specialist now for almost two years but considering the length of time that it takes to train.
I've been doing just oncology now for at least five, if not six years.Yeah, Okay.So we've got to ask the journey from vet school to on College because it's not a common specialty at all and a lot of people.Yeah, I want to dig really deep into oncology as a field.
The why and the what, and what it looks like.But first of all talk me through what your career Journey looked like?Yeah, so I suppose it kind of before bit school.I grew up in a very medical family.Both my parents are in the human medical field and and so I serve, I knew from a young age that like science and medicine were far more interesting to me than like, art or English or anything like that.
But my dad, he was a cardiothoracic and ethicist.So like high stress but and that's a terrible Field.Open.Heart surgery in ethers.Yeah.So like your hearts already not great.
But hey, let's make the pies.You and try and fix you and then try and wake you up.So super high, stress, particular, part of medicine.I saw him do so much on call work.And, you know, when I was younger I was like, oh, I don't To be a doctor because, you know, I don't want to have to do all of that which is incredibly ironic because my first few years in practice for basically on call anyway.
Yeah.I volunteered a lot in vet clinics during high school and when I started vet school so I went to Sydney uni, I managed to get a job as like an animal attendant kennel hand in both a GP and The Specialist Hospital during that first year.
And from that set of cannot hand position I progressed up into Seen while I was at vet school and so I would work evening and overnight shifts in the ER, or like during uni holidays, I would work in the specialist departments and then go to UNI during the day, and I look back on that time.
And I recognized that I was a bit crazy.Like that was a lot full-time, Muni and full-time nursing.That would but I just I loved it.Like I just absolutely loved it.So when I graduated I got a job.
In a big mixed practice in the hunter Valley.It was a big nine vet clinic, and I was getting to do a pretty nice mix of small and large you stuff during the week.Mainly small, but big killer was he on call?
Yeah, one thinking I'm sure.Yeah.Which you couldn't do, when you're on call it was like the biggest issue, right?The clinic was like a nine Vet Clinic during the week.And there was some vets who just did large, he's just did Smalley's and there were some bits who did both but on weekends it went down to a one vet clinic and so you'd send all Saturday morning doing small he's consults.
They'd close.You get handed a list of large pay large.He's consults that you had to go do and then essentially spent the whole weekend bouncing back and forth in the clinic out, the clinic, and it wasn't unfortunately, a one in nine rotor.It was actually a lot more frequent than that.So it was just So exhausting and by yourself you're doing this by yourself.
Yeah.Yeah.And you know, one of those things as a new grad where they're like oh you won't have to do any on call for like the first month they took a month is enough to induct you in eurion is Yvette 11.Yes but then it was like day two and I was Uncle great like stamina and my ability to deal with that level.
Live workload just wasn't there anymore.I think maybe it was different in that school because I was like the nurse and I wasn't necessarily the responsible one, and now going to being like, the buck stops with me.That was that was full-on.So I was in next practice for 18 months and then I decided to go and do a rotating internship, which I was very fortunate to get a position its Ash, which then was a year of that.
Then another year of an oncology internship, two years of Already.Working as a registrar and now working as a specialist.So it's been a bit of a, bit of a road Journey.Wow.Yeah.So many places I want to go with that.
The first thing is, I will just comment.I'm also the child of two doctors.Okay.And also had a dad on call all the time.And also, I think my massive dislike for one called stem from that.
And right from beginning, it was, it was my goal to not.Which is also ironic because I spent ten years on call investment and then opened an emergency clinic.So funny like that, aren't we?Like I don't want to do it and then he ended up doing it.
The all that Journey.My Western how many years training?You said it quickly.So what was your supposed great qualifications?How many years?Two years of internships, two years of residency training.And then two years working as a registrar.So six years or lower, Most people Penny on you, do one year of internship.
What happened there?It's interesting and I think that that is, that is changing a little bit.I'm sorry.That was a real bad thing.Barely felt it Egyptian know the first year of internship was a rotating internship.
So went through like medicine surgery up.So er, like all of the dimensions and you were exposed to basically every sort of specialty in the hospital which was fantastic.It was a great opportunity to kind of reaffirm the things that you didn't love which for me was surgery.
Sorry, okay.But then also kind of help you decide like is is this environment something that I really do want to continue to work in because a big specialist and like 24-hour ER hospital is a different vibe to him GP clinic and some people love it and some people just don't and so it was a good learning opportunity.
But the second internship that was a oncology specific internship.So it was a year of just being an intern in the oncology department.And I think that in Australia, there's no set standard for whether or not you do that.
But it is becoming a lot more common that you do have these sort of specialty specific internships that are being offered kind of as a almost like trial year before people.We'll get you on board for a residency which is very much that structured teaching program and whether or not they can work with you for the next 2-3 years and then beyond.
Absolutely because that's a big part of it.Like these are people your supervisors and like that this the rest of the stuff.These are people that you're going to have to work with really closely and almost exclusively for a really long period of time.So they've got to like you and you kind of gotta like them too.
I like the way you frame the internships, because I've heard I've spoken to quite a lot of recent grads who, considering internships, or doing them and not sash.Well, I've heard I've spoken to some people where they tell me about what they do during the internship.And it sounds a little bit like a kind of slavery, and doesn't it, Go!
Wow!You're really being abused.Yeah, you are actually a qualified, wait, but you have paid nothing renders hours clearly.It was worth it for you.You, but what's your view on it?Other internships and then it and chips.Absolutely.
And, and there's such a difference between a good internship and an internship.That is is really, yeah, you're like, you said, you're being used and abused a little bit, you're a qualified bit, but you're working for nothing.And I think the interesting thing about internships is like, when you look at the definition of an intern, it's in terms of the veterinary world.
It's a Veterinary surgeon.That's enrolled in a training program, where the intern is provided direct supervision, but that supervision just has to be by one registered vet.So it doesn't actually specify that, that person has to be a specialist.
And I think that's important because I definitely have seen internships being offered outside of specialist institutions, where yes, it, it probably is a very good Training Program.I am but I think people need to go into it with their eyes a little bit open in terms of like, what is actually, what are you hoping to get out of this?
Are you hoping to progress down a pathway by which you could be trained as a specialist because if so an internship, like that is not going to benefit you 100% because like we offer, internships has an emergency veterinarian hospital.Yeah, but having said that, I actually now we have create, we have career Pathways and residency programs within that emergency service Try to that our interns were we train you to keep you as opposed to, you know, usually labor and so forth but we didn't have there's no pathway beyond that so people go all women.
Do an internship there with you guys.It's like, well, what do you what's your plan?My plan is be a specialist in this later, will actually just internship.Won't help you get there.Yeah so I best you do an internship in the institution which enables you of the pathway.Absolutely.And I think that, you know, there are there are stats from the aviation Hey, about internships and that only about 50% of them ended up going on to achieving a higher professional qualification.
If, and whether that's a reflection of the quality of the internship or whether that's just a reflection of the people who are doing internships and then realizing that actually progressing with this is not what I want and, you know, certainly it could be either and, you know, I have a sister who has also done an internship and at the end, she's a vet and she's a fantastic that.
But at the end of her internship, She decided that she actually didn't want to pursue any specialist training.He's gone back into general practice and she's phenomenal.Like she, she weren't so much but like she's absolutely a better vet or it but she also is a better bet because she knows like I don't want to do that.
And that's okay.Hmm.Yeah, it's true.They I think a lot of people agonize about should I do XYZ should I do an internship?So I specialize, should I do this?And sometimes the only way to know is to dry Absolutely go.Let me just go and give it a shot here.
It's and I might absolutely hate it.It's not a waste of your time because at least you've ruled X y&z Out.And, as you say, you narrow your focus, you go.Well, if the only thing I learned is I hate this.Well, you've learned something, I'm serious.That's just lots of stuff like that is, like, super, Super Value because people think Clarity comes through rumination going.
Oh, I got to think about it.When you think about it more, let me talk to more people but then, but actually Clarity comes through doing it.Yeah, yeah.And it Upside is this things that you think you're going to love and you start doing it and you go, oh he's not really my thing.It definitely happens.
So for people who are considering internships Benny, have you got any advice or tips on how to help you pick?A, what are the things that you should look out for?Yeah, absolutely.So I think I think one of the big things is trying to go to a hospital that does that is multidisciplinary.
So like it's not Just there's one surgeon and there's an A&R Department.Like, as much as that's two disciplines that's not necessarily, all-encompassing in terms of your exposure, what's wrong with emergency?Would you not want to also have exposure to internal Medics and technologists and neurologists like all of the things rather than just to unless you were Super pissed and you just knew this is what you wanted.
Absolutely jump straight in.Do an internship in a place where it's just got what you want.But I suppose from it being like a, well-rounded experience, being in a multidisciplinary institution, is probably really important.And the good thing is that most of those places have had enough interns over however many years that they should have some sort of program in place, and I think that that's Thing really important to be asking if you're interviewing for an internship like what sort of programs do you offer?
Because the other thing that can sometimes happen is that interns can end up basically Staffing.ER, departments.Yeah.And spending most of their internships doing graveyard shifts and not having that direct supervision and not having that like you're going to spend five weeks with the neurology department and watch all this cool surgery and blah blah blah.
No.Your you spend maybe two weeks out of your You doing actual intern stuff and the rest of the time you are Staffing and A&R department.So I think making sure that you're applying to, and accepting offers from institutions that have a program in place.
I think that's really important FYI.Anyone who's ever look in an internship at an emergency service, you will be Staffing and emergency department but not but supervise.But certified status.Is it that it's a Very, very important promoted because I know exactly what you mean, Penny.
I have a to tell exactly that and they were basically just the overnight stuff.He can completely unsupervised.Yeah.Which just really great at me, I'm like, no, that's not, that's not an internship.That's just cheap labor.And and that's not to say that that ER, experience isn't valuable because it absolutely is.
But I think I think as an intern you're there to observe and you're there to learn Earn and yes you can do both of those things on an overnight, ER shift.But you're not going to get maximum value for that if that is all you are doing.
Yeah, that like I 100% agree with you.I was just, I was just kind of job in a little bit there but right, where they're more things.I do know that there is more.There was was Benny finished with the tips that we are going to dive into one of the things you said, right?Okay, you said there was that wine?
Hmm, its water settle down.I have to work tomorrow.Oh yeah.So you said there about asking a question about, is there a structured program, right?What I would add there and I'm sure that you would do this do right?
Is like, what does it look like?Yeah.Yeah.Because we get these questions in interviews is like, oh, do you have a training program?We're like, yes.And then it's like they don't don't go anywhere after that questions.Like they just take face value that.What?But whether they're expecting you're going to deliver.
I'm like, do you want to know what it looks like?Let me tell you just to make sure that were on the same page.Yeah.But I think that's a good question leading on from that is like you have a structured program?Yes, was look like what a where I'm gonna spend my time.How does it flick through?And I kind of stuff.
Yeah, absolutely.They don't care.Gerardo they just want to hang with you.Do you want to hang with me, Schubert go make your skin your knowledge, your really two hours?Wait for me, bro.Yeah, I think I think the other thing is, when you're asking about the program is also asking about the expectation for what your roster would be.
Because like we've all, you know, we've all been in that situation where you have well, back in my day, I worked 60 hours a day and walk backwards through the snow to get to work.And therefore, you know, you guys need to suck it up and be grateful that you can do over time.
Like, We've all had people say, variations of that to us but fortunately, we are now in a position where we know that that is not okay for anyone to be working.Ridiculous, like, 80 90 100 hour weeks is just that's not conducive to a learning environment and it's not conducive to a happy person.
So I suppose you know, the expectation is an internship and residency is going to be hard work.I'm not trying to make out like it's going to Some cushy walk in the park, it is going to be hard work, but you also shouldn't be taken advantage of and I think this is one of the things that I've been really Keen to enforce in terms of my role.
Now with being an intern coordinator, for our Clinic is making sure that they're roasted appropriately.So our interns generally will work four 10-hour days so and like yes there might be over time, but it's not, it's not arduous.
And you know what?If they get Get stuck back late in a surgery.They come in late the next day, like we try so hard.In fact, sometimes we have to tell them, like, please go home and do not come back early the next day, like, stop it.I know you're enthusiastic.I was once like that, but you need sleep.
And I just think that I would hope that most institutions that are now getting interns on board are a lot more mindful of that now, because running people into the ground is not like that's that's a very quick way of Ending out in terms of not having people who want to continue in a specialist field.
So I think talking about that is super important.Now you'd like you raised a really hot topic there.What do you said there before?We're just doing, you know, 200 our months and so forth and you just that you to be that was that was that was like a badge of honor, you know.
He's absolutely badge of honor.So remember doing it. 20 to 22 hours shift, finishing a thoracotomy going home.Eating McDonald's on the way home too.To stay awake to drive home, slept, five hours, and then came back for my next shift and the rocked up looking like a zombie.
Yeah, that might was that need to be microwaved and warmed up, but then, but that was like oh, you're amazing.But that mentality is so not right.No and and it and it even took me as a business owner about two years to get my head around that, that badge of honor isn't a badge of honor that's that's burn out.
Yeah, it is crazy and it's unsafe.Unsafe.And it goes back a long way.And it also reaches forward a long way that culture.It's a culture that we pick up at University, probably most of its schools have that?
Yeah, you gotta cram got to leave exams.We toughening you up for real life as a bit because you know it's not for sissies and so you have that thing and then it is that thing up.Tough Enough I can I can do it.Then you look step into the to the work world.And then, as you say to her, I don't get rewarded to be a hero like that and actually not a hero.
You just an idiot.But that attitude becomes a thing and we carry it with us in our careers and then you get what we have in our profession where people burn out because they think this is how I have to be and there's no me still I you know everybody I know knows that I'm all for part-time work.
I think part-time work sustainable work as a bit and then I still do you do it but people still look at you funny.Like what?Why are you not?I said I still I still get it.I still get it in.Workplaces Eiffel Tower or maybe I just Feel it.Maybe I'm sensitive about it but the expectation is no, you should just work more.
Why don't you want to work?Yeah, because if I work that if I work that much, I don't like it anymore and I want to quit or For Worse it's great that you guys are focusing on it at that intern level.Because again, you have to say that culture from from the word go, I will go.
But it starts at this starts at the top and it's a mindset shift because the mindset is Is I did this.This is what they need to go through.In order for them to be successful, they need to go through this to be resilient and then no, no, no, yeah, totally.
And you have those older vet practice owners who will often still have that culture, and they will model it.And then they will say to their beds, usually go home.But the Vets are looking at the bus going, but you're not home yet.You still here?So I should be like you should night.
So, one thing that someone told me was Was and this is actually being really impactful in my career, my was it something?I said, no, I think you have a say to be here with this really impactful for me.No, I don't know.Actually many things you say Hubert acquaintance faculty this reason why I walk up these podcasts know it's more.
So it was it was look at The person that you were deciding to be a mentor or the person, you're looking at the being business partner with, or look at the boss that they are.And you go, if you get, if you want to be like them, that's fine.
You could be like them, but don't expect them to accept you if you want something different, if what they are continuing to do is something you don't want to do.So, if your boss values Lifestyle Family time, and all that kind of stuff, then that's a boss that you want.
To select because they then would them respect your desire to have that too.It's something that really made me choose to stay at animal merchant service was because Robin Simon were about family, we're about sustainability.And I look at them I go a if in ten years time rugby them and that was like a hundred percent.
Yes.Yeah.So now you've done you're doing your rotating internship.Yeah.And you've exposed to all these fields other than not being on call as a no.Allergist, what about ecology was it that Drew you are one ecology.
Oh, so many things, it's just it's so fascinating.Like it is a field where stuff is always changing and we are learning so much and like to its credit cancer is a really bloody smart.Today's it's just fascinating but it's also a specialty where and this is what I really like.
It's not just one body system, it's not just you know the brain and the spinal cord or you know, the Heart and that's it.It's you've got to know everything because cancer pops up everywhere.So from a science level, it's fascinating from a comparative medicine level.
It's also fascinating.So like dogs are a really good spontaneous model of cancer and so they use dogs a lot in Pre human clinical trials because you know that unlike mice and rats where you actually have to give them cancer compromise their immune system, Is kind of stuff dogs, get it.
And they get it in the same sort of unfortunate way that people do.So we also get to work a lot with human clinical trials and access to really cool technology before people do so that's fascinating.But then, I think the really big thing for me is the people, the clients, like, I loved when I was in general practice when you would have those client and it's that liked you and wanted to see you and I trusted you and were nice to you.
And those are basically all of my clients now like they.These are all people who are coming to me now because they're choosing to come me and coming to me because they want to do something or at least just find out information.
So they're receptive to listening to what I have to say.And their clients that if they do, go ahead and they treat their pets.We see them on a really regular basis and you get to build up that really nice.Shouldn't ship with them and with their pet.So that's probably the bigger draw card for me, is that human interaction in those client relationships that we get to have?
And, yes, the unfortunate reality of it is that those relationships don't often lasts forever, but I think that being able to help people and their pets during that, what's often their final sort of portion of their life, is a really special thing.
And I really, really Ali, love that.So that's some of the many reasons why oncology.Yeah, because ultimately, your own, your patients die, don't they look a lot of them do.Yeah, we don't often talk about the concept of the Cure.
That's a word that we don't bring up much because sometimes it's just not realistic, sometimes it absolutely is and there are so many cancers that people cure all the time.Like, mainly those like low-grade mast cell tumors and soft tissue sarcoma, But I don't really ever get to see those because they're generally dealt very well in general practice and you know, GPS get to be the heroes.
Like I killed your dog of cancer.I don't usually get that but we're often not talking about a cure.What we're talking about is a treatment and we're talking about having a happy patient, able to have still a good relationship with their family but it's often for a period of time that was actually a big shift in my mind.
And actually when when they when I heard an ecologist say that, hmm, it was like I thought they cured this stuff, I thought it was you know, all all sort of sorted and disappears but then there was explained to me that it was actually about quality of life and stuff like that.
Yeah.And that's why we don't get dogs walking around with no hair like, Chinese Crested dogs because the intensity of the chemo and so forth is not the same degree.Is something, is that?Is that is that right?Or absolutely.So I think that I was really fortunate during my training.
I actually got to spend some time in the human oncology area.And I actually spent a couple of weeks at the Chris O'Brien Lifehouse, which was just mind-blowing to me because these are all amazing human medical and Surgical, and radiation oncologists are so part of your residency training is you do something called time and related disciplines.
And this was my elective and it was just fascinating to me seeing people going through.Through cancer treatment for varying things, but it was also heartbreaking because these people were not well, and these people were not happy and it just was so funny to me that whenever I'd introduce myself to, you know, another doctor or a surgeon or even like a radiation therapist.
And they asked me what I did their first reaction was, oh, that must be so sad and in my mind I was trying very hard to be polite.I was like, definitely not as sad as this.Mike G, my patients of Bloody Happy.
Like I'll take my patients over your patience any day of the week, because yeah, because our focus is their quality of life when not.And, you know, the idea of a cure with cancer or some things.Absolutely, in the human world, you can cure it and you can go through that as a person, you can say, Okay?
Treat me, I'm going to be feeling terrible for six months, but I'm going to have the opportunity at the rest of my life and as a person you can you can sort of comprehend that but it A dog who doesn't even know they're sick, how do you ethically?How would you make a dog?Go through that if you can't guarantee that they're going to be cured and most people wouldn't choose to do that anyway.
Most people would be like, nope, I've seen my mother brother.Our next door neighbor go through cancer treatment and that is not what I want to do and I think that's one of the big barriers that we have is the assumption that they're the same when they're absolutely so different.
Hmm, But that helps it is a excuse me.That is a Time shift, help me, help me talk to clients that want to be referred.Because I think that's exactly that we often diagnosed cancer at a level or an, or an emergency quite a bit often like something crashes.
And you, you pick up something nasty and then you've got to have that talk.Where do we go now by that, either we euthanize or you get referred and people go, oh no, I don't want to put them through it.Yeah.It's not that same level of sick that people associate with human ecology is and is that At those dependent this wood because we use low doses or why don't they get a sick?
Yeah, so a lot of it is dose-dependent but some of it is just the way that we're giving drugs.So when I talk to people in consult about chemotherapy the statistics, that I generally put out there for them, is for an animal that's undergoing chemotherapy treatment.
The risk of them getting sick from chemo, is about 20%, so one in five, but if you are in that one in five, Where You Are, Going to get sick.The likelihood is that side effect is going to be very mild, easily treated by the client at home and resolve within 24 to 48 hours.
So we're not talking about animals that are sick for weeks in between treatment constantly, feeling sick.Just generally miserable.We're not talking about that at all.And certainly, if that was to happen, we would have to stop.We would have to reassess what we're doing because we're not about to make an animal.
Sick on a repetitive basis and no guarantee of a cure but when you compare that to people, most people who are undergoing chemo, you're guaranteed to have side effects because in the human oncology world, they're walking a really fine line between killing your cancer and killing you.
And you know and in Veterinary oncology we just don't tolerate side effects.So for a lot of animals who are diagnosed with cancer, there may be and there often is treatments that can help them to feel better.And it sounds counterintuitive that chemotherapy would make them feel better because of what we Associated to be.
But if we can reduce the amount of cancer in your body, lymphoma is a great example of that.Like if we can decrease the amount of cancerous, Blood cells, you have with chemo, you are going to feel better and it's lymphoma can be one of those diseases where the clients sitting in front of me and they're like, oh, you know, the pets not actually that sick, he's just a little bit slower, he's getting old, you know, and then we found these lumps and within two or three chemo treatments, they're coming back to me and they're being like, it's like he's a puppy again, we thought he was just old, but this was obviously all to do with the cancer and that's amazing when you can get them to feel.
So so much better so quickly that's like that's what we're about.We're about having happy patients.One of the biggest challenges I find the cancer and emergency perspective is the whole the Bloods didn't show anything.The referring that didn't dip Bloods and they didn't see anything.
Yeah.And it's like but he was fine yesterday and all of a sudden have ruptured.I don't know.I'd like you did get the how do you tackle that that conversation with clients?Yeah, I think that can be a hard one and I think some of what I will often talk to people About is that animals compared to people far more stoic, more able to hide when they are unwell, which can be incredibly frustrating because it means that when we're figuring out that they're sick, it's when they can't hide it anymore.
And it's, when it's really bad for a lot of cancers, we don't see even any early indication on blood tests, that something might be wrong, except if we've got things like organ dysfunction, or we've had like Oracle bleeding, we might see something when patients come to me in their blood tests, looking great, and normal, I take that as a really big positive because it means we don't have something else to worry about.
Like let's just focus on the cancer.This is really good.That your kidneys are functioning perfectly and your liver is good because you're going to need both of those in order to have chemo.Yeah actually that's a really good spin on it actually because quite often they feel like as if they're the money they spent on these Bloods and stuff like that.
Like I just Bloods for my yearly checkup one month ago and they didn't pick up cancer.I'm like yeah well actually quite commonly actually using no indication that cancers there on routine Bloods still valuable but that's it that has like for all people who are out there, listen to that, that's a great explanation of of, of how you can shift the value of a negative result, right?
Clear result to something, that's a positive.So yeah, so we're talking about blood tests, I'm going to ask a slightly clinical question, blood test Don't pick it up but I've heard probably podcast or books or something way.They talk about human ecology without working towards more tests that are sort of General, screening tests to pick up cancer, even if it's not a specific answers inflammatory markers things like that, is there other stuff like that in the pipeline?
Like, well, we have a taste too soon.We go, well, coming for you or six monthly cancer, taste.Look, we might, we certainly don't at the moment and people in the veterinary world, have done things like looking at.C reactive protein like differences in some other inflammatory markers as to try and usually they're used as sort of like an additive to like, oh, we've already got this test that suggests that.
So maybe we'll add the C-reactive protein and if that's high, then it's more likely.But at the moment in the veterinary world, we don't really have any of those blood tests.I think that the big one is that state specific antigen?Yes, definitely that.Yeah, men with prostate cancer, so we don't have anything.
I'm like that yet but it certainly is something that is in the pipelines and we may have access to.I think just the biggest difficulty is funding for things like that.Yeah, you know there's all the funding in the world for human oncology because they're wanting to try and detect things early so that they can cure people.
Yeah.And so certainly we might have more of a push for something like that in the veterinary world if we could directly translate that then into people and that's not how things happen.But at the I meant there's no real specific test that we can do on Bloods.That's going to be overly helpful or overly predictive in saying that.
The other thing that is happening a lot now is they're looking at looking at free DNA fragments in the blood as well.Instead of taking blood from people and looking for DNA markers of cancer for a number of different things and that certainly could be something that we might get looking on.
Because we know that we have a few breeds of dogs that seem to be too.Genetically predisposed to some cancers.So maybe we might be able to be doing some more screening early for those dogs like, dog.David Jose, how is it the French mastiff they get everything.
Well, I mean the, what the big one for me is Bernese, Mountain Dogs and histiocytic sarcoma, but then boxes golden retrievers sharp a staff.He's okay.Staff is in Marcel's that these in Marcel's Sharpay's and Marcel's boxes and everything.
But like brain tumor Has lymphoma Marcel's and Golden's and everything.Golden's are all this beautiful dogs, golden.Yeah.And like, maybe that's just because there are so many of them, golden definitely popular breed.Maybe they've just got the numbers there to say, ooh there, you know, we're finding cancer more in them because we've got more examples where their owners are, I don't know.
Maybe their owners are more proactive or that, I don't know.From his back to the to the goal of treatment.Again, I'm trying to get my head around, how wheat at a GP level, talk to our clients about it, to make sure they end up at places like like you.So you said the goal is for the animal to feel better.
Yeah, it does.It does it extend life like you.There's a generally make them live longer than they obviously, obviously, if we euthanize them once we diagnose it.Yes.Yeah, much longer.Yes.So the goal is to me therapy is to make them feel better and if they're feeling better, they're going to live longer, okay?
So the ones that spring to mind, the first thing is lymphoma, so most common cancer that we see in dogs and cats, but we know that for your typical large cell multicentric lymphoma.So, big lymph nodes all over the dog's body, if you don't treat them with chemo and you're just doing bread, we're seeing survival times of maybe 23 months, maybe the generally pretty happy.
Is no risk of side effects to them except for the pred related ones, but we don't usually see them live a lot longer than that.If we're looking then at say, gold standard multi agent, McNary P.We're looking at survival times of greater than a year usually and about 20 to 25 percent of them get more than two years.
So there is a big survival Advantage there and the other one would be like your home.Angiosarcoma so your ruptured splenic mass that comes into emergency to see Jurado.You take the bleeding screen out, you're the hero you saved the dog at the time but then you have to give the owners the really terrible news that this is a really terrible tumor and if they don't do anything more, their dogs probably not going to be here for more than maybe six to eight weeks.
But with chemo, we are seeing now survival times more around the six month plus.So that's also a disease where we can see a significant survival advantage and these are happy dogs for that time.I'm which I think the owners do find really valuable.
The whole like, okay, I feel that I have this kind of like these people have a water stick in the go, in the desert that will stick in that when it when it can, like, do you need?This is where the water is, right?You start digging there.I feel like that I can walk around and go there with my hand ago.I gave him out doing and keep walking.
See, so many, it's a classic there's a classic presentation so pattern matching earlier but, yeah, it's just the shock.It's like normal dog.Sick, dog.Two hours later vet says, need emergency surgery or Death.Yeah, and they just like put it was fine this morning.
It was fine this morning.Yeah.And and then all of a sudden they go to surgery, right?And then like it's good to know that there is this degree of outcome longer, six months.Six months is enough time from the spend heaps time of the pet whatever they want, make it super fat and then it can't move and then take it to the beach and then press and all that kind of stuff.
But yeah.Like valuable time I do like to write bucket lists for And I had pets, do amazing things like, you know, ride on a ferry, goes through the snow, like, there's a whole list of stuff and they would bring back their photos every week to their chemo of them going through their bucket list.
That was just like, that's just so nice for us and for their owners and for the pet obviously, but like that's such a nice thing and they're happy dogs.And I suppose it's like, yes, these owners from the ISO from the outset, I will always talk to people about the option to put them to sleep.
I'm always, because euthanasia is always on the table.Get any point.It is not going to be wrong to put their pet to sleep and they won't, they don't want to do it.They'll probably never want to do it, but they're probably going to have to.But I think it's important, especially when I meet people of bringing that up first up, not saying that you have to do it now, but just saying that it is something that is there because if something doesn't work for their pet for them for the camp, There's no point continuing something that isn't working, if they don't have a happy dog, and they've got an incurable disease euthanasia is going to be the kind of thing that they can do.
But I just, you know, my one of my pet peeves is that and certainly having owners come to me saying my vet said, there was nothing we could do and told me to put my dog to sleep and then these owners sort of Self-refer.
Essentially, they don't like to hear that.They do a little bit of Googling and figure out that there are people like me, who exist come to me.And it's just so disappointing because it means that the relationship with their regular.Vet has really been fractured from that point that, you know, when I sit there and I say, well actually we do it, we can do these things.
Like we might not be able to fix your dog, but they're certainly treatment options and we might be looking at this amount of time.It makes them really Reluctant to then, go back to their General bit.And like I'm very much, always trying to get people to like, do blood tests with your, but I don't want you traveling 3 hours to see me, just so I can run a CBC please.
Do it at home, get them to send it to me.But I just it just is so disappointing when they come to me from the outset and you can just see that that relationship with their vet has been fractions.Probably the best word because they were told there was nothing that could be done.I just worry that a lot of that comes from people, just don't know.
Like, you know, we're a very small new sub specialty and and you're not taught a lot about cancer in uni or like in general.And people just don't know what treatment options are out there.Do you know what?I think.And I brought probably guilty of that.
That I've probably have been in my career have been guilty of being overly Cynical with was not cynical.I'm - about outcomes, but listening to you talk.I think it is an important paradigm shift for the for us as GP, vets, or for referring weights.
And for me, listening to you, right now, if I read a text book or an article, let's say I diagnose cancer in a patient of mine, and then I go reading about it because I want to give the owners information and I read maximum survival time six to nine months.Yeah.My head goes, there's nothing I could do for the It's going to be dead soon, but the shift that I'm getting here, and that's probably really important, because for many people six to nine months is not nothing.
That's not a nothing.Whereas I go well, this is I'm just going to waste their money, you know.It's going to be dead in six months anytime.So I think I'm being very nice to them to just telling them the painful truth but maybe it's really important to go.Well leave it up to the owner what is nothing and what is not nothing?
Six months might be a huge amount that's that's 10% of the animal's life form.Most and yeah it's just going to add their that it's because sometimes what we try to do as Marian's as choose for the clients and make the decision for them based on our perception.
But also our experience is what I was taught by really quickly in emergency is that you cannot choose for the client you offer.And then because some people might think mechanically ventilated tick paralysis patient with aspiration pneumonia with 60 percent.
Right at likely around about like, at 12 to 15 thousand dollar final invoice, right?You would never offer that.But that people choose their people out there.You when we select we make a decision on behalf of a client based on our past experience of people say no no no no no, the people who actually do want to go to that next level.
Hmm, I don't know if it's all, I don't know if it's all knowledge.I think.Yes I think it's, I think that's what I'm trying that's from.Trying to get to.It's not knowledge.It is what I think it's my values and my yeah, I wouldn't necessarily want to drive three hours once a week with my dog and spend 10,000 15,000 out of.
But that's, that's me.And I think I'm guilty of exactly.Like you say, Gerardo after signing for the client instead of saying look this is what we can.Yeah, I've seen that, like, I literally actively.We have interns we have students that come to the hospital and In the consult room and I deliver the stuff.
I will actually walk out the room as we walk in and the room going.Hey look, I'd like, literally I felt as if I was going to decipher the client there, but I still then gave all the options, no matter how much how expensive it was regardless of where not, they had thongs on or not or whatever, you know.
I mean like I shared what about if they're not wearing a shirt.That doesn't look man.Me where our hospital is, not sure it shower, not shower, it doesn't really matter but it's still people come up.They people can be resourceful.Yeah, I joke about the shed thing but I had that when I worked in West Wales and the UK we had a guy come in no shoes.
No shit, stinky shorts expensive surgery Andre I fitted thinking no friggin way and he pulled a role of hundreds out from his rugby shirts and said do you want me to pay now, as I know, afterwards is fine.
Thank you very much and I think the other thing that that I've definitely noticed since Starting out in the veterinary, profession is the increase in uptake of insurance.And I think that, for me, that's fantastic because cancer is not a pre-existing condition.
So when I'm saying the people you can spend ten to fifteen thousand dollars or laugh on treating your dog's cancer and we're looking at, maybe a year or two.Usually, what people are saying now is, will my insurance cover it?And I'll be like, well, yeah, as long as you've got illness insurance and it's not just accident, but it just depends on what your annual limit is.
Yeah, they probably will.And that's generally been the case.And so that also is really helpful in terms of taking a little bit of that pressure or the clients making decisions that aren't based on how much it costs.The other thing that I find really useful in this is, I've shared this because Alex told me this, she's a super Guru in the consult room, she will deliver.
Whatever thing is, gold standard and go and we have finance options available, hmm?Right.At the before, like Like, just go like we got anyone.It doesn't matter if they drove up in a Merc and they have this, you know, I'd like whatever kind of amazing watches people.We're right and you're like it's still the option of we have finance options available and it gives them options regardless and so most same thing as insurance.
It gives them this thing where they can choose.Yeah, Well, do you in your role?Was this this come back to the GP more, because the end result of your treatments, inevitably will be about the end result of all of our treatments, eventually his death.
But do you deal with it?More is end of Life.Care.Is, are you palliative or you also there for that?Last we making we definitely do a bit of both.And it's really interesting to me, been having this conversation just frequently about out the number of euthanasias that I personally do now is far less than what I did in general practice.
Okay.And I'm trying to figure out why that is because it's because my patients are definitely dying.Like it, I know this, but we were sort of talking about, you know, is it for a lot of my clients in particular.They want their pet to be put to sleep at home and that's just not something that I personally can do.
I tell people that from the outset and give them options for looking into that.I do find like all of the euthanasias that now I do, or have happened to my patients.Absolutely Justified.So I'm very fortunate in that.
I now don't have to euthanize things that maybe could be fixed.Like, that's, that's not a moral and ethical quandary for me anymore, which is actually such a leaf because any anytime that I'm part of euthanasia ink, it is incredibly emotional.
Because I know these people, I know this pet, we have been seeing them every week or every two weeks for the last year, like you learn about their lives that that, you know, the pet becomes really special to you.So yes, it's very emotional but it's also the right thing and it's a tough thing to do, but it's the right thing to do.
But it was interesting to me talking to my nurses about, you know, the people who then choose to go back to their regular vets for the euthanasia.And there are a lot of them who do that.And I don't know whether it's like a full circle closure thing, or whether they just don't know like you.
They don't want their last memory being at The Specialist Hospital, they wanted at home.There's so many personal choices around that but I definitely do far fewer euthanasias now than I did in general practice.But all of the ones I do now completely Justified How do you help your clients to decide?
I have a few things that's a very common question.Is, how will I know when it's time?Such a big decision for people to make.Yeah, and I have my little things but what are your, what Your guidelines that you give your clients?So I will normally say to people that my personal like non-negotiable things.
So these are things that your pet has to do is eating drinking going to the toilet, and being able to go to the toilet and move away from it.So like they have to be able to do those four things.And if one of those four things stops happening, that is an immediate red flag.
That quality of life is not good enough and that you should be considering putting them to sleep soon.But I do also say to people that before we get to that point, we will often see some more subtle and more like personality-based things.
So you know, if they can no longer do or no, Longer want to do a no longer able to do the things that they love.Like for my dog, it's ripping up, cardboard boxes, like if he could still be eating and drinking, but if you give him a cardboard box, and he doesn't, rip it up, there's something wrong, like he's sad, but for every pet, like their family is going to know.
Yeah.Oh, she always runs to the door.She loves playing with his squeaky toys when they're not doing those things that you have to start to question.How happy are they?Because, for every client and for every The family, the threshold is going to be different.
There are people who it will take until they stop eating for them to put them to sleep.But there are also people who at the slightest sign of a, I don't know.They turned up their nose at their special treat.That's it.Everyone's got a different level at which they think it is acceptable for their pet to still be here versus not.
So that's usually the conversation I haven't for some people, you know, I will try and get them.To write stuff down.Especially when you've got a family where maybe there's a little bit of disagreements like you've got one client who is, you know, holding onto every single possible, positive sign and really kind of glossing over all of the negatives versus the one who is all doom and gloom.
And from the outset is, you know, condemning this dog to not very much time.Sometimes getting them to actually write it down and agree like on a threshold on an actual quantifiable.Can't do five out of ten things that is enough.
Yeah that's a really good like that.I really like that because as emergency sometimes 20% like it depends 15-20 percent of our patients we will put to sleep.Right?Just because of you know that water of the Beast nature of the Beast, right?
Yeah.And they and we will see quite a lot of oncology patients actually.Yes.I was thinking any of the reason you don't even his opinions because they crash on weekends, we don't work, I mean, but but the whole decision making process as an emergency veterinarian is is it the like euthanasia is part of the art and skill of emergency and T like getting them to come to a decision, that is a comfortable with that, then also, then putting into perspective like the, the what's happening with the pet and patient and making sure they're not Euthanasia into early as well as just quite difficult sometimes but the criteria you said there which is, well it for me, it's always on, you know, your pet best and do they spend more time looking uncomfortable and Ill than they do because the vast majority of time.
It's the people that I see the people who hold on for, too long.Yeah.Way too long to yeah.I definitely see that too.But the other thing I suppose I find interesting is that, how do I tell people that it's time?Because sometimes that can be really hard when they're like you.
You need to tell me when they've had enough.I feel like the relationship that will often build with our clients and I know that this happens in GP land as well is that like I've been seeing these people, I've been giving them options.I've been like, this is what we can do next.
This is what we can do next.This is what we can do next.And sometimes I get to a point where I have to say there is nothing more that we can do.I feel like they respect that, like, I've heard me, give them option after option, after option.
And I've said, yes, we can.Yes, we can.Yes, we can.And so when I finally, if I have to, because often they say it for me, but if I ever have to say, we need to stop.This is enough, I feel like they really respect that because they know that I wouldn't just not tell them that there's something else that we can do.
Yeah.There's there's another one I had in that discussion.I started putting it in recently and it's often a see, a noticeable sort of a shock response on the owners faces when you say it, but shock of realization, but I go through the animal things as well.That so what my my rules for what I see as a quality of life and then I said, but there's also your quality of life as a, as an owner.
Mmm, you have to be the one who has to look at the dog every day and go, is he suffering is this too much?And don't underestimate this.This came from after I have to my dog, had I still suck.That an estimate, the emotional toll on yourself and on a family of living with that.
And as I said, if you have my permission when you've had enough.Yeah, even if you think your dog hasn't been you had enough, please tell me because that is also something to keep in mind.I think that's really important too because a lot of the time these people are incredibly committed to the point where it is actually negative affect negatively, affecting their quality of life.
Like they have a patient that they have to medicate every four hours.Hours and they're getting up during the middle of the night.They've got a dog that can't get downstairs or they having to carry it everywhere and then not coping with that.And that it can be really hard for them because they want to do it.
And it's really hard for them to recognize that it's actually having that negative effect on them too.And so often you'll hear once they've made that decision, it is a sad as it is also a little bit of a relief that's a pretty but that that like they're done and they Try everything and they did everything right, and they did everything they could.
But it's also, you know, the sadness and emptiness after their pets gone.But also just realizing that the they had committed so much of their time to their pet and to not have that.He's a little bit of a relief for a lot of people.
The acknowledgement, the acknowledgement from a veterinarian to an owner about how committed they were, how much they did.Did how far they went?Oh my God, the amount of times I've said that not, not, not just like for an effect, but how to reality?
But having said that, like room, when you say that and you see the relief in their eyes and and they're just the emotional toll, the burden that's come off their shoulders, where they feel like they're going to get judged for.Even bringing up euthanasia.Yeah, that's that's the word I said earlier.I you have my permission and I will not judge you if you decide this is too much for you.
Yeah.And and that's Really value that such happy conversation.Now we've never just like finished wrapping up death.All right so really how do we re how do we come back from Penny?We've talked about a lot of stuff and I feel like we skipped over stuff I wanted to talk about right at the beginning when we were talking about your career journey and internships.
So let's go back to your decision-making.You're thinking you've done that rotating internship.You decided I really like this one.Field of specialty.I want to go further.First of all, how did you decide that?Yes, specialist.Because that's a very common question, I think a lot of it's after five to ten years in their career, get bored and not bored, but maybe start thinking about further challenges and go.
Well, is specialization for me or not, how did you just know or how did your decision-making look?Yeah, it's interesting.I think so.I think I kind of knew because when I was still in vet school, and I was working as a nurse, I But exposed to working with Specialists and in a specialist environment.
And I knew that the oncology city of area was something that really fascinated me and and during University, I did my honors project on oncology based topic.So I knew that that was sort of my area of interest, but I didn't know that I was like, set on that being where I was going, but during my rotating internship, I think a lot has to be said, for the people within that department.
Moment and being incredibly warm and open and and really enthusiastic to have someone come in who showed an interest and really kind of nurtured that and so that definitely helped cement the idea in my mind that these were the people that I wanted to be like this was the specialty that I felt.
I had, you know, that I couldn't see any downsides to it.And so it Combination of the two.The actual specialty itself is fascinating and you know, for all of those positive things that I said before, but then to have the people within that specialty be so enthusiastic about having someone come on board because me in Australia, there's so few oncologists it's a very small community.
We all know each other very well and everyone's lovely, but it's also.It also means that it's really hard.And to get a training position because you don't have a lot of options at least within Australia.So I was just very fortunate that they liked me.
I liked them and we got into a second internship and then into a residency.Yeah, that's interesting.So it wasn't that you had this drive because I was my question, my next question was going to be.It clearly was a lot of work.
It was a long time.What drove you to do it, what was your reason?For going for it, but it sounds like it wasn't that you had this lofty goal.And at the end you had to go through this massive ordeal to get that sounds like the process itself was actually sort of what sucked you into it.
What get you engaged?Absolutely.I love, I love to the learning.I love being taught.I loved everything about the specialty but also the process for me was and I'm very fortunate.The process for me was actually a really fantastic training program.
So I had people Who who were and still are absolutely phenomenal.Like the best people that I could have ever have got to work with.They were my supervisors, they are absolutely still mentors and role models and people who I look up to now, even though we are, you know, colleagues and even if playing field, I suppose, these are people that I just love but the actual grit of the clinical work as well, just fascinated me.
And and you know, it's It's crazy to think that it's, it was sort of a six-year continuous learning process.But I loved that.I loved the study and learning about the things that really interested me.
And so I'm not saying that it wasn't hard, there were some pretty tough times, mainly around exams and things like that, but it was also a really really good couple of years.That's maybe the answer to the question.
Should I specialize or not?Hmm.The answer is not just, should I be a specialist?I watch it.I specialize in, it's going to be hard but I want to do it for XYZ, right?It sounds like the the right answer is.There's this thing that I can't get enough of and I love it and I want to be really not just get really good at it.
Just learn more and more about it than do it.That would be a very good indication that you should probably specialized absolutely.And I think I think maybe You know, if you're approaching this from the perspective of I like from an ego perspective, from a financial perspective, like you've got to go through so many years of really hard work and, you know, like time away from friends and family know when I was still in my residency and I was looking at my peers, who are three, four, five years out of uni and that learning so much more than me.
They're working less You know, having Hobbies God, I didn't get, I'm probably going to like two years ago and it's but I loved it and you know, to the point where crazy person but I'm currently doing a postgraduate qualification in Psychology now.
Like I obviously love the learning part, this is obviously nothing to do with oncology because you know, I feel like I've achieved the Pinnacle in that so far.And it's not that I don't have anything left to learn.There's always things to learn.
Yeah, but I wanted to do something that in my mind was somewhat complementary but also from a slightly different perspective.So doing this psychology thing has been amazing.So completely different style of learning, and writing and assignments, like, going back and doing uni, assignments, that's crazy.
But yeah, I think, I think that there are people who that learning process and the study process is, He's a really enjoyable thing for them.I think if you're coming at it from, I just want to be a specialist.And I want to earn a heap of money and have people look up to me.
I don't know whether those are necessarily the right primary motivators to feels like it's going to be much harder if that's what's driving, isn't it?Absolutely, you probably won't enjoy the process as much and you might be.It might be disappointed with the end result anyway.
Yeah, potentially.And that would be terrible like God putting all that work into then be disappointed.Anyway, you've mentioned the psychology thing?I feel like I have to go there but we're going for a while.Yeah, I wish I were to try to decide to we wrap it up there or but I'm just going to ask why, how is the is the psychology?
Just an interesting or does it differ lat compliment your work?I think it's 50/50.Interesting, definitely, that's always fascinated me.But from a work perspective for two And this one is I want to be able to better help my clients, and I don't think I do a bad job now, but I want to be able to do an excellent job for them.
Like, I want to be able to help those people that are really struggling with and it's mostly grief.I want to be able to help them in a way that they can benefit from that and so that's one reason.But then the other reason is from more my intern clinical management.
Type position, I want to be able to better deal with the people that I work with.I want to understand them on a deeper level and be able to, you know, navigate conflicts like interpersonal, workplace conflict, and and those sorts of things that are so that I can look after our interns better.
So those are sort of the reasons that is and is the psychology?Is that offering you?The answers?Is it was that?Is that the right?Is it really?Wow.Yeah.It's it's been.I mean like it's taught me a lot about myself too.Yeah.Why I am the way I am?
But yes it's been absolutely wonderful and I'm kind of a bit like well when this is over like well I do next I don't know.I'll have to I have to find another hobby.So studying psychology is that the hobby that you referred to earlier or do?
We actually have it's one of the things that you're feeling my time, I do have legitimate.Hobbies.Yes, but just more from like a I like to learn stuff.So when you're not curing cancer and learning about psychology but what are your other Hobbies Wilt Wilt beasts?
Well no so I go to the gym.I do CrossFit, I love that.Yeah, that's been a really fabulous thing for me in terms of like a community and friendships but also from an exercise and like health and Being expected, that's been amazing, my dog.
And I do the Delta Therapy Program.So we volunteer and, and spend time doing that, which is also really, really lovely.I don't know whether that's technically a hobby, but it definitely happens in my spare time sighs.
Well, It's tricky because it involves animals, maybe, maybe still kind of work with that as long as you as long as you enjoy it, and it gives you a release.Yeah, and then I have a horse who I love dearly who has been in my life since before.Vet school went, hopefully, we'll continue to live for a lot longer, so he he is also a source of great joy and time.
Yeah, so underlying goal with this whole podcast is always, well, it started off again as a research project to figure out how to vets have sustainable long, happy careers.And I think you fall in the camp of You just love what you do.
Am I right?Am I right in saying, well, you curious you keep learning, you have that growth mindset but you find that you have true joy in the actual path that you chose.It doesn't sound like you ever think to work.No, no, no in saying that there are some days where I try not to do this now because I know it's not good for me.
I'll look at my schedule like the day before and then be like, oh god.Oh like I'm stressed about this.A patient or like this client, it's mostly the patients and, you know, then I'll be like, oh, I don't want to go because this dog is going to be mean, and like he's going to be difficult and, you know, but I try not to look in advance now so that I can't, you know, have that anticipatory anxiety about my day.
That's good too, like that.We should probably wrap up any.Mmm.Can we wrap up with podcast?So you are in between your hobbies.Do you ever listen to podcasts?I do.Yes.It's so my favorite podcast is called Shameless and it the tagline for it is.
It's a podcast for smart people who love dumb stuff.It's like a like a celebrity and pop culture podcast and I just love it because it is So, it's talking about so many things.Some of them are very serious but so, unrelated to anything else in my daily life and it's just that the two presenters on there, just so refreshing and their Australian and they took they interview people.
They talk about, you know, Big Pop Culture news, which is often relatively inconsequential but I just love it.Awesome.Yes, I'm gonna have to look, I've actually heard of it.I think it's quite a huge bike guy.So I think it is.Yeah, because he's in Australia and they're fabulous.And then let's wrap up with the final question if it is at the world, new grad conference which is coming in 2022, in covid is over and all of the world's new grads are sitting in a lecture Theatres and they want to learn one bit of advice from Penny on how to have a happy veteran career.
Watch it one bit of advice, I think, I think my one bit of advice is that being a bit?Is a job.Please don't forget that it's a job.But for a lot, Of us it's also a big part of who we are.
You just need to make sure that you leave room for other parts though because at the end of the day, it is a job and you are allowed to be something else other than a vet all the time.I think that's probably the big thing because for a long time, being a vet was absolutely everything to me and it's very possible to be a vet and so many other things and I think that's that's how we stay happy.
So, how did that change happen?Well what what, precipitated that change and how did you make it happen?So just a Mite, I was at a mindset change or was it a physical change?Like a change of yours routine or your structure day, or I think I think it actually it happened to me after I failed my first lot of Specialists exams and for me that was the first time that I'd really build something and and it was devastating for me, but it also made me realize that everyone else around me.
I was still the same person they still loved me like I wasn't I wasn't a failure to anyone except me And I think it just made me realize that there is more to me than penny is a vet and that I am allowed to do other things.
And I think then allowing myself to do other things helped me then go on to pass the next year because I was much much more balanced in my approach to all of that.So I think that was probably the big thing.Let's wrap it up the penny.
This was a little Slice of Heaven particular.You're an example and an inspiration and we will definitely get you back on for some clinical content.But thank you so much for your time.Oh, you're so welcome.Thank you for having me.
You know, those conversations that you have at conferences, back in the days, when we still had big bed conferences, when people are chatting to the lectures and asking questions, and you hear things like, this isn't really the books.But here's what I think, it's in those kinds of conversations that the best nuggets of wisdom appear, the nitty-gritty of real-life details that you can only get from here is and years of experience.
And it's exactly those kinds of conversations that we try to emulate on the vent valve, the clinical podcast, It's we don't want lectures.We want to hear about the challenges, the tips, the stuff UPS there.This is how I do it.Go to VV n dot super cast dotnet to join in the conversation.
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Dr Penny Thomas