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“Many of us suffer in silence for myriad reasons. Being a physician with infertility presents a perfect storm of stress, anxiety, guilt, and shame – all of which we know don’t contribute to managing any medical problem.
Consider what it’s like to undergo a typical cycle of in vitro fertilization. You administer nightly hormone injections to grow your follicles in preparation for an egg retrieval procedure. The process usually takes 1-2 weeks, but you don’t know exactly how fast your follicles will grow. For the first week, maybe you just need to arrange to get away from the hospital or clinic for a couple of blood draws. But during the second half of your stimulation cycle, you must physically go into your clinic for daily transvaginal ultrasounds to monitor the progress.”
Dawn Baker is an anesthesiologist who blogs at Practice Balance.
She shares her story and discusses her KevinMD article, “The voices of women physicians with infertility.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Dawn Baker. She is an anesthesiologist, and she wrote the KevinMD article “The voices of women physicians with infertility.” Dawn, welcome to the show.
Dawn Baker: Thank you, Kevin. I’m so excited to be here.
Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?
Dawn Baker: Yeah. Well, I’m an anesthesiologist, and I have been out of my residency training for approximately 10 years. We’re doing this podcast in winter, and I graduated late. I actually graduated about exactly 10 years from now, because I had some sick leave that I had to do during my residency. To make a long story short, I ended up having a pituitary tumor that took a long time to diagnose while I was in training and really too busy to pay attention to my own wellness and health. It was through just an innocuous fertility workup that the diagnosis really started.
So on that path, I knew that I wanted to share what I had done to regain my health. Thinking that some of my symptoms were related to burnout, I started out writing about physician burnout, more in the wellness range, and that has really changed to encompass lots of different subjects on my blog, which has grown into a speaking career and also life coaching for other physicians who want to attain better work-life balance, and now encompassing physicians who are going through infertility diagnosis and treatment.
Kevin Pho: So tell me, what are some of the things that you did to overcome some of the health challenges that you had during your medical education journey?
Dawn Baker: Yeah, so it was a difficult time, as you can imagine, because we’re all very, very busy and have very limited time off. But I was forced to take time off because I had this illness. So I really prioritized sleep, as we all should be doing, but it’s difficult to do. I learned about mindfulness and meditation and tried lots of different modalities of that. I really learned a lot about myself by going deep into reading, researching, and doing assessments to figure out things about myself, like if I was an introvert or an extrovert, what kind of things I like to do, what kind of things I gained energy from, or what kind of things zapped my energy.
It seems like we would know these things about ourselves, but we actually don’t. We are kind of blind to a lot of the things that we really like and dislike when we go into medicine, because we’re just focused on that one thing and our training. And so I learned a lot about myself and ways that I could take care of myself better, specifically for me.
Kevin Pho: So tell me some of these lessons that you learned for yourself and how you apply them in your coaching with other physicians.
Dawn Baker: Yeah, so I would say one of the really important things that I learned was what my values are. I always take my clients on a journey into figuring out what their core values are, the things that really resonate with them, and then that can shape the kind of work situation that they should be striving for.
One main thing that I figured out about myself was that I was really an introvert. And so in order to rest and to rejuvenate when I am in certain social situations, I needed to be by myself. Spending a lot of time by ourselves is not something that oftentimes is valued. We think that we need to be out and about and doing social things all the time, but it can actually be counterproductive for certain people. So that was really useful.
And then I figured out, through some self-assessments such as the five love languages, how to better exist in my relationship with my spouse, and also, through the four tendencies, which is something that I teach on with coaching, how to respond better to my habit formations, as far as losing bad habits and then gaining better habits or adopting new habits.
Kevin Pho: All right, let’s transition now into the KevinMD article that you wrote. It’s titled “The voices of women physicians with infertility.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?
Dawn Baker: Yeah, so I have been coaching on work-life balance and writing about work-life balance for a while, but a big, pivotal part of my work-life balance is being a mother, and that journey was a long one for me. Through my severe illness in residency, which was a pituitary tumor diagnosis and then a surgery and resection, I was left with infertility. So I found myself in a place, as a young attending, navigating infertility treatments.
I realized that that is a very, very unique set of difficult situations: to be a new physician, to be the kind of person that is getting your feet wet in a practice, navigating not having all of your vested benefits maybe, or being the low person on the totem pole when it comes to leave and vacation, and then being in an environment where it’s very difficult to take time off. I struggled myself with the journey, but I was successful. I did have a daughter, and so she’s a big part of why I decide to work the way that I work and do the kinds of hours and different things that I do.
So I began researching infertility by talking a little bit to other women that had had a similar situation to me, and I decided, when I was chosen to do a speech at an upcoming conference, that I would talk about this situation. Infertility is actually quite common, and it is even more common in physicians. So this is a big issue: If you’re not dealing with it as a woman physician, you’re going to have colleagues that are dealing with this issue. And so it affects all of us, as far as our workplace wellness climates.
So I decided, as part of my preparation for the speech, that I would do a survey of women physicians who have navigated infertility on any kind of level; either they have started or they have finished an infertility journey. I put this survey out, and I got an overwhelming response in the infertility Facebook groups that I’m in for women physicians. I realized that they really wanted a voice for the things that they have been going through, so that people can understand.
A big part of it is that a lot of people like to keep it a secret. I was very open about my infertility and about the kind of things that I needed when I was working and going through treatments, but some people really don’t want their colleagues to know. They really don’t want to talk about it. They want to keep it private, because it still has a lot of stigma associated with it. So I wrote this article to summarize what some of the women said to me and to give them a voice for the issues that they’ve been dealing with, being a physician and having infertility.
Kevin Pho: Now, you mentioned how difficult it was being a new attending and also having to deal with infertility. Take us through perhaps a representative day that really articulates some of those challenges that you faced.
Dawn Baker: Yeah, so there’s a perfect storm of a situation where you’re very anxious, because you have a lot of uncertainty. Infertility treatments can change on a day-to-day basis. You can have this plan where, for instance, if you’re doing in vitro fertilization, you’re going to have an egg retrieval on a certain day, and then that day may change by one to three days. So you can’t plan in advance for time off.
But say you’re a brand-new physician in a group. How do you navigate getting that time off when you have a full schedule of patients, or maybe you have an OR schedule, or you’re a surgeon and you actually have your patients that are scheduled for surgery on a certain day? It’s very difficult to cancel a whole day of clinic or a whole day in the operating room without disappointing a whole lot of people and messing up a big schedule for a whole team. So that is very anxiety-provoking, and then not wanting to talk about the subject can bring in even a whole other level there.
On top of that, well, most of us have a lot of debt from our medical training, medical school and residency, and infertility is not cheap. Infertility treatments are most often something that is paid out of pocket. There are some insurances that cover that, and it’s becoming a little more common, but it wasn’t so until more recently. So then that brings in another aspect, which is the financial aspect.
Kevin Pho: So what are some of the things that you did, or people that you turned to for support, during that difficult time?
Dawn Baker: I think it’s really important to have some sort of a support system. When I surveyed the other women physicians in this cohort, they all said the same thing. Most of them also made a comment that it’s very important to have an open line of communication with your spouse, or whoever you are on the journey of infertility with, but at the same time to have another type of support system, an objective third party, whether that be a trusted friend or family member, or a therapist, a counselor, a coach, or even, if you want to be a little more anonymous, a group such as a Facebook group. There are a couple of different Facebook groups that are private but that you can find for women physicians that are undergoing infertility, and some of the physicians that I surveyed really mentioned how useful that group was and just how important it was to them.
For me, I definitely confided in key players at work and told people like the operating room scheduler, the anesthesia group scheduler, so that they understood what I was going through and how I would need to have some kind of leeway in my schedule. Also, I personally had a very supportive spouse and a good, open relationship there, and I did use some counseling and some coaching while I was undergoing my infertility.
Kevin Pho: Now, how about the hospital and the administration? How accommodating were they?
Dawn Baker: So in my personal experience, I did not have too much trouble. However, I did use vacation time for some of the periods of time that I needed to do treatments, as opposed to using it for something fun or going on a trip. It really depends on your system. For me, I was able to get vacation without too much lead time, but not everybody is lucky in that sense, and some hospital systems and some practice groups actually have punitive repercussions if you do take time off with really short notice. That’s very sad.
I heard lots of stories through this survey of people who said, “I can’t ask for time off if it’s more than two days in a row without three months in advance.” Now, I didn’t have that issue, so I didn’t have any kind of problems. People talked about being written up for, quote, “unplanned absences,” or difficulties with needing to cancel patients in clinic because they had to, at the drop of a hat, go to an appointment or a procedure.
Kevin Pho: Now that you’ve had time to reflect on this experience, is there anything that you would have done differently?
Dawn Baker: Yes, personally, there is something I would have done differently, and I think that any person is going to answer this differently, because infertility diagnoses and journeys are all very individual. But for me, I’m a second-career physician. I worked as an engineer for a while and went to medical school late, and so you can imagine that my childbearing years came sooner in my training trajectory to become a physician. I wish that I had started sooner. In retrospect, that’s really hard to do now. I mean, it’s something that you can’t just say, “Oh, I wish I did this,” because everything was the way that it was.
I feel like a lot of women, though, when I surveyed them, did say the same thing. They said, “Start early, investigate early, escalate early.” So my other thing that I wish that I had done was that I wish that I hadn’t kind of dawdled around on my diagnosis and the fact that I had some covert symptoms and things going on that initiated this fertility workup. I wish I had been a little more vigilant about it and started it sooner. Because the older you get, if you have any kind of organic infertility diagnosis, age just compounds your ability to get pregnant, and it makes it even harder.
Kevin Pho: We’re talking to Dawn Baker. She’s an anesthesiologist, and she wrote the KevinMD article “The voices of women physicians with infertility.” Dawn, for those other female physicians who are going through medical training, or new attendings, also going through the infertility journey, what are some of your top tips for them?
Dawn Baker: My top tip is to remember that you are not alone. There are other people going through this, and people that you don’t even know that are going through this that don’t want to say anything. So find a trusted colleague, find a friend, find a coach, find a therapist, or someone that you can talk to, so that you can navigate all the feelings that you’re having with the help of somebody else and not feel too isolated, not feel too much shame and guilt.
And then I would say, like I was mentioning about my learned lessons, make sure that you advocate for yourself, that you remember what your priorities are, and the fact that even though being a physician is very important to you, your family life is also super important. And make sure that you talk to different people that have gone through what you’re now navigating, so that you can figure out their learned lessons as well.
Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?
Dawn Baker: On a general level, I would say the very important key to work-life balance and wellness as a physician, or any other professional, is to take some time to learn about yourself. Take some self-assessments, read books about mindfulness, read books about self-care, figure out what works for you, and figure out your unique set of values. That will help you to navigate any kind of work-life balance situations and make the right choices that are going to help you to have a long and fulfilling career.
Kevin Pho: Thank you so much for sharing your time and insight, and thanks again for being on the show.
Dawn Baker: Thank you so much.
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