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Join us in this insightful podcast episode featuring Sarah Wittry, a hospice and palliative care physician, and Kim Downey, a physical therapist. Sarah shares her journey of navigating burnout, finding balance, and embracing mindfulness practices while discussing the importance of aligning life with core values and maintaining harmony between professional and personal roles. Together, they delve into topics such as emotional intelligence, teamwork, and dismantling societal norms to chart one’s own path.

Sarah Wittry is a hospice and palliative care physician. Kim Downey is a physical therapist.

They discuss the KevinMD article, “Ditch the guilt and stress: Embrace your core values like this inspiring doctor mom.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Kim Downey, and we’re going to introduce Sarah Wittry. Sarah is a hospice and palliative care physician, Kim is a physical therapist and a physician advocate, and together they co-wrote the KevinMD article “Ditch the guilt and stress: Embrace your core values like this inspiring doctor mom.” Sarah and Kim, welcome to the show.

Sarah Wittry: Thanks, Kevin.

Kim Downey: Thank you so much.

Kevin Pho: So Kim has been on multiple times, bringing physician guests onto the show. So Kim, how did you find Sarah, and what about her story resonated with you?

Kim Downey: So actually Sarah reached out to me last July. She was curious about what I was doing, and we went back and forth a bit. And then a few months ago she shared a comment on someone’s post that said, healing is speaking our truth, validating our experiences and those of others. And I thought that was really good, so I saved it.

And then soon after that I was collaborating on an article with Dr. Frances Mei Hardin, and I was like, wow, that would be the perfect ending to our article, because it was about having crucial conversations. And we reached out to Sarah and asked if we could use her quote, and she graciously agreed, which led to her and I having a conversation, and evolved into us collaborating on this article.

Kevin Pho: Excellent. And Sarah, you’re a hospice and palliative care physician, so just tell us a little bit about your story and journey, and then you can use that to lead into your article with Kim.

Sarah Wittry: Sure. So my background, I did residency actually in PM&R, physical medicine and rehab, and then did a fellowship in hospice and palliative directly after that, out at the University of Washington in Seattle.

And during residency training, I had kind of planned out everything, how I thought it would go in terms of starting a family and all of that. And yeah, things didn’t quite go how I planned. And I think that’s one of my main things that I’m taking away, is just that we don’t have as much control as we think we do over family building and how our life will look. And so it’s really helped me to refocus and pivot so that I’m able to still show up and be the mom I want to be, the physician I want to be, and ultimately the person I want to be.

Kevin Pho: All right. So the KevinMD article that you co-wrote with Kim is titled “Ditch the guilt and stress: Embrace your core values like this inspiring doctor mom.” So Sarah, tell us about your professional life, and how did that interfere with what you wanted to do at home?

Sarah Wittry: Yeah, so we have four kids that have come to us, two from foster care adoption. And then I also, before that and kind of during that time, navigated infertility myself, which is something I don’t think a lot of people talk about, but it’s much more common in women physicians, particularly women surgeons. And it was a very lonely journey, especially as a trainee, without much extra time or money or anything like that for workup or treatments.

So I think that that did shift a lot of my perspective and open me up to a whole new world as far as parenting and the needs of kids, particularly who have had a traumatic early childhood. We had two more kids, one was a surprise and one, I had IVF and our little baby girl joined us. So we have a happy family of six, but just not in the way I expected.

And my early years of being an attending included starting COVID, right? And so the start of the pandemic, and moving to a new state, I think was very traumatizing in some ways, just because there was so much unknown, of course. And the palliative care team, I felt like we were kind of thrown in the fire in terms of talking to families and patients that were dying rapidly, and trying to have these really difficult emotional conversations with loved ones over Zoom, or with restrictions with visitation and all that.

So I think that that was really the time in my life, like that 2020, 2021 time, where things sort of blew up, like how the things that had been working for me as far as balancing and being able to get home to my kids and meet their needs, as well as try to support my team, the patients, other physicians and teams, was just kind of all coming to a head.

Kevin Pho: So Sarah, sounds like a confluence of major events. Obviously you have your kids, new attending, COVID. Just take us into your mindset during that time. Maybe a typical day that really kind of illustrates all those different challenges coming at you at once.

Sarah Wittry: Yeah. So of course there was just so much variety and things changing every day, it felt like. But kind of in the thick of it, I remember not knowing when our kids were going to have daycare or not, if they would be closed, the schools were closed, trying to set up my oldest ones on their Zoom kindergarten, first grade and stuff like that. As well as get to the hospital, have these really emotionally draining conversations.

And just so much fear circulating, I think, and anger. I just feel like our team and me, we received a lot of that emotion. And so it was like holding a lot of that while also worrying that I wasn’t able to give my family very much at the end of the day, because it was so exhausting, and we were understaffed so I was working a lot more hours.

So I felt like in that time I knew I could not keep going at that rate. And also I think, by nature of being in palliative care, we see so many people whose lives are shorter than they expected, or even if they are long lives, they still have regrets. And usually their regrets are of inaction, right? So things that they wish they would have done, that they didn’t have the courage to do, and things like that.

Kevin Pho: Kim, when you heard Sarah’s story, and you’re hearing it again now, tell us what was going through your mind when you first heard her story.

Kim Downey: Yeah, well sure. When we had our conversation, it was neat to see the things that we kind of shared in common in some ways. And that was, between her starting out her medical career in physiatry and PM&R, and I’m like, oh, I’m a physical therapist.

And then when I found out that she’s a hospice and palliative care physician, my dad was in, and my husband’s dad, were hospice and benefited from those services, and I’m so grateful. And friends, sadly I’ve had friends die that used hospice. So I’m so grateful for that, and I was so appreciative to Sarah for the work that she does.

And then we also talked about that we’ve both actually had good experiences in being part of well functioning teams. And I think even in physiatry, like PT, OT, speech, we’re really good at collaborating, and I always loved my colleagues, and from the last job, we still get together, they still consider me part of their team in some ways, and that’s beautiful.

And then we’ve also both benefited tremendously through working with a physician coach, which we came to in very different ways. And then when I also found out that Sarah was raising four kids, and I only ever had two, and she’s a physician and she has a coaching business, I was like, oh my gosh, how do you have time to talk to me? And she just seemed so calm that I was like, oh, I have to know more.

And I hear over and over again how difficult things are for physician moms, so I thought if we collaborated on an article, that she would really have a lot of wisdom to share that could help other busy physician moms.

Kevin Pho: All right. So Sarah, tell me the next chapter of the story. So you’re telling me how you’re being pulled apart in all these different directions. Tell me what happened next, and what did you do next?

Sarah Wittry: Yeah. So I would say that kind of in the midst of all the things, I was very much a self-help person, so I tried to do a lot on my own, and listen to a ton of podcasts and read books and do journaling and all the things.

But really it was during that time that I moved beyond therapy for myself to discovering physician specific coaching. And found really that, not just the tools I learned in coaching, which helped me so much about determining and really getting clear on what was mine to control and what was not, and so much was out of my control, but I gained so much more agency in coaching. Figuring out the power of my thoughts, as well as determining what I was feeling, which I was so out of tune with, could really impact how I showed up and what I was able to do and how I felt moving through my days. I think more than anything that was so huge.

And then I think the power of community in coaching, and interacting with other women who also felt pulled in different directions, and felt like they were always busy like myself, but sometimes still that deep sense of being inadequate somehow, and just not feeling like you’re able to show up your best self for anyone. It’s a really disempowering feeling.

Kevin Pho: So Sarah, you make the distinction between coaching and physician specific coaching. So tell us a little bit about that distinction, and what is it about physician specific coaching that specifically helped you?

Sarah Wittry: Yeah, I mean, I think coaching is becoming so big now, right, and there’s so many different arenas it can be helpful in, for all different types of things like career and life coaching and business coaching and all the things.

But I think that physician coaching was so instrumental for me, and how I want to be, I went through certification to become a coach as well, because I want to help other women physicians. Because I think the main thing is, we get it, right? We’re in it, we know the struggles that we all face similarly, regardless of specialty. We know the parts that are unique about being a physician and about being a mom. There’s a lot of that shared emotional experience.

And I think feeling the need to be a leader in our homes and also at work. So I think that the camaraderie and sharing similar struggles and empowering one another has been really what’s led me so much to be a huge advocate for physician coaching, and I think, resiliency and us being able to sustain ourselves in the long term of medical careers.

Kevin Pho: So Kim, I know that you’re such a passionate physician advocate, and I know that you have your own show and you interview and talk to so many physicians. What are some themes from Sarah’s story that you think would resonate with other physicians who have to juggle that balance between what they have to do professionally and managing a family? Are there any themes from Sarah’s story that you could share with other physicians that may resonate?

Kim Downey: Well, one, and we could let Sarah speak to it again in a minute if she has a chance, is that we spoke a little in our conversation about what it is to be a good doctor and what it is to be a good mom. And just in an episode I recorded on Monday that will air next Monday, we spoke to that as well. What does it mean to be a good doctor, right? And you kind of have to chart your own path.

And another one is setting boundaries, because a lot of physicians, and especially women physicians, end up being people pleasers, and they feel like they have to prove themselves over and over again. And also being able to say no, and that no means no.

Kevin Pho: Well, Sarah, do you want to expand on some of the things that Kim said?

Sarah Wittry: Yeah, I think those are all really good. I think things that I’ve learned that I like to impart upon other women physicians are just that, for better or worse, no one is going to come save you. And I think I kind of hoped that that would happen for a while.

But just being really clear, and you have to allow yourself some time and space away from all the noise. So however you can carve that out, little bits at a time, to really get clear on where you’re at, how your energy is being managed, how in tune you are with your physiologic state, your stress state, what is taking energy from you, what gives you energy. And really starting to say, what do I value and prioritize the most? Truly, like, within the whole blend of life, right, not distinct roles, but within each thing, what are my core values and priorities?

And then using those as a filter, I would say, for your decision making and your boundary setting. That’s really, I think you can feel the most agency when you have done that process, and kind of continue to come back to it. Because, like Kim said, you really have to kind of figure out how to chart your own way and kind of push back against the status quo. Because at the end of the day it’s your life, and you have every right to do the things that bring you joy and spend time where you want to.

Kevin Pho: So a couple themes that I see here, setting boundaries, saying no sometimes, pushing back against the status quo, those things really resonate with me and I completely agree with what you guys say about that. So Sarah, that’s not always easy for physicians to do, right, to push back? Because to be where physicians are, we do in a way have to be people pleasers and jump through all these hoops to be physicians in the first place. So Sarah, tell us about your process in terms of setting those boundaries. What are some tips and advice that you could give to other physicians, and how long did it take you before you felt comfortable setting those boundaries?

Sarah Wittry: That’s a good question. I’d say I’m still in process, to be honest. It’s an always evolving thing.

But probably the skill that I learned that helped me the most in that process was learning to allow and sit with my discomfort. Right when I thought about telling my boss, or whoever it was, that I was going to cut down to 0.8, or when I was going to not do that committee, it was just like, what comes up for me is fear, and I don’t want to be perceived a certain way and judged.

And so it was learning how to sit with that, process it, and sort of at the end of the day come to trust myself in my own decisions, and say, yep, that’s going to be uncomfortable to go through, but this is what I’m going to do to get through that, and the worst that can happen is a feeling.

And so yeah, sometimes people don’t like boundaries, or they don’t like you kind of saying, that’s not what I want, or that’s not in line with what I’m wanting to prioritize. But I think that when you do it, the more you do it, you sort of get more confidence in the doing. You’re still scared, but you’re kind of doing it scared and letting that fear come along for the ride.

Kevin Pho: We’re talking to Sarah Wittry and Kim Downey. Sarah is a hospice and palliative care physician, Kim is a physical therapist and physician advocate. We’re talking about the KevinMD article “Ditch the guilt and stress: Embrace your core values like this inspiring doctor mom.” Now I’m going to end with both of you just sharing some take-home messages to the KevinMD audience. Kim, as always, we start with you.

Kim Downey: OK, sure. So recently Dr. Michael Hersh commented, while systemic change can take a long time, we don’t have to wait. We can implement immediate change simply by deciding we want things to be different. As we grow, change, set boundaries, and recognize intolerable behaviors, we force the systems we work in to change alongside us. And I think he’s living that, and I thought that was really powerful.

And what I would add to that is, if you’re feeling dissatisfied, take a single step and try something different. So I thought I’d share a personal example, that when I was going through cancer treatment and struggling with some things that had happened, I took advantage of some cancer center offerings, and it all added up to be incredibly helpful. From counseling sessions with a social worker, to participation in a midweek mindfulness Zoom, to some art offerings and writing groups, to a grief yoga session and acupuncture.

And no one thing will be the answer for most people, and no one of those things was the answer for me, but you will help yourself by reaching out to make true, deep connections, and by seeking support in whatever way resonates with you.

Kevin Pho: And Sarah, your take-home messages to the KevinMD audience.

Sarah Wittry: Sure. I guess specifically for women physicians, I just urge you to courageously invest in yourself. Take that bold step, and recognize that it’s going to feel messy and imperfect as you are sort of figuring out who you are as a unique human being and clarifying what matters to you. Do not let anyone else tell you what that needs to be.

And once you are clear on that, in that process, then if you are able to align your life and your time, your energy, your schedule, with those biggest priorities for you, then I feel that you’re going to live in the most authentic way for you and have fewer regrets down the road when you get towards the end of your life.

Kevin Pho: Sarah and Kim, thank you so much for sharing your stories, time, and insight, and thanks again for coming on the show.

Kim Downey: Thanks for having us, Kevin.