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Join us in this episode with Diana Londoño, a urologist, for a thought-provoking discussion on the true essence of intimacy. Together, we challenge the common belief that intimacy is confined to the bedroom, exploring instead the deep emotional and spiritual connections that truly bind us. Diana offers her expert insights on how to nurture these bonds, the power of vulnerability, and practical steps to maintain intimacy in relationships.

Diana Londoño is a urologist and can be reached on Twitter @DianaLondonoMD.

She discusses the KevinMD article, “The surprising truth about where intimacy really begins.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Diana Londoño. She’s a urologist, and today’s KevinMD article is “The surprising truth about where intimacy really begins.” Diana, I know you came straight from the OR. I appreciate you coming here.

Diana Londoño: Kevin, thank you so much, just for always your grace, your humility, your love, and everything you do. And I really just actually want to acknowledge just how grateful I always am of you and everything you are.

And I was reflecting this morning about my first article, which was almost three years ago, July 2021, that I submitted. And I just want to say that people sometimes have this thing like their time before COVID, their time before JFK was assassinated, like there’s a time where they remember there’s a big change in their life. And I have to honestly say, my reflection this morning, it really was my time before my KevinMD article and after. It really, really was a big pivot in my journey, and I’ve said that before to you, of healing and of growth. And I feel like from three years ago to now it’s such a different place, and I’m just so grateful to come back and to come full circle in a different place. So I’m very grateful to you and everything you do. Appreciate you.

Kevin Pho: I appreciate that, thank you so much for saying those words. And I know you’ve come such a long way, because I see you all over LinkedIn, you have a wonderful platform now, you do coaching. Tell me how all that’s going.

Diana Londoño: Well, it’s definitely been a growth journey. And I think even this year my word was expansion. And I never had a word any year, but I did do that this year, and it really, words are very powerful, they manifest, they become your reality. And it really has been a year of growth, stretching, being uncomfortable, breaking, falling, crying, laughing, dancing all at once.

And this article we’ll talk about in a second is very personal, and all my articles are personal and all my posts are personal. It really is my journal that I just share with the world, because that’s how I heal. And my healing journey has been writing, and I encourage people to do that. Maybe they never have to submit or share, but do it in their own comfort of their own home, their journal, their computer, because it can really be so transformative to write. And that’s really what this whole journey has been about. So I can’t emphasize that enough.

Kevin Pho: Writing, doing something that you say is uncomfortable and just embracing that vulnerability, it’s not only helping you heal but just giving you so many other opportunities as well outside of clinical medicine.

Diana Londoño: Oh absolutely. I mean, it really is something you look forward to, and it helps others. I share, people call it vulnerable, that I share things that I do, but it really gives other people the courage to maybe get a little uncomfortable themselves, try something new, and to realize like you’re not alone. Like we all have the same struggles with shame or impostor syndrome or crying or being angry.

And that’s OK, like they’re emotions and we are human, and we have to embrace our humanity. And our humanity is filled with emotions, and robots don’t have that, and rocks don’t have that, but we do, and it’s a gift. But in medicine it’s sort of been like, well, you shouldn’t have those, and those are dirty words and you don’t have those emotions. And so it’s really about giving people that permission to have their humanity back and embrace it and just go along with the ride, just ride that wave, that roller coaster of emotions.

Kevin Pho: So you mentioned we’re going to talk about one of your latest articles today, “The surprising truth about where intimacy really begins.” Now tell us how this article came together, and then talk about the article itself for those who didn’t get a chance to read it.

Diana Londoño: Yeah, well, also first, thank you for the title, it’s beautiful. You changed it and it really hit the point. And that picture was absolutely outstanding, and a picture is worth a thousand words.

But yeah, that’s also personal. It’s been a personal journey of my own growth, of course, but I’ve been married almost 17 years, and marriage is challenging, and it doesn’t come with a manual, and it’s not just the wedding that is the goal, it’s a whole lot of work. And especially for me, when you have children, it’s a lot of strain, there’s a lot of energy being put into different places. And if you don’t really spend that time to nurture that relationship, sort of like you water the grass and the plants, if you don’t do that, then disconnection is going to happen. There’s going to be a lot of things that change, and it may not be great, but it’s really important to sit with that discomfort.

Think about intimacy, and this article talks about intimacy, and I’m not talking about just having sex in the bedroom, that’s what people think about. Intimacy starts outside the bedroom, 100 percent. And it’s that connection with the other person, and it’s that vulnerability we sort of talked about earlier. It’s a connection of the mind, of the thoughts. It’s a connection of the voice, speaking to each other. It’s a connection of the heart, of opening the heart, of being vulnerable and asking for forgiveness, asking for what you need. I mean, there’s so many things that are so important. And then of course, yes, that other connection is going to be sort of like your sexual organs, your intimacy that gets aroused. Everything is activated when there is that intimacy.

And I heard somebody on a podcast, it was actually two male doctors, talking about like you should schedule time for physical sex, that intimacy sex part. And that’s really important, and that’s a good point, I understand where that’s coming from. But even if you schedule that time for physical sexual act, if you don’t schedule that time outside, and if you’re not really doing that every day outside of the bedroom, that sexual union is going to be OK, but it’s going to fall a little flat. It’s just not really going to be that blissful state that people think about.

And even in Eastern philosophies, and kundalini and that sexual union, I mean sex can be very triggering and there’s a lot of things about it. But at the core of it, if you have everything aligned with your partner, the mind, the thoughts, the voice, the connection, the heart, and yes, your divine energy and all your sexual energy, I mean it really is a blissful state, is what people dream about, whether you’re in a meditation or during sex, in Tantra, like what Tantra, that union.

So I think it’s really important to understand that that all happens outside, and it’s work, and it’s vulnerability, and it’s really love. Because love energy is the key that’s going to unlock all the other ones. Like if you don’t have that heart open, everything else is going to shut down. So it’s really important to think about it that way.

And also the other aspect of it too is, I’m a urologist and I deal with this all the time, the balance of pleasure and pain. We see that all day whether it’s sexual or not, there’s a lot of that. And we have a lot of drugs, testosterone and Addyi for women, for increasing your desire, your libido. I mean, you can give all the testosterone in the world, honestly, but if you don’t have that connection, that’s kind of pointless. But in Western and in all society we want that easy fix. I want that shot, I want that pill that’s going to give you the solution. But it actually takes a lot of work, and that’s really what this article was about.

Kevin Pho: So what are some examples where couples can express that intimacy outside of the bedroom? So you gave some general things of what we should do, but what would be a scenario, what would be some examples of what that would look like?

Diana Londoño: I think it starts with many things, but one of them can be just curiosity. When there’s miscommunication, instead of getting defensive, because that’s what we do, our ego gets flared, then we start getting attacking and we start getting triggered and all our traumas probably just vomit on each other. We have to step back a little bit and get curious and let go of our ego, which is hard especially for surgeons, but for anybody. Everybody’s going to be flaring up with their ego.

And we sort of come from the side of like, OK, I hear you, I see that’s your viewpoint, tell me more. Get curious. And when you get curious with the other person, you ask them more questions, that wall and that resistance and that fighting energy actually comes down. And that really can be whether it’s a patient or it’s your spouse or any relationship. When you ask tell me more, it’s an invitation to really connect.

So I think that could be a first step of what can you do outside the bedroom when communication may not really connect. And with the men are from Mars and women from Venus, I mean we sometimes speak different languages, so we have to say, OK, well, I didn’t really get what you said, tell me more. And so I think that’s a huge key when we’re starting to feel defensive, when the communication just went flat.

Kevin Pho: Now how did you come to that realization? Is this something that counseling helped with?

Diana Londoño: Yeah, it’s a lot of work. I mean, I think it’s not an easy thing, it’s mindset. I mean, coaching of course, coaching is about mindset. You have to think about basic one-on-one coaching, your thoughts create a feeling, and that feeling is going to lead to an action and result. So if I felt attacked, then I’m going to feel angry, and then I’m going to start sort of yelling back or shutting down. That’s going to happen. That’s not going to lead to intimacy. So in the bedroom, yeah, I’m sure you can schedule your sex time, but it’s going to be like, nah, I’m not really into it, but yes, I’m just here for the motions.

And also there’s a whole part of it which is a huge thing, like what are women, and even men, but especially Latin and many cultures, we’re just there to please the man, and it’s our duty to have sex like this many times a week or an hour, however much they want to say. And we have to sort of be like, if you don’t feel it, if you don’t have that connection, then it’s actually OK for you to stand up and say, I’m not going to have the physical act of sex because I don’t have that connection outside, and I don’t want to do it here, because that’s actually inauthentic to have sex, have that physical transfer of energy, if you don’t have that connection. So it’s about authenticity in and outside the bedroom, and it’s about vulnerability in and outside the bedroom, of saying your needs and saying what you want and saying what’s true to you.

Kevin Pho: So like you said earlier, couples these days, families these days, so over scheduled, especially if you have kids. I have two teenage daughters, and certainly I can understand how difficult it is. But you said it does take of course a lot of work, so tell us the type of work that it would take to maintain that intimacy, that communication, despite how busy typical families are.

Diana Londoño: Yeah, I think when our society, which it is, is in fight or flight all the time, because chronic stress is a real thing, it’s about 90 percent of all doctor visits are stress related, 80 to 90 percent are truly in every specialty stress related. Burnout in all sectors, not just physicians, is the pandemic. So chronic stress leads to burnout and we’re all experiencing it.

So what does that mean? That means we’re running in fight or flight, we’re always just reactive. And when you’re reactive, when you’re in fight or flight, you can’t be curious. It’s just not going to exist.

So how do you get out of the fight or flight? Well, you have to cultivate a practice, a time to have that silence, have that quiet, whether you call it prayer, whether you call it journaling, whether you call it meditation. Whatever you call it, it has to be scheduled. If we’re going to talk about scheduling, we’ve got to schedule that time for you. Because in that time you’re going to go from that fight or flight sympathetic to a parasympathetic, that is going to give you that space when somebody or your spouse says something triggering, that you can then have a pause between your thoughts and your reaction.

So you have to do that. That is your work you have to do. So that every day, whether it’s your spouse or your kids or challenging conversations in the operating room or wherever you’re doing them, you can have a space of not attacking, getting curious, and opening your heart instead of closing and fighting.

Fear is an energy, and any emotion is an energy. Fear is very constricting. When you’re scared you actually clench down. Love is expansive, love is magnetic. So it’s a different energy, like people feel it. You walk in the room, you feel somebody happy and joyful, and you feel that. I mean, you can’t deny that even if you don’t feel energy very well. So we have to switch to a place where you’re in love, where you are calm.

And another way, something to do tactical or practical, is really gratitude. Gratitude is not just fluffy, it’s not whatever, something to also do. It’s a state of being that changes your physiology. It actually changes your cells, it changes your energy. And the more you’re grateful for, the more you find things to be grateful for. I mean, it’s like a multiplying effect. So all of a sudden the lens of what you see is very different.

So these are things you can do practically, like have that time scheduled, not for intimacy and sex, but for you to be in a calm state. Schedule that time to really just take care of you. And it is really important. If you don’t do that, well, yeah, it’s going to be chaos, because we’re all so busy.

And the reality is we have so much time. I mean, people tell me, oh, you’re so busy, how do you do it all? Because I schedule my time to really be centered and have something in the morning that I’m going to focus. Like what’s my center today, what do I want to face the day with? With joy, with happiness, with peace, with calm. What is my goal for today? And it’s a mindset, it’s a mantra, it’s something that you’re going to focus on.

But if you just wake up and get out and roll out and just pour the coffee and run, well, I think your day is going to be different. And again, you can try it out and see how it works, but you’ve got to try it, you’ve got to do the work, you’ve got to get curious. Well, would that work for me, would there be a change if I do something different? And I think there will be, but we have to do it.

Kevin Pho: We’re talking to Diana Londoño. She’s a urologist, and today’s KevinMD article is “The surprising truth about where intimacy really begins.” Diana, as always, we’ll end with some of your take-home messages that you want to leave with the KevinMD audience.

Diana Londoño: Well, thank you so much. I mean, I want to just say, really, please realize you’re worthy. Realize you matter. Realize that love is the biggest, most important energy in the universe. It really, it’s not corny, but it can change everything. If we change from love instead of being in fear and division and hate, what would the world look like? What would medicine look like when we’re compassionate and loving, not just to patients but to each other, how we speak to each other?

So love, practice it, love, feel it. We are love. We just got to get rid of all this other junk that’s on top of us and realize it’s within us, and we are love.

Kevin Pho: And thank you again for sharing your perspective and insight, and thanks for coming back on the show.

Diana Londoño: Thank you Kevin, as always. I’m so humbled and so grateful. Thank you.