A physician’s infertility story [PODCAST]

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“My IVF baby turns 12 this week — and having attempted frozen and fresh IVF cycles six years ago, which did not result in pregnancies — I can also hold tenderly the space for those who have heard those words, ‘Only one child?’

Yes. Only one. Only one, magical, amazing, child destined to be ours.

How blessed am I?

Our thoughts are so very powerful, and I would like to leave you with these thoughts:

You are not broken.

You never were.

Be gentle with yourself.”

Dympna Weil is an obstetrician-gynecologist.

She shares her story and discusses her KevinMD article, “A physician’s infertility story.”

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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. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. On today’s show, we have Dympna Weil. She is an obstetrician-gynecologist. She wrote the KevinMD article “A physician’s infertility story.” Dympna, welcome to the show.

Dympna Weil: Hi, thank you so much for having me. It’s a pleasure 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?

Dympna Weil: Sure. So I’m an OB/GYN in upstate New York. I’m currently not practicing; I’ll get to that in a minute. But I knew I wanted to be a doctor when I was 11 years old. I lived with my grandmother. She had colon cancer, and I wanted to be like the doctor who saved her life. So that was it; I was hooked. We had no doctors in our family, but I just wanted to be like Dr. Cohen.

So I went to NYU for undergrad, and imposter syndrome set in early. I got off track a little bit, falling off the premed track very early, getting spooked. And so I had a gap year by default. I applied early to NYU Med and got in, but during my gap year, I took the time to get my Irish dance teacher’s license, because I was a lifelong Irish dancer. I taught Irish dance during my gap year and then went to med school right after.

During medical school, I had thought about pediatrics, because I loved children, but I decided on OB because the hair on the back of my neck stood up the very first time I delivered a baby, and I did every single time thereafter. So I studied, and I did my residency at Stony Brook, out on Long Island. I was chief resident there, stayed on faculty, was the assistant clerkship director, and just loved it. It was while I was there as an attending that my husband and I went through our fertility treatments and ultimately had our pregnancy and delivery.

Eventually, I left academics. We moved upstate. I joined a private practice, where I hoped to have a slightly more balanced existence, and several years later, I became an OB hospitalist, again searching for that balanced existence, again teaching residents, and then having a little bit more autonomy in my schedule to be a little bit more available to my daughter as she entered school. And that’s where I remained until late 2020.

2020 needs no introduction to people, but late in that year, I started having some unusual symptoms. Suffice it to say, I had some neurologic conditions that were diagnosed, and I couldn’t be running around labor and delivery, operating and delivering babies, anymore, and some days I couldn’t be doing very much at all. So I wasn’t really able to trust my body. And so I didn’t choose to stop practicing, but I had to stop practicing because my body stopped me in my tracks.

That was not easy to manage, and it made me confront a lot of things about my identity, as you might imagine. I assembled a great team of doctors around me, but throughout that time, I had to learn how to manage my own emotions around all of that. And so between therapy, which was part of my vestibular recovery, and coaching, I had to learn to allow myself to just be for the very first time and to allow myself to feel, and then choose how I wanted to show up moving forward, because in fact it is a choice, and it was my choice. And that was the greatest gift, to know that I had some agency in a time of disconnect and mistrust between what my senses were gathering and what my brain was registering from the environment. And so that’s where I am today.

Kevin Pho: Now, for those other clinicians who may be listening to you and have to unexpectedly leave clinical practice for whatever reason, from your own experience, what kind of advice do you have for these clinicians?

Dympna Weil: Yeah, it is an exercise in surrender. I had to learn to surrender control, and it was trusting those who were caring for me. I developed this mantra that I am only accepting care from those who will get me well. And it was feeling into that trust of who is going to help get me well, and being OK with being a patient and not getting so wrapped up in my identity of doing. As physicians, we feel our worth in wearing the white coat, in running around seeing patients, and if we’re not doing that, “What good am I?” That is kind of where I was when it first started.

And I had to really question those thoughts, like, “Is that true?” Part of it, through both therapy and coaching, was questioning the thought: Is it true that I’m not worthy of my own care? Am I not worthy if I’m not earning money through seeing patients? Am I not worthy to call myself a doctor if I’m not doctoring in the way that I used to be? And of course it’s not true, but it felt really true at the time when it first happened.

And so surrounding yourself with support is really crucial, and not doing what I did back when I went through my infertility, which was stay isolated and alone and silent and feel shame. I started out there, but as I allowed myself to be surrounded, open up, and allow in some support, it made it a lot easier to manage.

Kevin Pho: So let’s talk a little bit about your infertility journey. You wrote about that in your KevinMD article titled “A physician’s infertility story.” Now, for those of you who 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?

Dympna Weil: Sure. So the reason it kind of came together, I guess I’ll start with, is that as I was going through this transition and I was dealing with this new experience of worthiness and sharing, it brought me back to that time of loneliness and support and healing from some of the times of loss in my life, and this was one of those times. My daughter was just about to turn 12. It was National Infertility Awareness Week, and it really kind of came together, where I recognized that this was a period of my life where, had I had some of the tools that I now have to step back a little bit and look and examine some of the ways I was thinking about that very painful time, it would have helped me.

So my story was, I was in academics. I was 32. We were looking to start our family, and it didn’t happen. As doctors, we’re very organized: “I’m going to graduate, I’m going to work for a few years, and then we’re going to have a family. That’s how it works.” And it didn’t work that way, and there were no clear identifiable reasons. It was the unexplained infertility. We went through all of the normal infertility workups.

And my thoughts about it were really like, I spent all this time, like many, right, trying not to become pregnant while I was trying to go about my young adult life, controlling cycles and trying to get through residency and doing all these things. So many young women think about these issues, right? Like, “I want to get my career going.” And then when we start thinking about wanting to become a mother or beginning a family, we just take it for granted that it should just happen when we want it to, or we anticipate it going one way, and then it goes another. It’s humbling.

And I felt it as a patient, and I felt it as a physician, being on the other side, taking care of those gravid bellies every day, measuring them in the office, and running around labor and delivery from room to room to room, in between C-sections running upstairs to give myself my own injections before I ran to deliver another baby. So I wrote about it to complete my own healing, and by speaking my story, to release some of that carried shame that I had left over from all those years ago.

Kevin Pho: Now, when you said that the story affected you as a physician, what are some examples of that?

Dympna Weil: Well, it was everything from going to the office. You see patients in the office, and I felt their pain differently. I would hear colleagues say, “Ah, it’s another very high-needs fertility patient.” Well, I’m that patient. I held them a little gentler because I understood what they were going through.

But as a physician, I also had responsibilities at the hospital. I had to be at sign-out at seven o’clock when I was covering labor and delivery, but yet I had to go get all my labs and ultrasounds done at 6:30 and needed to arrange to have somebody, a close friend, just cover me for 45 minutes so that I could do all those things. And I wasn’t getting the support that I could, because in the patient support groups, half the patients were my own patients, because I was their OB. There were nuanced things that were just a little more challenging, passing in the hallways at the doctor’s office, and some of them were other professional colleagues. We just kind of put our heads down, because you’re not there to work up your irregular periods at 6:30 in the morning. We all know why we’re there.

And then on the other side of it, there was caring for these patients and trying to hold the compassion as you walk into a room on labor and delivery when someone has presented with a stillborn, or someone has presented with an undesired pregnancy and they come in to deliver, and trying to come in and just care for them, knowing the pain that I’m carrying, and trying to cast that aside as I care for that patient. It was very challenging in a lot of ways.

Kevin Pho: Now, you’ve been on both sides when it comes to infertility, and that’s certainly a valuable perspective. For those clinicians who may not encounter a lot of patients going through that infertility journey, what are some things that we should know? What are some of these nuances that you talk about when we talk to patients who are going through this infertility journey?

Dympna Weil: Yeah, I think it’s the innocent sort of questions, right? Even just the family members, the colleagues, also the newlyweds: “So when are you going to start having kids?” We were married six years, and we got that all the time. And some of it was, we weren’t, because I was still in school, but maybe we were. You don’t know that someone hasn’t been trying. So maybe it’s a decision that they’re not, and maybe it’s not a decision. So we just never know what’s going on behind closed doors, right?

Or others, and I remember being asked, “Oh, are you pregnant?” I had gained some weight, but some of it was actually just that I had lots of fluid because I was taking all these injections. I wanted to say, “Yeah, I wish I was,” but no, I didn’t want to share that. I just said, “Yes, I have gained. Yeah, I gained some weight.” And the reason is because I was taking all these injections that I was running up to the call room to do, but I didn’t feel like sharing that in that moment, because it was just so tender.

And you see a lot now, people are a little bit more gentle about it, April Fools’ jokes and those sorts of things. But people, it’s all done innocently. Our hearts are very tender around the subject, because you never really know whether someone is trying or not, and what they have been going through or are going through.

And after writing this article and sharing it, and I appreciate you sharing the article, so many reached out to say, “I had no idea.” Even people who were part of my birth, my delivery story, had no idea what I went through. Nurses I’ve worked with in various stages of my life reached out to say, “I had no idea.” Or people have reached out to say, “I’m taking care of patients in my clinical practice as a psychologist,” people I don’t even know, to say thank you for sharing. Because the more people share, the less it becomes a stigma or a shame point. And so I think it’s just having an awareness that we don’t know what goes on behind closed doors.

Kevin Pho: We’re talking to Dympna Weil. She is an obstetrician-gynecologist. She wrote the KevinMD article “A physician’s infertility story.” Now, for the other physicians who also may be going through the infertility journey, do you have any advice for them that you could draw from your own experience?

Dympna Weil: Yeah, seek support, whether that’s from a close friend, support groups that are out there, therapists, coaches, whomever it may be. It is a far easier journey to traverse when you have support around you, because the shame comes when we do this alone, and it doesn’t need to be that way.

Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Dympna Weil: I think it’s that we have agency in how we get to tell our story, and that we can say we’re broken, or we can choose not to tell that story. We’re not broken. We are every bit as deserving and every bit as worthy of a family. And maybe it may not be the way we had envisioned it; it may be a different path than we had expected. But be open to the possibilities that maybe the plan we had in mind, maybe there’s something better out there. It just may not be what we had anticipated and pre-written, when we pre-wrote our notes that night before. Maybe there’s something better out there, and we just have to allow ourselves to be open to different possibilities. And definitely with support, it’s easier.

Kevin Pho: Well, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

Dympna Weil: Thank you so much for having me.

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