Empowering Women Physicians on the Fertility Journey with Dr. Sunny Smith

Love & Science Fertility was founded two years ago this November. I’m deeply grateful for everyone who listens to this podcast, trusts me to walk with them on their fertility journey, and for the community of professionals who help bring this mission to life.

Sunny Smith graciously shares her wisdom and experience on today's episode, both in terms of her personal and ongoing journey finding wellness as well as how she empowers other women physicians to do the same. 

We discuss the following:

• her journey into coaching, first with awareness of thoughts, and then embodied awareness

• how to notice emotional activation

• how to calm the nervous system 

• her own story of a diagnosis of infertility

• how awareness of our feelings and needs can lead to meaningful changes

• how embracing our humanity can make all of the difference

• how we can challenge the status quo and charter a better path for ourselves (and potentially others) moving forward

Guest Details:

Sunny Smith MD is the Founder and CEO of Empowering Women Physicians.

Dr Smith brings her background as an awarded Medical Educator, Clinical Professor of Family Medicine and Public Health, Community Director, Course Director, Medical Director, and long history of being an advocate for medical student and physician wellness into the coaching space.

She advocates for physician wellness through her comprehensive and collaborative coaching program, podcast, retreats and Facebook group that seek to change the culture of medicine through normalizing and humanizing the experience of being a physician.

 Dr. Smith is the recipient of multiple teaching awards including Humanism in Medicine, Excellence in Teaching, and Outstanding Community Leader award. Her work has been published in many peer-reviewed journals including JAMA and she has been featured in Forbes, Inc5000, and Entrepreneur Magazine.

https://empoweringwomenphysicians.com

As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice.

If you found this conversation valuable, book a consult call with me using this link:

https://calendly.com/loveandsciencefertility/discovery-call

Also, be sure to check out our website: loveandsciencefertility.com

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Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always.

In Gratitude,

Dr. Erica Bove

Transcript:

Hello, my loves and welcome back to the Love and Science podcast. Today I have as our guest, Dr. Sunny Smith. If you do not know who Dr. Sunny Smith is, she is like the mother of the physician coaches. And I will share, you know, this is my first one on one conversation with her, although back in the day, even before I went to coaching school, I was gifted a retreat, a Karen Lightner retreat in Massachusetts. And when I went there, Sunny was not there, although so many of her coaches were there in that small, intimate, beautiful space. And that was really what kind of kickstarted my own transformation of becoming a coach and doing the work that I do. So, you know, before I sort of talk about her credentials, I just wanted to say thank you, Sunny, for all that you do, because your influence in my life has been so profound, even if this is our very first conversation that it probably started back, you know, when do we start the clock? Do we start it in 2020? Do we start it in 2018 with all the people that you influenced? Really, I think sometimes we think about impact. Your impact is just so vast. And I really, really appreciate everything that you've done to in the coaching space, in the physician coaching space to empower us all to live the best lives we can. Yeah. Thank you so much. That is the kindest introduction. And I think it's an example of how when one woman physician changes, she changes the world around her. And this ripple effect that you cannot imagine, right, you're speaking about mine. And yet each one of those people there has their own, and that impacted you, and then yours has impacted all these people. And so it feels sometimes like selfish to focus on ourselves. Yet, when we really do this deep work, and reflect and sort of become aware of what's going on with our human psychology and our life and the choices we make, it really changes us and the world around us in this really profound way. So thank you so much for seeing that and recognizing that and saying for you. No, no, thank you so much. And we encourage each other. And I think we are stronger together at the end of the day. And I think it's just so nice to call it out. So but I would be remiss if I didn't like, you know, talk about some of your credentials. So Dr. Sunny Smith is the founder and CEO of empowering women physicians, which is an amazing coaching program where she advocates for physician wellness through her comprehensive and collaborative coaching program. It is fabulous, it includes group coaching, one among coaching. And you know, there's data, if you know me at all, you know that I'm obsessed with data. And the data is that it works. So get yourself to her website, get yourself interested in what she's doing, because it saves lives, it changes the world. She also has a podcast, she does retreats, she has a Facebook group. And her mission is to change the culture of medicine through normalizing and humanizing the experience of being a physician. She is the recipient of multiple teaching awards, including Humanism and Medicine, Excellence in Teaching and Outstanding Community Leader Award. Her work has been published in many peer review journals, including JAMA. And she has been featured in Forbes Inc. 5000 and Entrepreneur Magazine. Dr. Sunny Smith, it is so wonderful to have you today. Thank you. It's so beautiful to be here. Thank you, thank you, thank you. Absolutely. So you know, what I really wanted to talk about today, you know, I love the work that you do helping female physicians, you know, be empowered to find better fulfillment, to have better relationships, to have better relationships with ourselves. One thing I think that I've sort of noticed from your posts on social media and talking about your own journey the last couple of years is this whole notion of the nervous system. So can you share a little bit, maybe first by way of introduction about your foray into the coaching space. And then at this moment in 2025, and I can talk about my own experience too, like my own strategy is like, how do we really calm this thing called the nervous system so that we can live these fulfilling lives? Yeah, I mean, if you had asked me 10 years ago, I'd be like, I don't know what you're talking about. I took neurology, like, what do you mean, nervous system, you know, like many most physicians probably. So I came to coaching through the more thought work and cognitive approach to the circumstances in our life. So I had been a full time academic professor, clinical professor of family medicine and public health. I got in a bicycle accident. So unwillingly was in a forced stillness, you know, from director, medical director, course director, all these things, mother of a small child, to absolutely no ability to do anything, couldn't feed myself, dress myself, care for myself, nothing, couldn't stand, couldn't walk. And so I listened to the some other women physicians who have always have amazing resources, right, and are great to have as a community, recommend I listen to a podcast where if you can't change the circumstances, you can change the way you think about them and the way you see them and your perspective on it. And I did not feel there was any useful or positive thing about my circumstances at that time, except that I was alive, like I was so grateful that I was still alive. However, you know, not being able to care for myself was very frustrating. And I just wanted to go back and reverse the clock and have a time machine. And that was my only wish in the whole world, take back one second of life and change things. So during those months, I really sort of took a deep dive into, okay, these are my circumstances. And the same for all of your listeners, whatever the actual fact of the circumstances are, you know, separating from opinions and emotions and all of that, we can kind of reframe without gaslighting ourselves, you know, because people can try to put on some toxic positivity and things that could be really harmful and even worse. However, if it comes from the inside, and we can start to see a little bit of a shift about maybe just maybe it was okay that I needed this break so I could think a little bit about my life and what I'm choosing and what would I have continued to choose had I not had time to slow down. So that was sort of like the cognitive shift, looking at what I was thinking in particular about it, which drives how you're feeling. And then, you know, I started this coaching program, teaching women physicians, because once I went back to work, I wasn't willing to do all of the things that I used to do. And I was like, what actually matters to me? What is most important to me? What would I re choose now that my physical capabilities are less than they used to be. So I re chose the most important things to me, which helped me realize that women physicians don't have to do every single thing that we are that is asked of us forever, including nights and weekends and all the things. So I was able to see that it actually works for other women physicians, because I thought maybe it was just me. Maybe I was crazy. But it worked for locked in lots of women physicians to see that they had choice in their life. And then only recently, as you mentioned, in the past couple of years, did I really get more into the body and somatic and nervous system, sort of automatic responses, not the intellect and thinking our way through things, because I think women physicians could be really drawn to this work, because we are, we can out intellect almost anything, you know, we can just think about it, we could figure it out, we'll figure it out, we'll figure it out. And then there's this, sometimes you can reach sort of a limit of figuring things out. And that's when your body's in this like, panic mode or trauma mode, or when no matter who you know, how much money you have, how smart you are, you can't get yourself out of things because you're still human. And so this is the human experience, your human mammalian body. So that kind of brings us to the type of work that you're talking about. Yeah, no, thank you so much for sharing that. I think you're right. We do not stop in medicine, like we are just on this train. And we're always looking at what's next, what test, what residency, what fellowship, what, you know, job. And it's just like this constant like, like hamster wheel. And I think, you know, we would never wish a bike accident on anybody ever, right? I can only imagine how difficult that was for you and your family. I think sometimes when we have these forced, these big life experiences that really do cause us to stop in various ways, it's wild what comes out of those experiences and things that come out of them, which we never could have thought or imagined or felt, you know, without that pause. And so I think that was so it sounds like it was like the first crack in the system for you, right? In terms of there being a different way and then fumbling your way through figuring out what you needed and then realizing that, you know, other people aren't different, all that different from you, maybe in small ways, but not at the core. And that we, you know, we as female physicians, I will say that's what really started, got me started to form Love and Science was I was in my office as a new attending, trying to take care of female physicians with infertility, finding that none of the information that I was saying was being absorbed. And I thought to myself, like, I'm going to PubMed, I'm showing them studies, I'm showing them the data about their own bodies. But until we can get out of that, like deer and headlights, hypervigilance, trauma response, nothing else is going to filter in. We're going to stay in that analysis paralysis, as I like to call it. So, so, so right. So, you know, as I was sort of getting into my own coaching, you know, journey with relationship coaching and other types of coaching, I started to say, huh, like, I think these tools are what my patients actually need to get into their bodies to make empowered choices to to identify their values, to make sure that the decisions that they're making are aligned with their values, because we all know you can have two people on paper who are look identical, but like, they might make very different choices, depending on who they are and what matters to them. Right. And so that's really kind of what what catapulted me, but then all the time going through my own journey and my own traumas and trying to be a human being, right, dealing with life. And also the traumas that can come along with that. So what have you found in the last couple of years that has truly helped, you know, I think we have the tools, right, those are becoming more and more widespread, which we can access if we want to, but what has really helped you heal in your body from some of the life experiences that maybe you didn't expect to come your way over the last couple of years? Well, you know, the first time I sort of was introduced to this more somatic work would be when Kemya Saraf, who has like a trauma informed approach and certification and speaks nationally, we were just at ACGME together, like in the place where residencies are made talking about how not to traumatize people. And it's like the irony of being there because medicine and residency is so traumatizing, you have no control, right, or we perceive and you have little control, right, over your schedule, over when you eat, over when you sleep, about when you have to take call. You know, I ended up in status epilepticus during my internship because of it was before work hour restrictions. So just sleep deprivation. I was like, all I wanted to do first of all, back then was just get back to taking normal call. Let me just go back, put me in the game, coach, come on, let's go, I can do it, I can do it. And it's like that look at the indoctrination there, instead of me saying, you know, maybe 36 hours in a row isn't healthy for me. Maybe I should take some modified call, maybe any of these things. And so that when I learned from Kemia, who is also a physician, for those who don't know, and as a coach and specializes in trauma, I thought trauma back in the day, I was like, yeah, like war, you know, like a bomb. And she taught me and my clients because I brought her into our coaching program, that all of us have been through some kind of traumatizing situations. That's where you have like little control and there's continued, you know, you could see medicine if you wanted to, and through a lens of like an abusive relationship, because you kind of get brainwashed. And there's all these demands on you. And you don't realize it's like a pot of boiling water and the frog doesn't jump out, right? And it keeps demanding more and more and more. And you're like, yes, yes, okay, okay. And then you think you're broken, if you can keep up, right? So that's when she started talking to me about sort of when people are having these somatic responses, which I'm guessing your audience might know some things about because of who you are and what you talk about. But like, say you're even the Gottmans, who I've learned about in medical school, who are relationship experts who studied relationship interpersonal dynamics in apartments in Seattle, at the University of Washington for decades, would like measure the heart rate of couples and then have them have a disagreement and they would measure the moisture on the palms. And I was like, I remember learning about that. And I was like, people's heart rates really go up when they disagree and their palms really get sweaty. And so the thing that I see now is, oh, that's a nervous system activation. And it really is a little bit of sympathetic nervous system activation, if your heart rate is going fast, because you're mad at somebody. And usually when you're mad at them, it's not about the thing you're saying you're mad at. It's about something deeper, like you're not feeling seen and heard, and you don't feel important. You're feeling dismissed. And maybe you never felt important as a kid in your family growing up, like no one ever listens to you. And so that's what it's about. It's not about when someone points out the window and says, look at the bird and you don't look, right? It's one of the examples they'd use. So those are like the nervous system activations when your heart goes fast, when you're getting kind of agitated, you know, some people get kind of blotchy. And so if we can have awareness that that's starting to happen, like say your boss is talking to you, and they're telling you to see more patients in clinic, or they're telling you whatever is happening in the hospital, right? Your heart starts to go a little bit faster. If you can have awareness of like, oh, and call that instead of calling it triggered, which is what many of us, you know, like on social media, you put trigger warning. But trigger has other meanings like guns and things like that. And what's really more accurate is it's a nervous system activation. If I remember, we had dog lab, you know, and like we would put different things that I refuse to do the dog lab, because I was a dog person, I just lost my dog, but, but it is it's physiology, you know, and so we study the physiology of sympathetic and parasympathetic nervous systems, and you can make nervous systems do this. And that's what's happening inside our body. So I think it's very useful. One of the things that was most useful to me is I was taught this through therapy and coaching, and repeated exposure, when you're going through a stressful time, save for your listeners, infertility, say for your listeners, work, something that's like, you know, really pretty stressful, to just like kind of had three steps. Number one, awareness on a scale of one to 10, kind of where you are on that activation. Well, first of all, just awareness, you're getting activated. I'm getting kind of activated, I'm getting kind of agitated, you could tell this to your partner, you probably aren't going to say it to your boss, but you could say it to yourself, I'm getting kind of activated, you can feel it's starting, right before it blows up. And then number two, say, so that's number one, number two would be like, label it on a scale of one to 10. And if you're getting above like a seven, disengage, like stop talking to the boss or the spouse, because you're about to lose your stuff, you know. So anyway, that's one of the most useful ways that I have found is to observe myself, have an awareness, oh, I'm getting activated, start to get to know my number one through 10. And then given what number I am, okay, what's my intentional response to this involuntary experience my body is having? So that's my reflection on how that started for me. Wow, I think that's, I mean, I do the same things, honey. And I think that we don't always have to have an excuse to leave a situation either, you know, say I'm talking to my boss, and, you know, all of a sudden, I start to feel activated, I might have to use the bathroom like style, like, oh, so sorry, I really have to pee. I seriously, like, you know, I'm very impeccable with my word, you know, I read the four agreements, I feel very strongly that I'm not going to lie in that situation. Oh, I just got paged when I didn't get paged. But like, I might have to leave the situation in that moment, like, maybe I need to go to the bathroom to like, splash water on my face to get myself back in my body. Like, we can have permission to leave situations which are not serving us. And to give ourselves that permission, I would say, because we're always like waiting for the other person. And people will say, because I just coached on this the other day, and somebody's like, Yeah, but the other person might get mad. And they're like, Yeah, let them have their mad. Yeah, okay, for other people to have emotions. And for us to, we are given this one human body, and we are the custodian and guardian of this one human body the whole time it's on earth. And we can't control anybody else's body or their emotions or their reactions or their thoughts. And they have decades of history, their family, their culture of origin, their upbringing, their current situation, we don't control any of that. So if we can just let that go and focus on okay, because when our nervous system is activated, that's our amygdala, right? And so it's lit up. If you put us in an fMRI, it's literally activated. And then the projections from the amygdala go to the prefrontal cortex and literally inhibit your ability to be creative to think clearly. So it's just like trying to work in this fog, somewhat not exactly paralyzed, but with decreased functionality. So go to the bathroom, put the water on your face, go for a walk, say, I'll come back later. Because when your amygdala is not activated, you have the rest of your playful or imaginative or problem solving brain. And you can get so much farther. It's just not it's really it's a coping skill that is a very useful, both leadership mechanism. It's a good conflict resolution mechanism. And it's good for any kind of stress that you have in your life just to be aware, oh, these are the things that activate me. That's good to know. And you can use it for others. These are the things that activate my spouse. These are one thing I found so useful. These are the things that activate my kid. And if you know, I know this also an infertility podcast, I had been told that I wasn't gonna be able to have kids. And I did have a son. And he gets activated often. And now I used to get irritated with him and make it mean all kinds of things. And now I just see, oh, he's activated. And so like, I just give him the space he needs, he can go to his room, he can go disengage from me, he can do whatever he needs to do, get something to eat or drink. And then I just come back later. And I really, currently this year don't make it mean anything about me anymore. Which is so lovely. So learning these skills, it like gives you such a more peaceful life because you give other people compassion and grace too, as well as yourself. That's right. And even in that context, you can say to your son, like, I'm starting to feel uncomfortable. Like, I need a time out. I'll be back, you know, I'll be back in five minutes. I just need a few minutes to get myself back together. And that's how I help myself in that context, not flip my lid to the point where then there's yelling and all of the things like that. So I think we need to be curious about our bodies first. I think we have to realize that we have a body. I mean, so much of the time we forget we even have a body and then, and then, and then that observing. And so the first time I ever heard this concept was by another physician coach, Kavita Sun. And she was like, for 48 hours, you were the observer. And I was like, what the heck is she talking about? Right? This notion that we can actually sort of have this like metacognition of our situation and be the observer of our reality of our, Oh, that's interesting. I was about to see two more patients before I peed. I think I'm going to take three minutes and be, you know, two to pee and one to wash my hands like, okay, fine. You know, I would rather, if I were the patient, I would rather, you know, have a comfortable provider physician taking care of me. But I think unless we have that body awareness and we're so used to gaslighting ourselves, like you just said, in terms of like, I don't need to pee. I don't need to eat. I don't need sleep. That becomes our norm. That is not true. So it's, it's like first step is we have to like realize we have a body and get curious about it. Second step is we have to be the observer for awhile and sort of understand what that looks like. And then we need to give our permission, self permission to act on the feelings and the activations and the, you know, whatever it is. And I think that's that for at least from my perspective, that's the entry into this work, to even get started. Yeah, I think also like meeting ourselves with the compassion that we've been conditioned to ignore our bodies and to act as if we're like ahead on wheels, just rolling around from room to room to use our intellect. We have been conditioned that when you are sleepy, you have caffeine and move around, right? You don't listen to your body's needs, their actual needs. And you don't listen to your body's feelings. So that conditioning, if you can have compassion and awareness for it, and then you said observer and metacognition. Absolutely. That is the beginning and most important part to distance yourself a little bit from it and observe it nonjudgmentally, if possible, eventually. Because sometimes with thought work, we start to blame ourselves. I know this, I should not be having this. No, you're human. Or yes and because we don't say no, we say yes and right. Yes, we understand you think that and you're human. So you're going to have this until the day we bury you. Like there is no escaping this human condition and being activated. And one way I've thought about that observer thing is it's as if it's a narrator to me. And it's like a documentary of animals or you know, like you're watching these animals on the Sahara or there's one with Barack Obama right now on Netflix where he's like narrating the under the sea what's happening with all the different sea creatures. And so you're like, okay, this is Erica. She's about to go in and see her patients, although she has impede. She's getting kind of snippy. The doctor gets snippy. If Erica would just take a break and do this, she would come back a little bit better. Right. And then you're like, and why does Erica keep choosing this? And if you really had this narrator over an entire hospital, I mean, I suppose that kind of a little bit like the pit is kind of working on that more realistically. I hear I haven't seen it. But just looking at it over a whole hospital system and all of the doctors kind of like from an eagle eye view, all the things that they are doing, there's like this cultural expectation of self sacrifice for all of them. Okay, this one that has to go home. There's actually a video called I am human by Stanford. And it's really people can like Google it. It's only a few minutes. And it's sort of a part of their physician well being initiatives there. And it shows people walking around in the hospital with the different roles like the surgeon and the tech and the people passing each other in the hallway, and all the things that are going on in their mind. And it just speaks it out loud. And you can imagine there's so much going on, whether you're thinking about your child who's at home with cancer or your spouse who's mad at you, or that you're excited about your publication, all these things. And just to be aware that you're having all these thoughts and feelings, you're doing all these things. And so is everyone around you. And make it really, again, not about you yet, compassionate awareness for what's going on in your body. I feel like our feelings are these signals, you know, that have developed over hundreds of thousands of years before language, right. And if we could listen to those feelings, they really are signals that are trying to speak to us. And if we don't listen, they get louder and louder and louder until we do tell you end up in status. Exactly, exactly. Like don't you think I did actually have focal neurologic symptoms before that? I did. I had complete aphasia when I was at cedar Sinai, I was taking out someone's staples from their c-section. And she I was like, she got out of her bed and put me in the bed and called the nurses. Like, okay, body I hear you. Right, right. So if we can, I mean, mine was so visible, and I have video footage and because I was part of a documentary because I was in Los Angeles, at the time. So my distress is much more visible than most physician distress, because you can see someone intubated. But most physician distress is invisible to the outside eye. Right, right. And if you're, you know, carrying a diagnosis of infertility, and you're going through treatments, I'd love to get into so like, you know, my patients, my clients, when they come to me, they are usually in this fight or flight. Yeah. And it's like, I think the reason why, and you may understand this from your prior experience is like, you know, this threat of being childless, right, that for people and their view and their vision of themselves, that is like the end, like there's nothing beyond that. And so I understand that the stakes are high, and that really is important to us that we know, fulfill this journey and take the steps to do that. How can we start to start? Yes, body awareness, but like, how can we start to calm that nervous system from your perspective and your tools, as we're trying to be physicians and trying to make these appointments and, you know, waiting for the phone call from the nurse about the, you know, test results and all those things like, but what, what do you what would you offer somebody who is who's in that state? Well, that's a good question. And I will ask you the same thing. But my response, I just remember, you know, 37 years old G zero P zero, I went in for birth control. And my it was a new OB/GYN. And she was like, So you probably have infertility. And I was like, I'm a doctor, I know how to not get pregnant. And she was like, Let's draw some labs, do some ultrasounds. And I was like, I'm literally here for birth control. I'm not even married. And I remember being and I went to my car, she asked me if I had a boyfriend. And if we were serious, and if we're gonna get married, and if we weren't that because she's like, Do you want kids? So I was like, Yeah. And she was just looking at me dumbfounded, like, you're not married, you've had a boyfriend for five years. You have no what are you doing? You need to move in with him? That's what she told me, or break up with him if you plan on having children. And I'm going to start this workout for you. So I went and sat in the car crying, crying, crying activated, right? Activated, not expecting this. And sometimes part of activation is like things being out of the blue, you just weren't prepared for things. And then I remember I was at my clinic, and they called with results that were not good. And they were like, Yeah, you have infertility. And I was just sitting there in front of my med students. Like, what the what just happened? And so that experience that your patients and clients go through of this, like, you're not expecting it. And it's just like you got hit by a truck. And when we talk about the hundreds of thousands of years and certain things that are like, I'm all you know, before many women, this idea of becoming a mother, and then protecting your young and all of that is it's just it gets stepped on. And it's very activating. So to have compassion for that. And I in particular was very pissed off that medicine stole it from me. I'm like, if I don't like it makes me fearful. But I was like, I don't get to have a baby this fucking medicine. Sorry, my love. Just wear medicine. Like, why? Why did it do this to us? Why does it steal this to us from us? This is not fair. This is what I wanted my whole life. And then, of course, that story ends up well, because I end up having my son. But I think just noticing, like, obviously, I get activated talking about it. So like, okay, here you go. Allow yourself to be human and activated and don't shame yourself if it comes up in your clinic, right? Like caring for people who are pregnant, caring for people who are miscarrying, caring for all of these things while you're going through this and trying to put on this good face. It's like it's such a disconnect in medicine when you have to put on this smiling face like a flight attendant. You're like, everything's fine, everyone. When on the inside, you're like one comment away from tearful. And so to just have that awareness and to get the kind of support behind the scenes that you need and to not try to like, just white knuckle through it like we always have done through everything. So I think that means therapy, sometimes psychiatry, sometimes coaching, sometimes a deep bent, sometimes others who've been through it, just knowing that you're human too and making space for that for you to be human wherever that is. And then, you know, again, learn to recognize when you're activated, learn what your healing techniques are. There's all kinds of things people will do to get you back inside of your body, depending, of course, if you're having a panic attack, or if you're just what is exactly going on. And so you can find those things that work for you. For some people, it's like going outside. Can you always go outside? No, as you said, there's like a bathroom. There's many different things, but what are those things, even deep breaths, what works for you? And so what have you found and what are you telling your clients and patients? Yeah, absolutely. And Tony, thank you so much for sharing your journey. I know how personal it is. And, you know, when we get this news, it's just like, it's just shattering. It's unexpected. And I think because those pathways are so ingrained to our amygdala, to our hippocampus and everything, it really does very quickly bring up such strong feelings. And so you're not alone. Everyone here understands and it's a very common and awful experience. That's why we need each other. So, gosh, you know, even myself, so I'll sort of, I'll go to my clients, but first I want to share. So I was on call last weekend and I was about to do a procedure for somebody I really cared about who was only expected to have a couple of eggs at best. And I was like, no, as the doctor, you're like, Oh, like I really want like better for her. And I started to, as I was scrubbing, I started to just have this feeling and I had already talked to the patient, but what if we get no eggs? What if we get one egg? What if we only get two and it doesn't work? I started to have these feelings for my patient, right? Like, Oh my gosh, what if this procedure doesn't go well? And so I thought to myself, I'm going to take a little bit longer and scrub, like nobody's timing me. I'm only timing myself. So I, you know, was sat at the scrub, you know, I'm sort of scrubbing myself as we talk here, if you can't see me and spent a few minutes, like really getting into my breath, really getting into my body, really that sort of trust your training. I've been doing this a decade, but sometimes as a doctor, I say that trust your training, Erica, you've got this. And so I spent, I intentionally spent more time getting into my body because my mind was starting to take off like a train. Right? So I, you know, scrubbed for like five minutes and I prayed this Serenity prayer as I do. It's one of my own personal calming techniques and put my gloves on and sat down. And I really was there a hundred percent there. I wasn't anywhere else. I wasn't with her past cycles that, you know, I wasn't in her future. I was like truly in the moment and fully using all my capabilities to do my best for her in that moment and breathing. Like I remember just being like, thank God I meditate because I can access my breath and this is really helping me and my nervous system in this situation. So I can do what I meant to do today. And lo and behold, we like got five eggs, which is wild and forward mature and we got to freeze them all. And it ended up being happy, but I started to feel myself becoming dysregulated because I care so much about her and I, you know, I'm worried about her. And that was one way that like, if you're a surgeon and like, you know, you take a little extra long to like scrub who the F cares, you know what I'm saying? Just like take that time. If you need to like, you know, scrub out during a procedure and use the restroom or get yourself back into things like that's an acceptable, you know, possibility as well. Some of my clients have started to do that as well. And so I think just looking for these opportunities to slow things down is really, really, really important because it's in that pause where our power is. Right. So, so for my, you know, patients and clients, maybe they're working 80 hours a week and they have to look at like, okay, is this really sustainable in the context of also doing fertility treatments? You know, maybe I need to talk to my manager and say, I need to go no point eight or point six for a time being, take some FMLA, you know, trade some shifts with some people. There's various creative solutions that can come up, you know, but I think like you said, like creating space to be a human, creating space to be a patient, you know, in one of our support groups the other week, one of the mantras was I deserve to be a patient. Like how often do we not give ourselves permission even to be a patient? So slowing things down, having this body awareness of what's going on and not that we may not be able to do it in the exact moment. Like if we're like seeing patients and we have to keep going, like sometimes we have to compartmentalize, but saying, huh, that's interesting that this sadness is creeping up. Oh, that's interesting that this anniversary of my loss is coming up. You know, maybe I need to carve out some time to play some sad music or honor the loss or write about it. Because I think unless we remember that we're human beings having human experience, we're not robots. And if we pretend that we're robots, like you said, those emotions, those feelings are going to get louder and louder and louder until something bad is going to happen. I mean, at first it comes what's like sideways irritability, right? We're just like, why am I so irritable? Like, oh, because information is desiring to reveal itself, but really carving out that time regularly to feel the feelings, to play the music that gets us into that space. But these are some of my strategies, you know, taking like a hot bath where I can really just, and again, the world is not saved by hot baths, but that helps my nervous system to get into a place where I then have more agency. And then, you know, like you said, like connecting with each other, we are not meant to do this alone. We are not meant to suffer in silence. There's so much shame that only the shame only exists in isolation. So when we can, you know, connect with each other, realize that we're not alone, see each other and each other's stories, celebrate the wins, you know, honor the disappointing news together. It just, that whole burden gets shared and all those wins get celebrated as they come. And it just makes the journey a lot more tolerable. Yeah. Yeah. And nervous system co-regulation is a very real biologic thing, like human brains are made to co-regulate together. And so that is something that in our individualistic, particularly Western society and medicine, you know, we're individuals, we're strong, we treat this individual, we are individuals. And yet, I mean, there's a reason things like AA and, you know, other group communal things work. It really does calm your nervous system. You know, if you hold a small infant or a dog, even, you know, there is something about holding and holding space and co-regulating that is very calming. And I think for some people you mentioned, I think in hindsight, so many of us, this older, wiser version of us would have given ourselves a break in time off and people are like, but I can't like going 0.8 just seems, I mean, I, that's what I did. Eventually, I went one, 1.0 to 0.8 to 0.6 to 0.17 to leaving clinical medicine eventually. And going to 0.8 felt just like the biggest identity crisis and like that was never going to happen. And everyone around me acted like it was the end of the earth. And I think in hindsight, there had been some pretty significant tragedies in my life where as there are in your audience, right, that it would have been completely acceptable not to just go part time, but to be like, I really need some time because if you look at the course of your entire life, say you're going to make it to your 80s or so, is that six months or a year or sabbatical really going to matter that much? You know, as you said, there's the bubble baths and then there's the creating the life you don't need to escape from. And what does that look like for different people? And people will say, oh, must be nice, you know, that you could have a sabbatical or you could take FMLA or you could go 0.8. But the thing is, like, I've never really found an amount of money that my clients make that makes them feel like they can do that. You know, they're like, well, I'm the primary breadwinner. And then something happens. Like again, say it was my accident or whatever. Yeah, we all can make it through taking a break when our physical health requires it of us. Yet that is the only time we give that to ourselves. It's like, why can we not give ourselves that without this huge break? And then there is also the type of person that really feels better during a crisis, at least going forward in that moment. They may see it differently in hindsight, who just wants to work through the crisis. And then there's those who feel expected to work through the crisis. Like how many have worked with miscarriages? How many? Every time I have a group coaching call, right? There's always women who've worked through miscarriages, like seeing the patients operating. I attracted for a vaginal hysterectomy during a miscarriage. And I was like, why did I do that? I didn't think there was a choice. Why? Yeah. So for people to at least you can choose to work because it's distracting. You know, it keeps your mind on other things. If you think that that's healthy for you and a coping mechanism that you appreciate, yet if it's because you feel you have to, we want to give permission to everyone to be human and to not have to do things that you don't want to do. Like if you don't feel you can get out of bed that morning, it's okay. And I will say the things that have worked for us in other aspects of life, like working harder, grit, all of that does not, it's actually counterproductive for the fertility journey. So I have to tell people, this is not about the learning necessarily. It's about the unlearning. And we have to scale back to create the space, to feel the feelings, to get into our bodies, to create that alignment so that there is the highest chance of this working. And we need to, you know, especially if women are not trusting their bodies, like we need to help people trust their bodies. We help, we need to help people, you know, hope for the best, but unattached from the outcome. Like these are all things that happen with time, but it's, it's not about grit. It's not about working harder. It's not about ignoring what's going on. It really is quite the opposite. At least what I've found in my clients that actually works. And so it's uncomfortable because we're not used to doing that. But I think that, you know, I would say if I powered through and the fertility journey never worked, and then I had all this regret, like, well, what if I had actually like given it space, given it time, if you get cancer, you're taking time off for chemotherapy. Like, you know, we don't think about it the same way, even an IVF cycle, an egg freezing cycle, if you had an appie, you'd be out for two weeks. That is the amount of time an IVF cycle takes. Why don't we just code this as an appie in our brains? People get appies all the time, but we don't think about it that way. So we need to give ourselves permission to think about it. So anyway, I could talk about this forever, but I think the point is we need to give ourselves grace. We need to give ourselves self-compassion. We need to unlearn the things that have been sort of created our success as we tell ourselves, and maybe they haven't, maybe they haven't, but that's our story. And we need to find better ways and usually less is more. Yeah. Yeah. And there's all the guilt of taking that because we don't, we, we still even have guilt with the appie. Like we're like, Oh, everybody's overworked. Oh my gosh, I have to get back. We go back from our post rectum ease or whatever, whatever procedure broken leg sooner because we feel guilty because medicine doesn't have a deep bench. And the thing is, it's not our fault. Medicine doesn't have a deep bench. Like my family, I'm from a hockey family. My dad, my uncle, my grandpa played hockey. And like when my dad got injured as a goalie, there was a backup. You know, there's just that people always plan for that. And in medicine, we plan for everybody being their full steam ahead at all times. And even when we are, we all know there's more patients and more demand than we could ever fill. It's an unfillable need. Right. So this is a chapter. This is not forever. This is exactly. If you look at the lifespan of a woman, right? I mean, again, we said around who knows 80 years, we used to only be 40, 50 years. So we have all these extra years, but this is a very short period of time. And if we can look at it as not a failure and also super important as you know, to not blame the woman, like it's not because she works too hard. It's not because she's overstressed. It's whatever is going on. And then we are just talking about how we can deal with the emotions of it and the experience of it, not blaming because there is a lot of self-blame. That's right. A hundred percent and creating a culture where this is valued and not sort of penalized as like a whole other conversation. I mean, even coming back, like so many people I've coached who have babies, they, you know, they're in their private practice and they're not billing. And so they come back and they have like a 60, 80, $6,000 debt to the practice because they were paying people without earning. I mean, what the hell kind of American system is this? It's a step system, I know. Right? So just giving ourselves time and how much we're allowed to. And I think one thing that can be helpful sometimes is if we were setting the precedent for all the women who came behind us, because we kind of are. So like if we only take six weeks or something, or if someone takes infertility leave, or if it's like what, because people say, well, this person did that. Well, this person did that. And so some people who've been through my program, they will decide that they're going to do something that's very different, say like six months. And then they can see that the person who comes behind them is able to say, well, this is the standard now. This is what we do. And so I think by changing ourselves, we change the culture around us. A hundred percent. No, I think that's, that's, that's right. And that's why we need programs like EWP to help people figure out the language. The first of all, you talked in the beginning about feelings and needs. The next step after that is requests. Right. And so I think, you know, what you help people do is align with their feelings, align with what they actually need, and then take that next step to say, okay, how can I articulate this? How can I negotiate this? How can I truly get what I need? And perhaps even in the process, you know, set change of the culture for the next person who wants to do something like this. So thank you. I think, yeah, sorry. I was just going to say one process. It's also from the Gottman's about that is like, and in many other systems is like what I feel blank and insert emotion there. And then when blank insert whatever's going on and what I need is, and so we can make those requests like think, feel, act, you can make the request in the world. And yet we don't have to wait for the world to give it to us. Because if we can look at what we need and give it to ourselves, exactly, like it kind of doesn't matter if the boss says yes or no. If you're like, I'm not coming in. It doesn't matter if they say yes or no. I know that seems ridiculous, but we're the ones who can recognize what we need and give ourselves what we need. And that gives us a more of a sense of control and safety and nervous system regulation where we're like, you know, like as I talked about when I was ill before, I could have been like, yeah, what I need is not to stay up all night. But what I was waiting for was for them to say you don't have to stay up all night. You know, so when you talk about the need, it's both what can I give myself and then what do I need from the system? How can we make these requests of the system? So that's right. Go ahead, I interrupted. So no, no, I think it's this combination of like these non-negotiables, like that we sort of set our lives up in a way where we have the things that we already do. You know that we moved our time for this appointment today because I needed to go to therapy and I was like, I can't, I can't cancel therapy. Like that's a non-negotiable. And I'm like, I get it, girl. I get it. I'm in weekly therapy. Like, oh, yes. Yeah. Yeah. So I think therapy is a non-negotiable. And so we'll just pause with that. If people don't know what EMDR, we should probably tell them when we're doing like trauma and activations and all this stuff. This is a very real neurobiologic treatment. It's evident base that I put off for way too long, where it really does reprogram your brain and your responses to these activating things. And so have you spoken about what EMDR is before on your podcast for people? We haven't talked about it. I think we would need to do a whole other podcast on that. I know. I think that every single person undergoing because the fertility journey is so traumatic with like, like you said in the beginning, that initial, you know, news was so traumatic and it is people who are going through IVF and everything. There's like hundreds of pieces of data that are, you know, traumatic and activating. And so I think figuring out how to walk the journey in a way that our brains can be, you know, constantly rewired, I think is really, really, really important. So, but I think for me, it's like I wake up in the morning and as I make my coffee, I do my 10 minutes of meditation. If I can't get it, then in that moment, I have to get it at some point because I know that I will be off-kilter all day unless I do that. Like, you know, eating healthy food, I'm very grateful to be able to have healthy food. Like for me, that is something that, you know, keeps me going, making sure I'm sleeping. If I have a talk the next day, I have a cutoff time. I do not work past that time. And so it's like setting up my, my life in a way that has like these certain non-negotiables. And then as things arise, then having the flexibility to get into my breath, to maybe schedule an extra therapy session or a massage or, or something that I know my body needs. Sometimes it's like, I need to go into nature. I need to see flowers. Okay. Well, then I will make that happen. Even if it's for 10 minutes, like there's these different things. Like what do I need today and how can I work those in to add to the things I'm already doing and pharmacotherapy. And you know, we can talk about that too, but that's the way that that's the way I think about it. Yeah. I'm like a huge component, coaching therapy, psychiatry, all of the above and I feel like it's like, you know, I don't know, you could look at it as Venn diagrams, because there's a lot of overlap. You could look at it as a pyramid where like all of us need personal support and coaching as an example. Every physician deserves a coach. You know who gets it? Every C-suite. But like who really, who has it right now? It's the C it's the CEO. It's the, and so yeah, every physician deserves this. Everybody, every fertility patient deserves this. And then you kind of go up in this little triangle where it's like, and some of them will need and want therapy and like a little bit higher, smaller portion on this little pyramid will also want psychiatry. But I think what I find is that women physicians are so resilient that we like right now we're doing these burnout assessments. We've done them in our coaching programs for years and 77% of our female physicians come in burned out. And we under, and the scores even are so high. We underestimate systematically just how burned out we are because it's been going on so long. We just normalize it. And so I think if, if people are wondering if they need their peer psychiatry, by the time you wonder, chances are anybody that wasn't a woman physician would have started a long time ago. And I think that there's a lot of stigma. Yet, you know, I speak very openly at all times, national stages in front of the deans, in front of everybody in my career has never once been hurt by speaking about depression, mental health, seeking support. I've never found any of my clients who took FMLA or short leaves or anything like that as sabbatical have suffered. And so I think there's a lot more fear and stigma around that than there needs to be. And again, the more we use I statements like you do and, and put it out in the open, the more people can see themselves and others and not have that shame. As you said, you know, shame can't stand to be spoken. It's just real, amazing experience. Gosh, so much wisdom here, Dr. Sunny. And thank you so much for sharing your experience and what you do for women physicians to help us access these tools to help us find our voices to help us find each other because we are stronger together. Where can people find you? They can go to empowering women physicians.com. And actually, because you are a podcast, they can go over in their podcast app and just switch over and go like empowering women physicians subscribe and then, you know, find it's interesting because I don't, I'm not the kind of person who does not even close to weekly podcasts. But those that I do, I find that they're like the most recent one is on choice. And it's by a Holocaust survivor. And if she can believe that in Auschwitz, she still had choice. I feel like there is no way a woman physician can listen to that and think she doesn't have choice. And so I try I try to make each episode like one that I refer back to regularly about something that I think is it can be really helpful for women physicians. So that just came up because I was thinking about how we're on your podcast. I'm going to listen to it now on the way to therapy. Good, good. Thank you again. I'll put all the information in the show notes. Such, such an honor to have you as a guest. Until the next time, I love. Thank you. Thank you. Thank you. Bye.