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Gifts with Erica Bove · Lean Out Podcast

0:00
SPEAKER_00: Welcome to the Lean Out Podcast.
0:03
SPEAKER_00: I'm your host, Dr.
0:04
SPEAKER_00: Dawn Baker.
0:05
SPEAKER_00: Are you looking for a new approach to finding authentic and sustainable work-life balance?
0:10
SPEAKER_00: You've come to the right place for inspiration, information, and a community of like-minded professionals.
0:16
SPEAKER_00: Let's get to the show.
0:24
SPEAKER_00: Hello, hello.
0:25
SPEAKER_00: Thanks for being here.
0:27
SPEAKER_00: I talk a lot about uncertainty on this podcast, and up on our homestead, we are currently navigating the uncertainty of the transition from fall to winter and the weather situation.
0:39
SPEAKER_00: Because we're an off-grid property with a somewhat primitive road access, we're much more dependent on weather conditions than other people.
0:48
SPEAKER_00: And right around now, it's always a crapshoot to plan for winterizing the property and moving the animals down off the mountain to our warmer property in town.
0:59
SPEAKER_00: And you can't take them all at the same time.
1:01
SPEAKER_00: So this planning is something that we need to think about as like a three-week process.
1:06
SPEAKER_00: And winter is definitely coming.
1:08
SPEAKER_00: This year is supposed to be an El Nino year, so it could just be an epic winter.
1:14
SPEAKER_00: We just don't know until we're in it.
1:16
SPEAKER_00: And it's kind of an interesting part of this whole adventure lifestyle.
1:20
SPEAKER_00: I talk more about our life and what it's like to live on a homestead in my newsletter at times.
1:26
SPEAKER_00: So if you're interested in that and you haven't subscribed, go over to practicebalance.com/slash connect and you can get on the list.
1:35
SPEAKER_00: Okay.
1:36
SPEAKER_00: Appropriate to this topic of uncertainty, my guest today is Erica Bow.
1:43
SPEAKER_00: Erica is a double board certified OBGYN and reproductive endocrinologist physician.
1:48
SPEAKER_00: She works at the University of Vermont.
1:51
SPEAKER_00: She is also the CEO and founder of Love and Science, Thriving Through Infertility.
1:56
SPEAKER_00: Eric is an organization where she helps women physicians and professionals optimize both the science and the emotional side of fertility journeys so they can maximize their opportunities for family building.
2:08
SPEAKER_00: Erica has a keen interest in marrying evidence-based approaches with intuitive knowing in the context of a trusting relationship.
2:16
SPEAKER_00: Her mission is to heal and support the healers and to create a legacy she is proud of.
2:23
SPEAKER_00: Outside her professional work, she enjoys running, yoga, kayaking, skiing, reading, writing, and spending time with her inner circle of great friends.
2:35
SPEAKER_00: In this episode, we talk about finding a unique work schedule even as a specialist with an ongoing patient panel.
2:41
SPEAKER_00: We also talk about identifying a serious need and implementing a vision of coaching for patients and others.
2:48
SPEAKER_00: And Erica gives her insights on navigating uncertainty through the lens of a fertility journey.
2:54
SPEAKER_00: So now please enjoy my conversation with Erica.
3:02
SPEAKER_00: Erica Bove, welcome to the Lean Out Podcast.
3:05
SPEAKER_00: How are you doing?
3:06
SPEAKER_00: I'm great.
3:06
SPEAKER_00: Thanks, Don, for having me.
3:07
SPEAKER_00: I really appreciate it.
3:08
SPEAKER_00: You're so welcome.
3:10
SPEAKER_00: So for the audience, please introduce yourself.
3:13
SPEAKER_00: Tell us a little bit about what you do, what you're into, and how your work life balance is different than other people that are in your chosen profession.
3:22
SPEAKER_01: Absolutely.
3:22
SPEAKER_01: So I am a double board certified OBGYN and reproductive endocrinologist.
3:27
SPEAKER_01: So I followed all the steps.
3:28
SPEAKER_01: I like to joke that they let me loose in my mid-30s.
3:31
SPEAKER_01: And I have been faculty at the University of Vermont for the last three years.
3:34
SPEAKER_01: So I have a part-time position there where I do all the in vitro fertilization and complex endocrine cases and I teach the fellows and all those things.
3:41
SPEAKER_01: I do that for about one week a month now because I was doing it more.
3:45
SPEAKER_01: And then what I'll share now is I have a fertility coaching practice, mostly for female physicians within fertility, where when people's treatments aren't working, they come to me and I bridge them to parenthood, which is a wonderful uh way to be able to spend my time.
3:58
SPEAKER_01: But there's so much need for that that I ended up cutting down my clinical practice to be able to uh really grow the coaching practice, which is my true passion in life.
4:06
SPEAKER_01: Um, I'm also a mom.
4:08
SPEAKER_01: I live in upstate New York with my two kids who are 13 and 12.
4:11
SPEAKER_01: I'm divorced.
4:12
SPEAKER_01: I mentioned that because I think that that is really important as I answer your next question, which is how does my work-life balance look a little bit different than other people's?
4:22
SPEAKER_01: I have a predefined schedule where I know that I, my former spouse is a hospitalist.
4:26
SPEAKER_01: So, you know, he has the kids for a week and then I'll have the kids for a week, and then we rotate.
4:31
SPEAKER_01: And I know my schedule pretty much indefinitely uh based on that.
4:36
SPEAKER_01: But it's really great because I have a job that allows me, like when I'm scheduled for my clinical shifts, they work around my parenting schedule.
4:44
SPEAKER_01: And it's three hours away.
4:45
SPEAKER_01: So I only go there when I don't have my children.
4:48
SPEAKER_01: And they know that when I do have my children, that I just I don't work clinically.
4:52
SPEAKER_01: And so I think having that boundary in my own life has been really key to me being able to live my fullest life at this point.
5:00
SPEAKER_00: That's wonderful that you've been able to get that arrangement.
5:04
SPEAKER_00: And so, did you just say that you are three hours away from where you do your clinical work?
5:11
SPEAKER_01: Yes, I'm a Vermonter.
5:12
SPEAKER_01: Like I wasn't born there, but I moved there when I was three.
5:14
SPEAKER_01: My whole giant family is there.
5:15
SPEAKER_01: We have like hundreds of family members.
5:17
SPEAKER_01: I'm not kidding.
5:18
SPEAKER_01: Um, and I went to the University of Vermont for medical school.
5:20
SPEAKER_01: And so, for in many ways, it feels like home for me.
5:22
SPEAKER_01: And so, well, I mean, it's it's sort of the story's a little bit deeper because I was in Michigan for my training, status faculty after my fellowship, moved back to the East Coast and got this job that I thought was gonna be like the brass ring.
5:34
SPEAKER_01: You know, I was like private practice, one of the top companies in the United States.
5:38
SPEAKER_01: It was super prestigious, you know, within two hours of striking distance for my folks.
5:42
SPEAKER_01: Like, I'm like, I have arrived.
5:43
SPEAKER_01: You know, I've I've put in the work and here we go.
5:45
SPEAKER_01: And then I, you know, lugged the patient care I was able to provide.
5:48
SPEAKER_01: I was a medical director of a whole office.
5:50
SPEAKER_01: It was like really fantastic on many levels.
5:53
SPEAKER_01: But when I started to have conversations about buying into the practice, I could really tell that I was not aligned with the leadership at all in terms of our values, in terms of the direction of a company.
6:03
SPEAKER_01: And in my gut, even you know, it's like one of those things where things look, you know, good on paper, but like in your gut, you know that something isn't right.
6:09
SPEAKER_01: My gut said, this is another bad marriage.
6:11
SPEAKER_01: Don't do it.
6:11
SPEAKER_01: I was like, okay, well, this is a really tough offer to turn down.
6:14
SPEAKER_01: You know, it looks very lucrative.
6:16
SPEAKER_01: It looks like, you know, I'm it's this is the community I'm in, et cetera.
6:18
SPEAKER_01: And my gut was like, don't do it.
6:20
SPEAKER_01: And so I separated from that practice about four years ago, truly without a plan, which if you know me personally, that's very unlike me.
6:27
SPEAKER_01: Just like many of your listeners, I'm very type A.
6:29
SPEAKER_01: I always have a plan.
6:30
SPEAKER_01: But I just, I just knew it wasn't right.
6:32
SPEAKER_01: And I knew that things couldn't continue.
6:34
SPEAKER_01: And so I called up somebody at the University of Vermont and said, Hey, you know, do you need anybody to see patients?
6:39
SPEAKER_01: I'm pretty close, but the only caveat is I have to work around this parenting schedule because I need to stay rooted in Albany.
6:45
SPEAKER_01: At least I think at that point it was like for the next 10 years or something.
6:48
SPEAKER_01: And she was like, not a problem.
6:49
SPEAKER_01: We'd love to have you.
6:50
SPEAKER_01: Give us grand rounds.
6:51
SPEAKER_01: And then after that, grand rounds, everybody was like, when, when can she start?
6:55
SPEAKER_01: Uh and and they, I mean, I I know it's probably inconvenient at some level, but they really do base their call schedule around my parenting schedule and then fill in the gaps.
7:03
SPEAKER_01: And that we've talked about what that looks like from their end.
7:06
SPEAKER_01: And we just hired somebody else, which is fantastic.
7:08
SPEAKER_01: But from my perspective, I had a limiting thought.
7:10
SPEAKER_01: You know, coaching talks a lot about limiting thoughts, like, oh, that's impossible.
7:13
SPEAKER_01: I can't have a part-time REI job.
7:15
SPEAKER_01: You know, you know, I thought to myself, if I could only do this part-time and really focus on the kids when I have them, like that would be so much better.
7:21
SPEAKER_01: But it really sort of took in a change that was pretty massive, which was like separating from this group that I thought was like the group, and there's only one other practice in my community that I didn't want to join.
7:31
SPEAKER_01: And then thinking, how can I do this?
7:33
SPEAKER_01: And then having, you know, leadership that was open to a creative solution.
7:37
SPEAKER_01: And that's what I've been doing for over three years.
7:40
SPEAKER_00: I'm so glad that I even asked this question.
7:43
SPEAKER_00: I did not know it was gonna go in that direction at all, but it's so bold that you turn down the quote golden job.
7:51
SPEAKER_00: That's the kind of stuff I love to hear on this podcast because I think that that holds people back too, where they think this is what is expected, and this is what I expected as well.
8:02
SPEAKER_00: So it's not only what you think you're supposed to be doing, but it's what you think other people are expecting of you.
8:09
SPEAKER_00: And then to do something totally different that maybe it's not gonna work, uh, you know, and now here it is, really fitting with your lifestyle and your values and all the things you want to be doing.
8:21
SPEAKER_00: It's just great to hear.
8:23
SPEAKER_00: But you're right, it's hard to think of an REI working one week a month.
8:29
SPEAKER_00: So tell me what does that look like in terms of like your patients, you know, who takes care of them when you're not there and those kind of things.
8:37
SPEAKER_00: Sure.
8:38
SPEAKER_01: Sure.
8:38
SPEAKER_01: So in the beginning it was one week a month, and then I went up to two weeks a month, and then I went back down.
8:42
SPEAKER_01: So, you know, every other week I have my kids, and so then it's like this checkerboard schedule.
8:45
SPEAKER_01: So, you know, I it was really hard for me to drop down to one week a month for all the reasons you stated identity, feelings of responsibility to my patients, to my colleagues.
8:54
SPEAKER_01: Like I truly cried as I was telling the people that I was doing this.
8:56
SPEAKER_01: But I I knew in my heart, you know, I say every day in my mantras, I'm kind to myself.
9:00
SPEAKER_01: And there was a point when I was saying that, and again, intuition, gut check.
9:04
SPEAKER_01: I was like, Erica, you know, non-judgmentally, but like you're not being kind to yourself.
9:08
SPEAKER_01: Doing this, living out of a suitcase, just every other week being in a different place, like this is not the highest expression of your life.
9:15
SPEAKER_01: Like it's not sustainable.
9:16
SPEAKER_01: And so I finally got up the courage after running the math like 15 million times uh to drop down to one week a month clinical.
9:23
SPEAKER_01: But I think even when I was working two weeks a month, I think a lot of it is an expectation setting.
9:29
SPEAKER_01: So I'm fortunate to have a practice where there's three fellows in addition to the three faculty.
9:34
SPEAKER_01: And I think people are used to seeing the different doctors of the practice kind of like how LB is structured now, where like, you know, people just say, we're a practice of six women, you're gonna meet, or you know, men maybe two, but six people, you're gonna meet different ones of us along the way.
9:47
SPEAKER_01: We don't know who's gonna deliver your baby, but like it's whoever's on call that night because we can't be working 24-7.
9:52
SPEAKER_01: So I think people are now getting more comfortable with the idea that there can be cross-coverage and things like that.
9:57
SPEAKER_01: But our fellows, they really do the bulk of the communication for the in vitro fertilization outcomes and things like that.
10:02
SPEAKER_01: So at the beginning, I say, when I meet a new patient, full disclosure, I'm here some of the time, but not all of the time.
10:09
SPEAKER_01: When I'm not here, I have excellent partners who cover me.
10:12
SPEAKER_01: The nurses are fantastic.
10:13
SPEAKER_01: We have amazing fellows, and that is our practice model.
10:16
SPEAKER_01: It's more of a shared model of care.
10:17
SPEAKER_01: And so I think that expectation is really important in the beginning because people know what they're getting.
10:22
SPEAKER_01: And if that doesn't work for people, then you know, maybe, maybe that practice is not the right one for them too.
10:27
SPEAKER_01: It is academic.
10:28
SPEAKER_01: I say you're getting really smart people thinking really hard about you.
10:31
SPEAKER_01: And, you know, we have these conversations about the tough case conferences, but I let people know, like, you know, you're seeing me now, you will see me again for a return visit in four to six weeks.
10:40
SPEAKER_01: The communication in the meantime will not be with me unless there's like a giant issue that we have to address, like terrible labs or something major.
10:47
SPEAKER_01: And the rest of the time, you know, there's cross coverage.
10:49
SPEAKER_01: And people have been pretty open to that, I will say.
10:52
SPEAKER_01: I did just entertain a job as an IVF proceduralist.
10:55
SPEAKER_01: So just like there's laborists, there are jobs starting to evolve where you can, you know, do quote unquote just IVF, like the IV, the egg retrievals and the embryo transfers.
11:03
SPEAKER_01: But you know, Donna, I realized like I really do value having my own patients and being able to follow them over time.
11:09
SPEAKER_01: And um, you know, if I happen to be there for the day of their ego retrieval or their embryo transfer, it's like a very happy moment.
11:14
SPEAKER_01: And I value that connection with my patients.
11:17
SPEAKER_01: And so I think maybe other places might not tolerate that model, you know, like the culture that's been established.
11:23
SPEAKER_01: But, you know, for me, it works out well.
11:25
SPEAKER_01: And I actually turned down that job for a few different reasons.
11:28
SPEAKER_01: But part of it was I want to keep serving the people of Vermont where I grew up.
11:31
SPEAKER_01: I get to take care of my siblings.
11:32
SPEAKER_01: I mean, I'm I'm too old now.
11:34
SPEAKER_01: Like nobody, nobody in my generation is still trying to conceive, but I mean every now and again.
11:39
SPEAKER_01: Um, but like it's really my younger siblings and their, you know, their friends growing up, I get to keep taking care of them for my home community.
11:44
SPEAKER_01: And so that's a value to me too.
11:46
SPEAKER_01: And I really appreciate that.
11:48
SPEAKER_00: Yeah.
11:49
SPEAKER_00: And as someone who has gone through multiple egg retrievals, I can say, and I was also at an academic program that that was the experience I had where you have a particular person that is your primary uh physician.
12:04
SPEAKER_00: And then depending on the timing, because timing is so unpredictable, as you know, for egg retrievals and embryo transfers and all those things, there would maybe not be that particular person there on that day.
12:18
SPEAKER_00: And so that is it's an expectation that has to be laid out early on in the talks with the patient.
12:26
SPEAKER_01: You know, Don, honestly, there may be a day when I stop doing clinical medicine.
12:29
SPEAKER_01: I think that day is probably coming because I see the vision of the coaching and the impact.
12:34
SPEAKER_01: And I really do think I can have an impact on a global scale at this point, which is a beautiful thing.
12:39
SPEAKER_01: And so that's part of my question now to your original question is like, what does a meaningful life look like and how do we do this?
12:44
SPEAKER_01: And there's 24 hours in a day.
12:46
SPEAKER_01: Those are the questions I'm asking myself right now is like, for how much longer does that part serve?
12:51
SPEAKER_01: Um, but I have more questions and I have answers.
12:53
SPEAKER_01: But what I can tell you is I'm frequently in touch with my inner voice.
12:56
SPEAKER_01: I'm frequently journaling, I'm frequently talking with my mentors and coaches.
13:00
SPEAKER_01: I get actively coached in this all the time because I need we all need coaches.
13:03
SPEAKER_01: And um, and that's what helps me stay authentic is remaining in those conversations, asking the questions, tuning in, and then making the best decision I can with the available information.
13:13
SPEAKER_00: Tell me about how you got into doing coaching for infertility.
13:18
SPEAKER_01: Yeah.
13:19
SPEAKER_01: So I was in new attending, and it was really the first time I had like my own patients from like the beginning till the end.
13:26
SPEAKER_01: And I was finding that there was a subset of patients who just weren't moving on with their treatment.
13:30
SPEAKER_01: They were, you know, cycle after cycle after cycle.
13:33
SPEAKER_01: Like some of the most painful things we do, people say, Oh, fertility medicine, that's so happy.
13:36
SPEAKER_01: And I think, well, it's happy when it works, but sometimes it's a journey of years for people.
13:42
SPEAKER_01: And, you know, when I look at when I'm not in the OR, like when I'm not doing IBF or surgical cases, I'm in the office either meeting new patients for the first time, or usually, you know, meeting somebody whose treatments haven't worked.
13:52
SPEAKER_01: I mean, every now and again, there's like one visit where you're like, these are your test results.
13:55
SPEAKER_01: This is what I recommend.
13:57
SPEAKER_01: But beyond those two kinds of appointments, then from then on out in that relationship, it's like, so sorry your embryo transfer didn't work.
14:04
SPEAKER_01: We don't really know why.
14:05
SPEAKER_01: This is what we recommend moving forward, or so sorry you didn't get any good embryos from your last cycle.
14:09
SPEAKER_01: Like it's it's like truly bad news conversation after bad news conversation.
14:13
SPEAKER_01: And, you know, I started to notice that there was almost like the presence of my patients had some similarities.
14:19
SPEAKER_01: So uh my patients who weren't moving on from treatment were incredibly anxious.
14:23
SPEAKER_01: Uh, they were starting to feel very hopeless and defeated to the point where I could tell that I wasn't reaching them in the office, which as a massive empath, you know, a caring physician, that was really hard for me to feel like I wasn't reaching my patients.
14:35
SPEAKER_01: And also I was angry for them that their treatments weren't working.
14:39
SPEAKER_01: These were oftentimes my own colleagues.
14:41
SPEAKER_01: I was taking care of or my friends, you know, in small communities.
14:43
SPEAKER_01: That's how it works.
14:44
SPEAKER_01: And I wanted nothing more than to finally bridge them to parenthood to be like, okay, you've served your time in this clinic.
14:50
SPEAKER_01: Like now you get to be on the other side and be a mom.
14:53
SPEAKER_01: And around that time, I was like getting divorced and engaging in parenting coaching for my own sanity and relationship coaching, and really was drinking the coaching Kool-Aid and decided through that process to become a coach myself.
15:05
SPEAKER_01: I remember just learning about these coaching tools and starting to make the connections.
15:09
SPEAKER_01: Like, I think these coaching tools are actually what my patients need to help them calm the nervous system, find their power again and to make these empowered choices that are going to help them finally move forward.
15:20
SPEAKER_01: So thankfully in REI we can build based on time.
15:22
SPEAKER_01: So I would like maybe do a whole appointment where I'd say, okay, you know, so sorry this didn't work.
15:26
SPEAKER_01: You know, these are my thoughts.
15:27
SPEAKER_01: Why don't we meet again in two weeks and have another visit?
15:30
SPEAKER_01: And we're just gonna talk about like, what does motherhood mean to you?
15:34
SPEAKER_01: Or like, you know, let's really tackle that question of like, do I do more, you know, cycles with my own eggs or do I think about a donor egg?
15:41
SPEAKER_01: Or like whatever it seemed to be like that block.
15:43
SPEAKER_01: Like we talk in coaching all the time about like where are people stuck?
15:46
SPEAKER_01: Like I would really, and I've always been fascinated by this.
15:49
SPEAKER_01: Like, where are people stuck?
15:50
SPEAKER_01: And what can we do about it?
15:51
SPEAKER_01: How can we give people back their power?
15:53
SPEAKER_01: Help them access their own power.
15:55
SPEAKER_01: So I started doing that, and it was amazing.
15:56
SPEAKER_01: Like the the patients were feeling better.
15:59
SPEAKER_01: They were able to make values-based decisions instead of that analysis process that I was seeing of people just like circling and self-doubting and all of that.
16:07
SPEAKER_01: Like they started to actually move forward instead of all this rumination and their and their treatment started working, like their next transfer would be positive, or they even call me in the middle of cycles and be like, Dr.
16:16
SPEAKER_01: Bove, the craziest thing happened.
16:18
SPEAKER_01: My husband and I conceived, and like, like it was just results that you couldn't even explain.
16:23
SPEAKER_01: And so that that's when I started to say, you know, I think there is something to this like nervous system activation that when the adrenals get involved, when the stress response is activated in the system, which we know infertility is a stress, like, but when when the when somebody is in that constant threat mode, sympathetic nervous system overdrive, and I can help them with the coaching tools, calm the nervous system, get back into that parasympathetic tone, allow for the physiology to be in the best state for the treatments to work.
16:50
SPEAKER_01: That's when the treatments do work.
16:51
SPEAKER_01: You know, obviously we have to reinstill belief in the process, go back to what I call authentic hope, which is hope-grounded in science.
16:58
SPEAKER_01: Like I have a whole method now that I've developed over time.
17:00
SPEAKER_01: But like now, over 90% of the clients who work with me become parents.
17:05
SPEAKER_01: And these are people where their REIs, their fertility doctors, send them to me because they're like, I don't know what's going on.
17:10
SPEAKER_01: Or, you know, the patients themselves are like, I think my treatments might not work.
17:13
SPEAKER_01: And most of these people end up becoming parents.
17:15
SPEAKER_01: And so it's it's really wild that mind-body connection.
17:18
SPEAKER_01: But that's why I did it was because I was disheartened as a, you know, as a new attending REI.
17:23
SPEAKER_01: I really wanted to help these people.
17:24
SPEAKER_01: And it was through the coaching tools that I actually learned how to help them.
17:29
SPEAKER_00: And talk about why it is so important to do this for specifically physicians.
17:35
SPEAKER_00: Because some people who are listening may not have read chapter three of my book, where I talk a lot about how physicians have a higher rate of infertility and all of those kind of things.
17:45
SPEAKER_00: So tell us a little bit more about that specific group of people.
17:50
SPEAKER_01: Absolutely.
17:51
SPEAKER_01: So, like you said, uh, female physicians have higher rates of infertility than the general, even wives of male surgeons, interestingly, they've done that study too.
17:58
SPEAKER_01: But there's something about like the medicine that is inherently stressful.
18:01
SPEAKER_01: And so one in four female physicians has infertility, one in three female surgeons has infertility.
18:06
SPEAKER_01: The treatments don't work as well.
18:07
SPEAKER_01: And once people do get pregnant, they have worse pregnancy complications than the general population.
18:11
SPEAKER_01: And, you know, you might hear, oh, it's just because surgery residency like takes all these years and people start trying when they're, you know, older.
18:18
SPEAKER_01: But even if you control for age, there is something about the female physician, like being a physician, that is harmful to the process.
18:26
SPEAKER_01: And, you know, we don't want everybody to just quit their jobs and say, okay, well, you know, it's either being a doctor or having a family.
18:32
SPEAKER_01: We don't, we don't want that.
18:33
SPEAKER_01: You know, we hope that there is a way through.
18:35
SPEAKER_01: I mean, most of us have trained for the better part of our youth to do this and we really enjoy what we want to do, but it's an epidemic and it makes me very angry.
18:42
SPEAKER_01: Like it's unacceptable.
18:43
SPEAKER_01: And so, you know, I think female physicians also like number one, we are more stressed out as a group than most other people.
18:50
SPEAKER_01: Like we kind of run with this baseline quote unquote functional anxiety, which I don't really believe in that, but you know, um, sort of this overdrive.
18:57
SPEAKER_01: Um, we don't sleep well, we don't take care of ourselves in general.
19:00
SPEAKER_01: Like a lot of my surgeons will be in the OR for 14 hours without a break.
19:04
SPEAKER_01: They don't pee, they don't eat.
19:06
SPEAKER_01: Um, the food that we do eat is often hospital food, which is not as good, the fluorescent lights, or like the sleep dysregulation.
19:11
SPEAKER_01: I have a whole series in my podcast about why the fertility journey is particularly hard for different groups of people because of their particular specialty.
19:18
SPEAKER_01: And so, you know, I think it's a combination of high stress at the job, sleep dysregulation, no judgment, but poor self-care, because it's really hard to take good care of ourselves.
19:27
SPEAKER_01: There are ways through, but I think the the default, especially if we did a residency, which most of us have, is to just deny our basic needs and put everybody else first.
19:36
SPEAKER_01: And so I think, you know, a lot of people defer even cycles, like, well, I can't do a cycle now.
19:41
SPEAKER_01: I have to do X, Y, Z clinically or whatever else.
19:43
SPEAKER_01: And part of what I do is say, you deserve to be a patient.
19:47
SPEAKER_01: You know, how can we help you give yourself permission to do this?
19:52
SPEAKER_01: Just as if you were having an appendicitis that's two weeks long.
19:54
SPEAKER_01: Like, you know, why can't we look at things a little bit differently to do this?
19:58
SPEAKER_01: And so I think it's multifactorial.
20:00
SPEAKER_01: But I do think that once we give ourselves permission to be a patient, to be a human, to, you know, get what we need, um, it really changes the script.
20:09
SPEAKER_01: And also the other piece of it that I haven't mentioned is that we often try to be our own doctors.
20:13
SPEAKER_01: And it's it's like impossible to turn off the physician brain, like I never turn that off.
20:19
SPEAKER_01: But I think that um there's a lot of like hypervigilance that goes with questioning that, especially when treatments aren't working.
20:26
SPEAKER_01: Like, you know, we go down the PubMed rabbit hole, which is now open evidence and AI and like just are they missing something?
20:32
SPEAKER_01: Is there any paper that's gonna prove to me that, you know, there's some other test that should have been run?
20:37
SPEAKER_01: I always tell my patients and my clients, like, let me take that burden from you because I know the data.
20:41
SPEAKER_01: I love the data.
20:41
SPEAKER_01: Like, you don't have to be up all hours looking at AI to figure this out.
20:45
SPEAKER_01: Like, I'll tell you what the science says.
20:47
SPEAKER_01: Um, but I think people feel that like, if it's up to me, I'm responsible for my own care, I'm responsible for my own outcome.
20:54
SPEAKER_01: And it's really hard to turn off that physician brain.
20:56
SPEAKER_01: It's almost like an obsession.
20:58
SPEAKER_01: So I help people stop those dopamine loops.
21:01
SPEAKER_01: Uh we know in coaching school, we learned about allowing urges.
21:03
SPEAKER_01: So allow the urge of wanting to look up the thing, but like knowing that there's a thoughtful plan and truly surrendering that control.
21:10
SPEAKER_01: Because when when we have the trust, when we have our A team, when we have an REI we trust, when we have a fertility coach like me who can help guide the process, and we can truly surrender that over, that's when the physiology starts to work better.
21:23
SPEAKER_01: And that's when I see the people finally cross the bridge to parenthood.
21:27
SPEAKER_00: It's so true what you said about doctors wanting to doctor themselves, even in these kind of situations, when I mean it's completely not their realm, completely not their specialty.
21:37
SPEAKER_00: But it is very hard to turn that off.
21:39
SPEAKER_00: I've seen it so many times in the Facebook groups for infertility, and I know that you're active in those groups as well, where you see these posts and the person is like questioning every little thing that was done in the protocol.
21:52
SPEAKER_00: And that's not the right physiologist.
21:53
SPEAKER_01: That's gonna be not gonna work.
21:55
SPEAKER_01: It's not gonna work in that scenario.
21:57
SPEAKER_01: You know, it just it's just not gonna work.
21:59
SPEAKER_01: And so It's hard.
22:00
SPEAKER_01: It's hard to like let that go.
22:02
SPEAKER_01: But I think, you know, if you can trust your people, um, trust the people, get a thoughtful plan, know the science is sound, figure out the emotions.
22:10
SPEAKER_01: And that's so that's what I do in my practice is I help, I help make sure the science is sound.
22:14
SPEAKER_01: I help make sure people have the tools they need to navigate the process and provide a community because again, we talked about this before we started recording, but it's so incredibly isolating to be on this journey and there's shame and you know, all these different layers that I think cutting through that really helps people really start to thrive throughout the process and find the joy again, even if they're not at their desired outcome.
22:33
SPEAKER_01: And then, you know, hopefully the fertility journey is just a part of their lives, like kind of like doing your taxes, you know.
22:37
SPEAKER_01: I mean, obviously it's more emotionally charged, but you know, we carve out time to do this and that.
22:41
SPEAKER_01: But it's like people say, you know, my my life has come to the forefront again instead of fertility taking every thought, every bit of energy, you know, all my all my all my field of view.
22:50
SPEAKER_01: So that's some things I'm really proud about.
22:53
SPEAKER_00: How do you navigate the crossover that there is because you are an REI specialist, but you're coaching in the infertility space?
23:03
SPEAKER_00: So I'm sure that there has to be some sort of understanding with your clients that like I am not your physician.
23:09
SPEAKER_00: I'm not giving you a sec, like a true second opinion.
23:13
SPEAKER_00: Yes.
23:13
SPEAKER_01: What do you do in that case?
23:15
SPEAKER_01: It's about expectations.
23:16
SPEAKER_01: I think most of my clients are female physicians who understand.
23:18
SPEAKER_01: And so I say all over all my contracts, all over our initial conversations is like, you know, I'm a doctor, but not your doctor.
23:25
SPEAKER_01: If like they ask me, what should I do?
23:26
SPEAKER_01: I say, like, run this by your REI, you know, they're the play person for your medical care.
23:30
SPEAKER_01: A lot of times we are isolated as doctors.
23:32
SPEAKER_01: And so sometimes I will actually get on the phone or text with somebody's REI, obviously with the patient permission, to really work through a challenging case.
23:40
SPEAKER_01: And everybody loves that.
23:41
SPEAKER_01: The patients and the clients love it because there's more people thinking about them.
23:44
SPEAKER_01: The REIs love it because they're at a loss.
23:46
SPEAKER_01: They don't know what to do.
23:47
SPEAKER_01: They want this person to be pregnant too.
23:49
SPEAKER_01: And I think, you know, I do that in a very non-threatening way.
23:52
SPEAKER_01: And so everything is as long as people understand this is my perspective, it's not medical advice.
23:57
SPEAKER_01: Um, ask your doctor.
23:58
SPEAKER_01: Ultimately, they come up with the final plan, medically speaking.
24:01
SPEAKER_01: But I do empower my clients to ask better questions.
24:04
SPEAKER_01: And so, you know, when they they feel that when they go to their doctor's appointments, that they're more empowered to ask the high-level questions.
24:10
SPEAKER_01: And I think that that empowerment is what we all deserve.
24:12
SPEAKER_01: But we know, I mean, you know, having gone through this yourself, like this, the medical system is not designed for a person, especially with high-level questions.
24:20
SPEAKER_01: And so I think helping people say you're gonna get what you need.
24:24
SPEAKER_01: We know the system isn't necessarily built.
24:26
SPEAKER_01: This complex process is like chemotherapy, like it's not built for a lot of touch points.
24:31
SPEAKER_01: And so let me do some of those touch points so that we can all work together to help out.
24:35
SPEAKER_00: That's really awesome.
24:37
SPEAKER_00: You have your coaching role, but you're functioning also as a patient advocate in some situations.
24:42
SPEAKER_00: Yeah.
24:42
SPEAKER_01: Yeah, yeah.
24:43
SPEAKER_01: Balancing trust and advocacy is one of my favorite things to talk about.
24:46
SPEAKER_01: People ask me all the time, well, do you think I'm with the right REI?
24:48
SPEAKER_01: Like my treatments aren't working.
24:49
SPEAKER_01: And obviously, it's a small community, I know everybody.
24:51
SPEAKER_01: And so I have a whole podcast on like, does your REI know the details of your care?
24:56
SPEAKER_01: Like that's a really important question because you know, a good REI is going to know the details of your care.
25:01
SPEAKER_01: You know, does your REI explain to you why they're choosing this protocol instead of that one based on science?
25:06
SPEAKER_01: And, you know, like if people can do that, fantastic.
25:09
SPEAKER_01: I think some people, the more private equity gets involved in fertility care and the appointment, you know, uh length goes, it shrinks and shrinks, and more of the communication is with non-physicians of, you know, other members of the medical staff.
25:20
SPEAKER_01: I think I say to all my patients who are physicians, hey, if you have a doctor-level question, call me, I'll give you a doctor-level answer.
25:27
SPEAKER_01: But I also think that that's not universal everywhere, right?
25:31
SPEAKER_01: And so I think people are leaving largely unsatisfied, which worsens the problem we just talked about with the hypervigilance and needing to figure it out.
25:38
SPEAKER_01: And so I think it just creates a more balanced approach to say, okay, you will be fully supported through this process.
25:44
SPEAKER_01: And, you know, like your REI is still going to be the one, you know, making these calls and doing the procedures and everything.
25:48
SPEAKER_01: But I think it's a much more supportive way to go about the process.
25:52
SPEAKER_00: Well, I can imagine that there are listeners who are interested in pursuing these types of side activities to get more fulfillment, but they're worried about that kind of like crossover.
26:06
SPEAKER_01: Yeah.
26:06
SPEAKER_01: I think, I mean, there's so I could talk for an hour about this.
26:09
SPEAKER_01: I think that um you have to know where the gaps in your care are.
26:13
SPEAKER_01: So, like if there's a field and say it's immunology and people are struggling to get the specific medicines that they need or like whatever it is, like in like what are people who have fertility problems have way different concerns than other people in other fields.
26:26
SPEAKER_01: And so I think the first thing is to say where are the pain points of the patients?
26:29
SPEAKER_01: Like what is the gap in the medical care of your particular field so that you know the problem that you're trying to solve.
26:35
SPEAKER_01: You know, and mine is that people just feel lost.
26:37
SPEAKER_01: You know, they feel like lost, they feel like just a number, they feel like it's never gonna work.
26:41
SPEAKER_01: And so kind of reorienting people.
26:43
SPEAKER_01: And I think it's important that like everything we do has to be grounded in science, understanding that there are a lot of data-free zones, and I'm very clear when we're in a data-free zone.
26:52
SPEAKER_01: But I think using the science, which is the common language of like both the patients and the clients who are wanting to have a successful outcome, and then the REIs who are reading the same data, I actually align with the REIs a lot.
27:04
SPEAKER_01: I do webinars at least quarterly for the REIs.
27:07
SPEAKER_01: Sometimes it's like, how do you sustain this work in the face of bad news?
27:11
SPEAKER_01: Or, hey, let me tell you about what I learned when I actually sat with that paper we all quote that says, you know, three transfers should have a 95% success rate.
27:19
SPEAKER_01: Guess what I found?
27:20
SPEAKER_01: That it's not applicable to over 99%, it's not generalizable to over 99% of the population.
27:24
SPEAKER_01: Isn't that interesting?
27:25
SPEAKER_01: Should we be quoting this paper?
27:26
SPEAKER_01: So I'm I get really nerdy about like, you know, being an advocate also for the REIs.
27:31
SPEAKER_01: So it's not like I'm a patient advocate because you know, I think we owe, you know, us versus them.
27:35
SPEAKER_01: I'm a patient advocate or I'm an REI advocate.
27:37
SPEAKER_01: I'm an advocate for everybody so that we can all have the best medical system possible.
27:42
SPEAKER_01: Or like there's a lot of people who have um unsuccessful IBF right now where it's uh undiagnosed endometriosis because a lot of us REIs don't operate all that much.
27:51
SPEAKER_01: And so it's out of our skill set.
27:52
SPEAKER_01: And then, you know, maybe we feel a little bit of shame by not operating, whatever it is, or maybe we just want to spend our time doing IBF.
27:58
SPEAKER_01: But a lot of people are not sort of, we're not having as a field, we're not having that conversation about, well, you know, you've had five unsuccessful embryo transfers.
28:05
SPEAKER_01: Have you considered that this could be endometriosis?
28:08
SPEAKER_01: Do you have pain with your belly movements?
28:09
SPEAKER_01: Do you have pain with inner cores?
28:10
SPEAKER_01: Like all the things that we would do.
28:12
SPEAKER_01: So I will often refer somebody, like, say, say to the client, the person in front of me, hey, you know, it sounds like you really could have endometriosis.
28:20
SPEAKER_01: Um, you know, I might say to your, your, you know, physician that you're interested in an evaluation for endometriosis at this point.
28:26
SPEAKER_01: I've never heard an REI say no to that.
28:29
SPEAKER_01: I think as long as they're not the ones doing it, if it feels like it's out of their wheelhouse.
28:32
SPEAKER_01: So I have certain people in different places, I say, oh, this is your geographic region.
28:36
SPEAKER_01: This is a really vetted surgeon.
28:38
SPEAKER_01: And so then everybody's happy because then, you know, if we find something that wasn't found before and the person gets treated and their next transfer works.
28:44
SPEAKER_01: So it you're right, Don.
28:45
SPEAKER_01: Like it, I think it takes a delicacy and an understanding of like what the interests are on all the sides, what the pain points are on all the sides, where there could be misconceptions and shame, you know, and really just wanting the best possible outcome for everybody.
29:01
SPEAKER_01: And so that's that's sort of how I think about it.
29:03
SPEAKER_01: Um, but I think about empowering the patients to say, you have wisdom, your intuition has wisdom.
29:11
SPEAKER_01: How can we help you process your thoughts and feelings in a way that all that clutter is cleared so that you can go to your REI and be able to have your emotional side of the street like clean and clear?
29:23
SPEAKER_01: Like there's so many different layers to it.
29:24
SPEAKER_01: But I think that this advocacy, I think, has gotten a bad rap, but it's really about saying like, how can we change the conversation so that everybody wins?
29:34
SPEAKER_01: I even have like a, you know, guide that I give to fertility specialists, like, you know, how who to refer to me, right?
29:40
SPEAKER_01: Because a lot of them are like, how do I know if Erica would help my patient or not?
29:43
SPEAKER_01: And, you know, I think I say, like, does your patient ask over this many questions a week of the medical staff?
29:48
SPEAKER_01: And like, you know, I think a lot of the um physicians, you know, they they code people as like high maintenance patients, or I say, do you get anxious when you see this person on your schedule?
29:58
SPEAKER_01: Because sometimes there's shame.
29:59
SPEAKER_01: Like the fertility specialists feel like, oh, I should have gotten them pregnant by now, and they're not, and I have to have this conversation one more time.
30:04
SPEAKER_01: And so, you know, it's those sorts of things that I try to say, like, you know, are these patients taking up more of your resources than you would like based on the way your practice is set up?
30:13
SPEAKER_01: And how can I take away some of that from you so that I can help with the emotional side of things, I can help the physiology, and then hopefully your next, you know, treatment's gonna work.
30:23
SPEAKER_01: And to me, that seems like a win-win.
30:25
SPEAKER_01: And a lot of the REIs have, you know, just really been appreciative that we work together and then their patients graduate.
30:34
SPEAKER_00: I just love hearing that you are in this space doing this work for the patients, but then you're also doing it for the physicians.
30:43
SPEAKER_00: This mix seems so fulfilling for you.
30:46
SPEAKER_00: And I know in my own personal experience of navigating this, and then also coaching some physicians who had infertility as well, that one of the biggest issues that I really want to know how you deal with is uncertainty.
31:01
SPEAKER_00: Just navigating uncertainty and the fact that you don't know what's gonna happen, you don't know how your cycle is gonna go, but also it's like not knowing, not having a plan, not knowing like next year am I gonna be pregnant or not, is so, so stressful and so hard.
31:18
SPEAKER_00: So, how do you navigate uncertainty in your own life or how do you teach your clients to do it?
31:25
SPEAKER_01: That's such a great question.
31:26
SPEAKER_01: So, we talk about this a lot at Love and Science, as you would imagine.
31:29
SPEAKER_01: And I think the first thing that we do is we we lean into what I call the deepest why.
31:34
SPEAKER_01: And that's the the deepest motivation of why we're still on the journey.
31:38
SPEAKER_01: Because what I learned is that if we can make decisions that are in alignment with our values, then everything else flows from there.
31:46
SPEAKER_01: And so, you know, I think it takes saying, okay, what are my values?
31:50
SPEAKER_01: What is my highest vision for this process?
31:53
SPEAKER_01: Why am I still on this journey?
31:55
SPEAKER_01: You know, I asked a woman this morning, okay, you've been on this journey for two years.
31:58
SPEAKER_01: It's not been easy.
31:59
SPEAKER_01: Other people might have given up by now.
32:01
SPEAKER_01: Like, why are you still here?
32:03
SPEAKER_01: What keeps you going?
32:04
SPEAKER_01: You know, because I've always seen myself as a mother and because I love my husband so much and we have so much love to give and we want to pour into a little one, you know, like, and so for her, that's her deepest why, but every single person has their own deepest why.
32:16
SPEAKER_01: So even recently on a support group call, we went back to that.
32:19
SPEAKER_01: Each person stated what their deepest why is to provide renewed fuel for the journey, right?
32:25
SPEAKER_01: And so with uncertainty, we have to remember that, you know, we always project worst case scenario.
32:31
SPEAKER_01: Like our brains have this negativity bias.
32:33
SPEAKER_01: And so we're always in the face of uncertainty.
32:35
SPEAKER_01: It's like, well, it's probably just not going to work out.
32:37
SPEAKER_01: And so what I do is I back up from that and say, okay, we have to hold the tension of it is possible that it might not work, but it's also possible that it might work.
32:48
SPEAKER_01: And in opening the door, cracking the door open to the possibility.
32:52
SPEAKER_01: So I think that's important.
32:53
SPEAKER_01: So the values alignment, the values-based decisions, the, you know, sort of reorienting to what our brains are offering us in the face of uncertainty, aka it's all, it's never gonna work, right?
33:03
SPEAKER_01: That's what our brains usually offer us.
33:04
SPEAKER_01: And then how to kind of rebalance that with some possibility thinking, and then to say, okay, well, you know, what resources do I have?
33:11
SPEAKER_01: Am I utilizing my resources to the, you know, maximum ability?
33:16
SPEAKER_01: Am I um, you know, am I doing this alone or am I doing this in community?
33:20
SPEAKER_01: I think it's a lot easier to navigate uncertainty together with other people who are also navigating uncertainty than to say, I'm I'm doing this alone.
33:28
SPEAKER_01: And so, you know, also, also the notion like nobody would ever ask for infertility, but to say, like, how is this process happening for me?
33:36
SPEAKER_01: And how can I use this as an opportunity to grow as a person and you know, to learn what I'm supposed to learn and to, you know, keep on moving forward.
33:44
SPEAKER_01: It's not easy.
33:45
SPEAKER_01: I mean, I think uncertainty is one of the hardest things, but I think ultimately what I help my clients with and my patience when I have time, uh, but my clients is really this notion of surrender, which is I think the hardest part about uncertainty is that like we think we have the control.
33:59
SPEAKER_01: Right.
34:00
SPEAKER_01: We think we think it's all up to us.
34:02
SPEAKER_01: And most of my people have some sort of spiritual bent, like, you know, like whether it's like there's a higher power who has my greatest again.
34:09
SPEAKER_01: And we don't get religious, we don't get, you know, we don't get into those weeds.
34:12
SPEAKER_01: But I think just turning it over to something greater than ourselves, it it really does release the pressure that it is all up to us.
34:19
SPEAKER_01: And if it doesn't work, it's our fault.
34:20
SPEAKER_01: And interestingly, when people are able to surrender, that's when I see that magic start to happen, such that they finally have their highest chance of success.
34:30
SPEAKER_01: Like it's usually like once I can, I can even sense it on the Zoom call.
34:32
SPEAKER_01: Like I can see the channels opening, I can see the surrender.
34:35
SPEAKER_01: And then when that happens, I'm like, oh, she's close.
34:37
SPEAKER_01: Oh, it's gonna happen.
34:38
SPEAKER_01: And then, like, you know, inevitably the next one works and it's pretty amazing.
34:42
SPEAKER_01: So I think it's that combination of like holding that tension, leaning into the authentic hope, leaning into the deepest why, doing it in community, knowing it's possible, it might not work, but knowing it is possible, if it does work.
34:53
SPEAKER_01: But I always say, spoiler alert, if it does work, that news is complicated too.
34:57
SPEAKER_01: So then we can navigate that together too, because that's a whole new level unlocked of uncertainty.
35:01
SPEAKER_00: Oh, yeah.
35:02
SPEAKER_00: Oh my gosh.
35:03
SPEAKER_00: Once you get pregnant, it's like now you have to worry about all the things that can go wrong.
35:09
SPEAKER_00: That's exactly it.
35:10
SPEAKER_00: We're always navigating uncertainty.
35:11
SPEAKER_01: We're always navigating uncertainty.
35:13
SPEAKER_01: It's just uh you get more comfortable, and I'm sure you do this with your coaching clients, like you get more comfortable tolerating the discomfort.
35:19
SPEAKER_01: Right.
35:20
SPEAKER_00: That is a very good point.
35:21
SPEAKER_00: Well, let's go back to you personally for a moment because as I'm sitting here watching you and speaking with you in this beautiful conversation, I see a plant in the background and I see a grand piano.
35:35
SPEAKER_00: Yeah.
35:36
SPEAKER_00: What kind of things do you like to do for fun that are related to your work?
35:43
SPEAKER_01: So many things.
35:45
SPEAKER_01: So I used to play the piano more.
35:46
SPEAKER_01: My children actually play that more than I do these days.
35:49
SPEAKER_01: Um, but I start every day with meditation.
35:52
SPEAKER_01: And maybe that's not considered like fun.
35:54
SPEAKER_01: But for me, that's like a non-negotiable because that starts my day with like a spiritual grounding and a sense of perspective and connection to my breath.
36:01
SPEAKER_01: So I always meditate in the mornings, and it's not like an hour on the side of a mountain.
36:05
SPEAKER_01: It's like truly like, you know, 10 minutes on my insight timer out.
36:08
SPEAKER_01: But it just before I get into my email, before I get into social media, it just really helps me ground for the day.
36:13
SPEAKER_01: So I do that.
36:14
SPEAKER_01: Um, I move my body every day.
36:16
SPEAKER_01: I I think exercise is fun.
36:17
SPEAKER_01: So I go to Orange Theory Fitness two to three times a week and I weightlift and I, you know, I sing on my treadmill.
36:23
SPEAKER_01: I feel like I'm in a club.
36:24
SPEAKER_01: It brings back the younger version of myself, you know.
36:26
SPEAKER_01: So I I love going to Orange Theory Fitness.
36:28
SPEAKER_01: I'm I'm gonna run a 14K race next weekend with my best friend from medical school.
36:32
SPEAKER_01: We do that every year.
36:33
SPEAKER_01: We do more races a year, actually.
36:35
SPEAKER_01: So we um plan races together and train and is, you know, that sort of kills two birds with one stone because it's exercise training, but then it's also, you know, you get to meet up with your inner circle.
36:44
SPEAKER_01: So I I'm very intentional about meeting up with my close friends in person at least once a year, hopefully more than that, like my friends from other stages of life.
36:52
SPEAKER_01: And um, that really fills my cup.
36:55
SPEAKER_01: I love to go to theater.
36:57
SPEAKER_01: I love to go to live music, I love to dance.
37:00
SPEAKER_01: Um, so making sure that I go to live music regularly and go to different, you know, venues to see Broadway and such.
37:08
SPEAKER_01: I mean, I'm at two and a half hours from New York City.
37:09
SPEAKER_01: So that's like, you know, really great that I get to do that.
37:12
SPEAKER_01: But just really um making sure that there's art and culture and colors.
37:16
SPEAKER_01: I went to a conference last week in San Diego and I arrived like half a day early.
37:20
SPEAKER_01: And so I made sure to like say, okay, what art and what flowers I'm gonna find.
37:24
SPEAKER_01: So I made sure that I went to the rose gardens.
37:26
SPEAKER_01: Uh, that was beautiful.
37:28
SPEAKER_01: And then I went to an art museum and then a Japanese garden, and then I went to the conference.
37:32
SPEAKER_01: Whereas in the past, I you know, we say in the past they might have done this, but now the current version of me does this.
37:36
SPEAKER_01: So I was like, oh, I don't have to rush to the conference venue.
37:39
SPEAKER_01: I'm gonna explore San Diego and get my feed my soul a little bit, and then I'm gonna go.
37:44
SPEAKER_01: Um, what else do I like to do?
37:47
SPEAKER_01: Just being outside as much as possible, spending quality time with my kids and my family and my friends, and um, you know, exercising every day.
37:54
SPEAKER_01: I think those are the major things that I really love to do.
37:57
SPEAKER_01: It's beautiful.
37:59
SPEAKER_00: Well, do you have any advice for listeners on how they can integrate all of these different aspects that you talked about into their lives to come up with a fulfilling balance, the clinical work, the the coaching work, or something else that is fulfilling a higher calling, and then all of the things that you're doing for yourself?
38:23
SPEAKER_01: Yeah.
38:24
SPEAKER_01: I mean, I think this is the forever arriving.
38:26
SPEAKER_01: I think um it starts with carving out time to ask ourselves, what do we actually want?
38:32
SPEAKER_01: And and maybe that's too big of a question to start with.
38:35
SPEAKER_01: I think that maybe the better question is like, what would feel good to me today?
38:39
SPEAKER_01: You know, like is it what do I need today?
38:41
SPEAKER_01: Is it a walk outside in nature?
38:43
SPEAKER_01: Is it a nap?
38:45
SPEAKER_01: Is it a conversation with a good friend?
38:47
SPEAKER_01: We don't think about what we need.
38:48
SPEAKER_01: We think about what everybody else needs.
38:50
SPEAKER_01: And so I think starting with that, like, what do I desire?
38:53
SPEAKER_01: That question, what do I desire today?
38:56
SPEAKER_01: And then that paves the way to ask the question, like, what do I actually desire in the long term or kind of on a on a bigger scale?
39:02
SPEAKER_01: And so, you know, when I ask myself those questions, it's like I desire a life of impact.
39:06
SPEAKER_01: You know, I desire a life where I'm making a difference in people's lives.
39:09
SPEAKER_01: And I think for many of us, it's hard to do that just inside of clinical medicine because of the way that clinical medicine has changed.
39:15
SPEAKER_01: I'm sure you would agree that like the the medicine that we were sold when we were pre-med or medical students is not the same version of medicine today with how everything has changed.
39:25
SPEAKER_01: And so I think many of us are finding that when we can find, you know, what our unique gifts are and and how that intersects with what the world needs and how we can make, you know, bridge those gaps, that that is oftentimes where we find that you know, slice of like, I'm really making an impact, or I'm really changing the world in a way that it wouldn't be better, you know, that it, you know, wouldn't be better if I wasn't doing this.
39:45
SPEAKER_01: And so I think asking yourself that question, how could I think outside the box?
39:48
SPEAKER_01: How could I, you know, sort of add, add to the world in a way of maybe, and oftentimes it's like, you know, the wounded healer, like maybe somebody's had a terrible burnout journey and they want to share their journey and what helped them, or maybe it's somebody else who has a creative talent and wants to bring creativity, you know, maybe the female physicians or whatever it is.
40:07
SPEAKER_01: But it's like, I think we all know kind of what our ninja strengths are and what we really enjoy.
40:11
SPEAKER_01: And that might not be the same thing that other people enjoy.
40:14
SPEAKER_01: And it's really cool when we can all combine our gifts and make the world a better place.
40:18
SPEAKER_01: So that's what I would start with saying, what do I desire today?
40:21
SPEAKER_01: Because even to ask that question, we need to slow down and pause.
40:24
SPEAKER_01: And like, we're not good at that in general.
40:25
SPEAKER_01: It's female physicians like actually slowing down and peeing or eating or asking ourselves a question.
40:30
SPEAKER_01: And sometimes, too, just like like you said in the beginning, like grabbing that journal and jotting some things down, it doesn't have to be eloquent, but just even just getting in touch with our feelings, because our feelings lead us to our desires and like what we like and what we don't like.
40:43
SPEAKER_01: And so getting reacquainted with ourselves, I think, has to be like the beginning of all of this, because otherwise we're just gonna keep living our lives according to somebody else's math, uh, but not our own inner compass.
40:54
SPEAKER_01: So that's really important.
40:55
SPEAKER_01: And then to realize there really are only 24 hours of a day.
40:58
SPEAKER_01: And so, you know, for me, it's really important I prioritize sleep, that I prioritize good nutrition, that I prioritize movement.
41:04
SPEAKER_01: So, you know, whatever I'm gonna do in the world has to be in the context of me having those staples.
41:10
SPEAKER_01: And like we can use the word self-care.
41:11
SPEAKER_01: I think that's kind of loaded, honestly.
41:13
SPEAKER_01: But I think, you know, like, am I meeting my basic needs?
41:16
SPEAKER_01: Am I connecting with the people that I love?
41:18
SPEAKER_01: Am I filling my own cup?
41:20
SPEAKER_01: Because we can only give from a you know, cup that's full.
41:22
SPEAKER_01: We fill our cup, we fill our cup first.
41:25
SPEAKER_01: And so, you know, those sorts of things, okay.
41:27
SPEAKER_01: So I have this many hours in a day after I do my self-care routine or the things that fill my soul.
41:34
SPEAKER_01: So then of what are my greatest priorities with the time that I have?
41:38
SPEAKER_01: And then saying no to things.
41:39
SPEAKER_01: Like a lot of us have a giant list of things that we're doing, committees, a PTA, whatever.
41:44
SPEAKER_01: I mean, no judgment if you're on a PTA, but like, you know, there's a lot of things that are on our list that are not filling our souls.
41:49
SPEAKER_01: And so really being intentional about how do I spend my time, with whom do I spend my time, and just continuing to um like prune it, which is a constant process.
41:59
SPEAKER_01: So, how am I making the most of this day?
42:03
SPEAKER_00: Erica, it's been a pleasure.
42:05
SPEAKER_00: Thank you so much for being on the show and tell us all the different places because I know there are many that connect with you if we want to ask a question or learn more about what you do.
42:16
SPEAKER_01: Beautiful.
42:17
SPEAKER_01: Um, so again, thank you, Don, for having me.
42:18
SPEAKER_01: It's been such a wonderful conversation.
42:20
SPEAKER_01: You can find me at loveandsciencefertility.com.
42:23
SPEAKER_01: That's the most comprehensive place to my website.
42:25
SPEAKER_01: It's where you can book a call, you can find my resources, you can link to the podcast, all the things.
42:30
SPEAKER_01: Um, I also have a podcast called Love and Science Fertility, wherever you get your podcast.
42:33
SPEAKER_01: I'm on socials, so Facebook under the same name, Love and Science Fertility Social, uh, Facebook, Instagram, LinkedIn under my own name.
42:41
SPEAKER_01: And so I always welcome a DM.
42:43
SPEAKER_01: I always love to know how I can steer people in a better direction, and I'd love to connect.
42:48
SPEAKER_01: Thank you again so much.
42:49
SPEAKER_01: It's been a pleasure.
42:51
SPEAKER_01: Yeah, likewise done.
42:52
SPEAKER_01: Thanks again.
42:56
SPEAKER_00: Erica's energy and dedication really came through so clearly in that conversation.
43:02
SPEAKER_00: There was a period of time when I thought I really wanted to do coaching on infertility for physicians, but I pivoted away from it after I wrote the book Lean Out.
43:12
SPEAKER_00: Erica is doing this work in such a beautiful way.
43:15
SPEAKER_00: I'm so glad she came onto the scene and is filling this great need.
43:20
SPEAKER_00: So here are my takeaways from our conversation.
43:23
SPEAKER_00: Number one, spend time thinking about needs.
43:27
SPEAKER_00: First think about your own needs and your own desires.
43:31
SPEAKER_00: Many of us have been so busy serving others in the majority of our adult lives that we forget.
43:37
SPEAKER_00: And this can help guide your own lean out journey to know what it is that you need on a daily basis.
43:43
SPEAKER_00: Once you've done that, then think about the needs of those that you are serving.
43:48
SPEAKER_00: It just may be the path you need to find more fulfillment.
43:53
SPEAKER_00: Erica talked about realizing that her IBF patients really needed some of the coaching principles that she had learned in her.
44:00
SPEAKER_00: Personal journeys.
44:01
SPEAKER_00: So she started incorporating those coaching concepts into her appointments as a first step.
44:06
SPEAKER_00: And this was met with great success.
44:09
SPEAKER_00: She also reminds me of when I interviewed Dr.
44:12
SPEAKER_00: Sondra Dalton Smith, who was on the show last year.
44:15
SPEAKER_00: And I will link her episode in case you missed it in the show notes.
44:20
SPEAKER_00: Sondra noticed that there were different kinds of rest and that her patients responded when she educated them about the different types of rest.
44:28
SPEAKER_00: So she came up with the seven types of rest framework, which has now become a successful book and a platform for speaking and coaching and basically all of the things.
44:39
SPEAKER_00: Number two, we will all have an opportunity.
44:43
SPEAKER_00: And I put that in quotes, opportunity to be a patient one day.
44:47
SPEAKER_00: Maybe you have already been one.
44:49
SPEAKER_00: I know I have.
44:50
SPEAKER_00: Give yourself permission to be a patient.
44:54
SPEAKER_00: And what I mean by this is we are not invincible.
44:57
SPEAKER_00: We are human.
44:58
SPEAKER_00: We need to give ourselves permission to be human.
45:02
SPEAKER_00: We sometimes need to rest.
45:04
SPEAKER_00: And in relation to this conversation with Erica, we sometimes need to surrender to the process and follow the lead of someone we trust, like a doctor or a therapist, instead of trying to steer the boat all the time.
45:16
SPEAKER_00: When IVF patients who are physicians themselves are able to surrender the process, they lower their stress levels and end up with better outcomes because of it.
45:26
SPEAKER_00: So this applies anytime you're sick or down for the count, not just during fertility treatments.
45:33
SPEAKER_00: Number three, lean into your deepest why.
45:37
SPEAKER_00: This is Erica's antidote for facing uncertainty, and I think she's spot on.
45:42
SPEAKER_00: You can't eliminate or control uncertainty.
45:45
SPEAKER_00: What you can do is make decisions based on your core values and your highest vision for your life.
45:52
SPEAKER_00: This is the part that you can control.
45:55
SPEAKER_00: Otherwise, uncertainty is about learning to tolerate the discomfort of not knowing.
46:00
SPEAKER_00: I struggle with this a lot as an infertility patient many years ago, and to be honest, I still struggle with it now when I'm thinking about how long I want to do my clinical work before I move on to other things or retire.
46:13
SPEAKER_00: Not knowing is hard, but it's not impossible.
46:16
SPEAKER_00: We can do it.
46:18
SPEAKER_00: Remember your values.
46:19
SPEAKER_00: And if you don't know them and you want help figuring out what they are, send me a message and I will get you an exercise to help you with it.
46:28
SPEAKER_00: My parting question is one that Erica shared with us near the end of her interview.
46:33
SPEAKER_00: What do you desire today?
46:35
SPEAKER_00: What do you need?
46:37
SPEAKER_00: Share your thoughts, both big and small, by leaving a fan mail through your podcast listening app, commenting on the blog post associated with this episode of practicebalance.com, or send me a DM on Instagram.
46:49
SPEAKER_00: I'm PracticeBalance.
46:53
SPEAKER_00: Thanks for listening to the Lean Out Podcast.
46:56
SPEAKER_00: If you find these conversations inspiring and useful, please forward them to a friend and also leave a review on iTunes or Spotify so that other people can find them used.
47:08
SPEAKER_00: If you want to get in touch with me, you can find me at my website, practicebalance.com, where you can subscribe to my newsletter and get updates regularly about new podcast episodes, blog posts, engagement, and you can also support my work by buying my book Me Now, a professional woman's guide to finding authentic work-life balance for yourself, a friend, family member, or coworker.
47:37
SPEAKER_00: Have a great day, and we'll see you next time.