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Board-certified pediatrician, certified coach, and mindfulness and yoga teacher Jessie Mahoney discusses her article “Pediatrician vs. grandmother: Choosing love over medical advice.” Jessie explores the internal conflict she faced between her medical training and her role as a grandmother when her twin granddaughters were born at home. She examines how the physician’s impulse to offer risk assessments and warnings can often feel like rejection to loved ones who simply want support. The conversation highlights the transformative power of asking “What would love do?” to navigate complex family dynamics without alienating those we care about most. Jessie shares insights on how to replace the need for control with the gift of presence and trust. Learn how to let go of the need to be right to preserve the relationships that matter most.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Jessie Mahoney, pediatrician and coach. Today’s KevinMD article is “Pediatrician vs. grandmother: choosing love over medical advice.” Jessie, welcome back to the show.

Jessie Mahoney: Happy to be here.

Kevin Pho: All right, what’s this latest article about?

Jessie Mahoney: This article is really about my own life. This fall, my son, who I had in medical school, had his second child, but it turned out to be second and third child. The story is that they had opted to have a home birth and then had unexpected twins. As a pediatrician, you can imagine I was not aware of this and I learned a lot through the process. As I learned a lot and shared with physician friends, many of my clients asked me: “Oh my gosh, how did you handle this?”

I did a lot of personal reflection on it, and it was clear to me that this is a huge issue for many of us in medicine. It was a huge issue for me just to be very honest. It is this idea of when our family makes choices that are outside of our own recommended ways of doing things in health care and how we focus on that relationship and stay out of judgment. Whether it is your aging parents or your children on the other end, or friends and family, this applies.

A few bigger issues came up around this. It is partly not being asked what it means. Or when they do ask and you give advice and they do not follow it, what does that mean? Sometimes they ask and we think they ask too much. I have those family members too. It is pretty much a no-win situation for us in health care.

It got me really thinking about how we want to show up for these situations. This very same week was the week that I gave a TED Talk on “What Would Love Do.” The two sort of dovetailed in this idea that your relationship with your kid and your grandchildren should be a loving relationship. It is not really about being a doctor. When you are a doctor, and in this case a pediatrician around childbirth and babies, you can’t not be a doctor at the same time.

So many people said: “Oh, well just don’t be the pediatrician. Be a grandma.” I said: “Well, I can’t do that either. I do not know how to do that. That is actually not realistic.” So how do you intentionally move forward and recognize that nervous system trigger and all the thoughts that came up? The other piece that came up here that was really stressful for me was I actually felt judged by many of my physician colleagues. They asked: “Well, how could that happen?” It clearly is out of your control. My son is very much an adult, he is married, and he has his own kids. There was a lot of judgment from the physician world about how they thought and whether they were scientists. My son and his wife are actually both into science very much so.

I think in our world today we have so much energy around this and judgment and conflict. So I decided to write an article about it. It was part of my way of processing. When I shared this with people, I just got so much feedback about how helpful the thoughts and the framing were.

Kevin Pho: So take us through that event. What was your role during that event? Tell us what happened.

Jessie Mahoney: My role was really nothing. I knew this was their second child and their first child had been born in a hospital. I had helped them get set up with a pediatrician and an OB. It was a birth center situation. But this time I actually just made assumptions. I have tried very much to be a gracious mother-in-law and a gracious grandmother and been very intentional in those roles. I don’t want to be the pediatrician or the medical person. I am always available for advice.

Actually, I think I end up filling that role a lot. I am not someone who espouses being “all in or all out.” Like saying: “You have your doctor, go ask them.” I think our system is so broken right now that is not really fair. If I can be helpful, I have good advice. But I think if you are always helpful or you are always judging or always saying things, nobody listens to you.

What happened here is I literally got a text about the event on the other end that there were these beautiful twin girls that were born and photos. No one actually ever even used the word “home,” but it was clearly obvious from the photos that they were at home. As parts of the story came to pass, it was clear that that was a very intentional choice that they had made.

We actually haven’t talked about it, which I think is better. It was really for me to process on my own how that happened. I will say in the end, it all turned out fine, but in the moment my brain just went absolutely haywire. It also went haywire about what they should do now and this and that and all these things and what could go wrong. That was clearly not my role, but it is very hard to be quiet and to recognize it took a real intention that love actually wouldn’t speak up and love wouldn’t criticize and wouldn’t judge what had happened in the past because that is not helpful.

Thankfully they were lucky and it turned out fine. It is also a reminder for us in health care that things actually do turn out well most of the time. But our lens is all of the terrible things that could happen. I think that that intentional handling took a lot of thought and mindfulness and pausing and breathing on my part. In the end, I am very proud that it worked out that way. I learned a lot from it, even as I carry it over to my brother who is always asking me for medical advice about his children. He is the opposite. He asked for more and my parents ask for less.

Even how to process the fact that I didn’t know was part of it. I was like: “Hmm, what does that mean? Are they rejecting what I do? They know I am a doctor. Do they think I will be upset?” My ultimate story would be that their not telling me was actually loving because had I known that would have been actually even harder for me.

In this case, I think that what is most important is my relationship with my son, my daughter-in-law, and my granddaughters, and I have my grandson. Knowing that they feel comfortable asking me questions is important. I think being very purposeful in how we show up for those situations is what maintains the relationship and has left the lines open for them to ask me pediatric questions, which I am a good resource for.

Kevin Pho: Yeah, so that intention not to judge, not to criticize in a way keeps you close to your family members who would feel comfortable asking you questions that maybe if you put on your pediatrician hat, you would give advice and you would judge, right?

Jessie Mahoney: Yeah.

Kevin Pho: So, at the moment it sounded like you had to pull all your coaching techniques and implement them during a time of stress.

Jessie Mahoney: Boy, yeah. My husband was stepping on my foot. Well, I just it was clear to me. I think in part I was stunned. It had never occurred to me that this would happen and I was thankful and worried. So in that moment, it is always the pause. We are trained to react. My job was not to react and was to remember that my job here was not the medical provider. Nobody was asking me for advice. They were sharing this good news with me and my job was to lean into that. It was great news.

I needed to be supportive of what I think was unexpected and overwhelming on their part. For me to sort of figure out how to do that takes that inner awareness, which I think we often turn off in medicine. That being said, sometimes we are thoughtful about what not to say. It is not really about what to say or not to say, but how to choose the role that you have in different scenarios. So it is choosing the daughter role with your parents or the sister role with your brother or the mom/grandmother role.

I think to be fair to ourselves, to understand that I hear from so many people, “Don’t be the doctor,” and you can’t not do that because you know all the things. So having compassion for yourself to say, “This is going to be super stressful,” is important.

Kevin Pho: So we have talked about this earlier, pause rather than react. That is a tremendously powerful technique and it came in very, very handy during this particular instance, right? But even at the moment, you as a trained coach found it so difficult to even do at the moment. I can’t even imagine how other clinicians, how some of your other clients would have responded in a similar situation. And I assume that is probably why you felt judged by your other physician clients when you told them the story because they were reacting. Right?

Jessie Mahoney: Of course. And I think the reason that I was able to do it is because I do a lot of work with other people and myself about showing up with intention. So I have been really clear, particularly in my mother-in-law role, about how I want to show up as a mother-in-law because that is such a noisy emotional role. I really wanted to be a non-judgmental mother-in-law and I really want to stay connected with my kids.

One of the things that I work with physicians and coaching on is this idea that we want our kids to be mostly healthy, mostly happy, mostly responsible, mostly independent, but we also want them to want to have a relationship with us. We want to have a relationship with them and that is the key thing. So if I want to have a relationship with them, I can’t show up as the naggy pediatrician physician who is always giving advice.

It does not mean that I disregard everything. I did say: “Oh, wow. Well, I am glad you guys got lucky.” That was kind of my version of “I am so glad that nothing went wrong.” You can start to drop hints or be sure. I had said in the past my thoughts about home birth with their first child, so I had already said it. There was nothing else to say. But I think we feel like we need to keep repeating it and repeating it and repeating it. We judge ourselves like: “Well, how come they didn’t listen to me? Did I not say it persuasively enough?” It had nothing to do with me. But in medicine we think that it does.

We also think it is sort of rejecting a career that we gave everything to, and now they are rejecting that and they are choosing to do this in a different way. It is not about that either, but we are trained to take it pretty personally as well as other people’s comments. The not asking you, you take that personally too, potentially.

It was a great reminder for me that it is not about me and a great reminder for me of choosing that intention and what is the energy you want of your relationships and just leaning into that, which is really love. As a person in most of our intimate family relationships, I think we get ourselves into a lot of trouble when we show up with advice and knowledge couched as love. We think: “Oh no, it is loving to give them all this advice.” Yet I think for me, it is also loving for me to ask my future self in that moment. My future self would have recommended that they take those babies in to see a pediatrician and I did.

I said: “Well, this is great and now I still recommend this.” My job is to throw it out there to offer help with figuring out how to make that happen. But not to push. We think our job is to convince them or make them understand. It reminds me of the vaccine dilemma. Our job is to inform and to educate and to share our knowledge when people ask for it. Which they do when they come to you as a pediatrician, but not in this case.

Kevin Pho: Now, did you ever have a formal debrief with your son and did your son ever come to you and say, “Hey mom, what did you really think about this?”

Jessie Mahoney: No. He is not, and I think I mean actually I think he knows exactly what I think. I think maybe five years from now, he will tell me: “Thanks for not creating an issue.” The other thing I think is when people have babies and twins, it is not the time to be discussing emotional, heavy emotional stuff. Even now, these twins are a couple of months old and they have got their hands full and it is not the time. There are all those postpartum hormones going around and nobody is sleeping. If my ultimate goal is a healthy relationship, that has to be the focus.

The only reason I think that that would need to happen is if I was still harboring some challenge. The work was for me to work through this. When I have talked to other people who have really struggled with family members who do not follow their advice, do not follow recommended advice, and or ask for their advice and do not follow it, which is even harder, I tell them the work is really for us on the inside. It is a very expensive, energetically and emotionally charged situation. I think it brings a lot of resentment and judgment that it doesn’t have to. And then we have these challenges with our family, which we do not need to have.

Kevin Pho: How did it feel to be judged by your physician peers and some of your coaching clients whom you told this story to who may have reacted? You said that you felt judged by them. How did that feel? And how did you manage those emotions?

Jessie Mahoney: Initially, I think I was probably judging myself a little bit too. We are so trained to people-please and have everyone like us. As you say it now, I think: “Well, I was probably judging myself a little bit too.” How could this have happened? They are all saying: “How could this have happened and why didn’t this and that?” Again, it was just the pausing and recognizing that everyone is going to have their own reaction.

I think that had this not been my own son and my own focus being on that relationship, I probably would have reacted the same way. We are trained to do that in medicine and we have talked about judgment. I do think it is this idea that imagine if we supported one another, which is something that we can just work on in medicine by saying: “Oh my gosh, that must be hard as a pediatrician. Yeah, I bet that flipped you upside down.”

That is not what we were trained to do. We are trained to figure out what we have missed and what could go wrong. I think ultimately in the end, a lot of people said: “I can’t believe that this is all fine. And this is turning out well.” Modeling that I think was really powerful.

But it reminds me of hearing a lot again about physicians not supporting other physicians, especially women. This is not actually personal at all, but it is that we are just trained to react in that way. We are trained to worry about the worst-case scenarios and to jump in and to fix and solve and judge, and that is what we do. So just like that wasn’t my role, other people are trying to take the same role.

What if in this world of medicine we asked people, even when there is an undesired outcome in medicine: “Oh my gosh, that must be really overwhelming for you. How can I support you?” Wouldn’t that be lovely? That is not what we are trained to do, but someday we may be able to get there.

Kevin Pho: So I am hearing that the fact that you stayed silent and did not jump in with advice in your opinions preserved the relationship that you had with your son, daughter-in-law, and your grandchildren. Is that really the case? I just want to make sure, because I completely agree, because having that safe space, that non-judgmental space, is a way to keep close contact. So tell us about how that has strengthened the relationship with your son and his family.

Jessie Mahoney: That is actually funny because I would say I wouldn’t have thought this would do it, but the fact that I have just shown up fully asking “How can I help?” and non-judgmentally has done it. I do a fair bit of work. When I am tired, I think this is true for any physician parent or grandparent, you are not at your best. So I do try to make sure that I take good care of myself and I go visit and I am all in and helping, but not to the point where I am depleted and then I say things I wish I hadn’t said. So again, it is being very intentional.

Having gone through this and my trusting that they did this for their own reasons that I may or may not understand is key. I do not even need to understand. This idea that you do not have to understand has been so helpful in coaching and I think is something that so many physicians find helpful. We do not have to agree on this. We can still love each other. I do not have to understand their rationale. They do not have to understand my rationale.

My trusting them is allowing them to trust me. I actually now get a lot of pediatric questions again. That is great and I am happy for that. That is what I would like. Especially as I say, with the chaos of medicine, it is pretty hard to get a simple question answered in a timely fashion. That is something that I can bring.

So showing up non-judgmentally is key. We have talked about aging parents as well. When you show up non-judgmentally, you get a lot more questions, a lot more information, and you can be a lot more helpful. Having been through this and showing up non-judgmentally has really strengthened the relationship and strengthened our conversation. I can see the next question like: “Well, what if this happens again?” I think I would ask: “Oh, what are your plans? I am so glad it worked out last time.” I still have the same opinion about this from my training, but we all get to have our different experiences.

One of the other things that this brought up for me was a real grief and sadness around how our medical system works right now, and that pretty highly educated people who I think are pretty reasonable are opting out because of some of the challenges of getting care and the processes and the way it feels to be in the system. That makes me really sad.

Kevin Pho: I have heard one piece of advice for others in that situation is before you say anything, just ask: “Do you want me to be a pediatrician or do you want me to be a more supportive role? What do you need from me right now?” And let them guide you in terms of how you can respond.

Jessie Mahoney: Yeah. And I will say, I think my son has learned quite well. He says: “I am calling you for pediatric advice,” sometimes now. As opposed to: “What’s your thought?” The questions are framed very differently. I think that setting that up is really, really helpful.

Over time, I think my family is pretty good about that. They say: “We need your doctor advice,” or it is clear they are not asking about it. “I do not know what to do” is not “I need your doctor advice.” I would agree being really, really clear helps. It is the pausing to be clear what your role is and who do you want to be so that you can maintain those relationships.

I think being a physician is so much a part of us. It is a real challenge to step out of that. Even when you are not being asked to show up in that role. So it just takes a pause and tremendous compassion. And that intention is key. I often help people really be clear about what their intention is in their relationship with their kids. What are the feelings you want to have there? Because we get very focused on achievement or on what terrible thing could happen. Being really clear helps if you want to have this long-term, healthy relationship with your kids, which is much longer as an adult than it is under 18.

Bigger stakes things keep coming up as this story makes clear. I mean, I would have said this would never have been part of my story at all. It just was never something that had crossed my mind and so there was real learning in it. I know from hearing from so many people that they have had experiences that have felt the same way internally and our natural reaction is just so strong.

So how do we have the wherewithal in the moment to grow that pause? Mindfulness is the key to growing that pause. I guess that is where I got it from. That is what I teach. But to recognize, I think many of us are like: “Ah, it is not that useful a skill.” But if you grow it over time and you practice it, you lengthen the space between the stimulus and the response, and it gives you those nanoseconds that allow you to catch yourself in the moment so that you could show up with love for the people you love.

Kevin Pho: Are your son and daughter-in-law aware of whatever you are describing here in this podcast? What if they saw this podcast? What do you think their reaction would be?

Jessie Mahoney: Well, I have thought about that. People said you really need to share about this. And I said: “Oh no, I can’t.” I think that my framing is that they did what worked for them, and I actually in many ways am proud that if my child or his partner believe in something strongly and that is what they want, that they did what they believed in.

I am actually kind of proud of how we navigated it in the sense that I feel pretty non-judgmental at this point. In fact, as a physician, I think it is really super helpful to see that people that you love and trust and respect make decisions that are different than you might recommend. That has been a really powerful experience.

So I am hopeful that if they were to listen, that they would see that this was more of a learning experience on my end and that they would feel really good that I leaned into the love piece and that that was what was most important to them. Part of me is like: “Yes, I hope they appreciate all the work I went to,” but in the end, I am not sure. That is not really the point. It is funny, that is your doctor. I wonder if they even noticed. I do not know.

But for me, it is really about the growth and learning on the physician end because our tendency is to judge people, whether it is those people we love or to judge each other. Which is really funny because what my children do is not actually a reflection of me. But in medicine we always make people’s behavior a reflection. Like if your patient does something, it is a reflection of you as a doctor, but it is not actually in your control. What is in your control is what you share with them and your beliefs and the energy you bring, and what they do with it is on them. Having it be someone in your family is very clarifying of that.

Kevin Pho: We are talking to Jessie Mahoney, pediatrician and coach. Today’s KevinMD article is “Pediatrician vs. grandmother: choosing love over medical advice.” Jessie, as always, let’s end with take-home messages that you want to leave with the KevinMD audience.

Jessie Mahoney: My message is: One, as a physician, we cannot separate that out from our identity. It will follow you whether you are a mom or a grandmother or a daughter. But two, choose your relationships and be intentional about how you want those to be. Own what is yours. As you mentioned, figure out whether people are asking for your advice or not, and be thoughtful about the right places and times and spaces to share it so that you can allow what matters most to you to be healthy and whole.

Kevin Pho: Jessie, as always, thank you so much for sharing your story, time and insight. Thanks again for coming back on the show.

Jessie Mahoney: Thank you for having me.