The Invisible Patient: Supporting Men Through Fertility Treatment, with Dr. James Kuan
Male factor infertility accounts for nearly half of all infertility cases in heterosexual couples. And yet your partner's workup is still often an afterthought- scheduled late, discussed rarely, and often treated merely like a sign out check box.
This week I sat down with Dr. James Kuan, a board certified urologist with more than twenty years of experience in men's sexual health, founder and CEO of Sexual Medicine for Men in Seattle, and medical director of the Seattle Sperm Bank. It's a candid conversation about the partner who's often standing quietly on the sidelines and what happens when we finally bring him into the process.
This one is for couples navigating fertility treatment together and especially for the male partner who's been struggling quietly without support.
You can listen to the full episode HERE.
In this episode:
The parking lot moment: what happens when a male partner can't produce a sample on retrieval day, and why it's more common than anyone admits
New onset erectile dysfunction shows up in a meaningful percentage of men during fertility treatment and simply naming it as normal resolves it for many, without the need for medication
The case for REIs prescribing Viagra during treatment: it's safe, doesn't negatively affect sperm, and reduces a barrier to care
Why the male workup should be completed in parallel with the female workup
The 2 to 4 day abstinence window before a sample and how there may be more flexibility than we realize
How central these issues are to a man's sense of identity during this process and how we can give him and his partner back their power
If any of this sounds familiar, give this episode a listen. Find Dr. James Kuan on Instagram, Facebook, or his newsletter at sexafterretirement.com.
You can catch the full conversation above or on your favorite podcast platform.
It's okay for this process to be imperfect.
Progress not perfection. 💜
With Love and Science,
💜 Dr. Erica
P.S. If you're navigating this for yourself, for your partner, or both, I'd love to talk it through with you. Book a consult here. I'd love to connect.
Also, be sure to check out our website: loveandsciencefertility.com
Follow us on social media:
IG: www.instagram.com/loveandsciencefertility
FB: www.facebook.com/profile.php?id=61553692167183
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.
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Erica (00:05.278)
Welcome back. And we are so excited to have you today. You are joining us for our second annual birthday conversation. Dr. Jesse Mahoney and I are actually birthday twins, which means that we were born on July 30th in different years. And last year we had such a fun conversation about our birthdays. Sort of the idea came really organically and I loved our conversation. I've listened to it since. And we decided that it would be really fun to do this again.
a year later to reflect on the previous year, to share wisdom, to inspire and and to reflect on our bodies a little more. Doctor Jesse, I'm so excited to be here with you.
Jessie (00:44.43)
I am so excited to be here with you. I love that I have a great twin. I actually have quite a few, but I love like connecting with one every year and the I love reflecting. So this should be fun. And looking forward both together.
Erica (00:57.774)
Yeah. Well, what I when I was considering doing your first the first time I went on a retreat with you, I was like, well, obviously we're birthday twins. It's meant to be like I ha like I like yeah. So here we are. And you know, you can listen to our episode if you're listening from a year ago where we introduced ourselves, but I also wanted to just give some context for those of you who might not know us. This will be aired on each of our podcasts, and so it's kind of a
Jessie (01:06.808)
There we go.
Erica (01:20.29)
Fun way to do it. So I'm Dr. Erica Bove. I'm a double board certified OBGYN and reproductive endocrinologist. I currently practice at the University of Vermont about one week a month. And I run my fertility coaching practice for female physicians and bridge them to successful outcomes three out of the four of the other weeks of the year. I am based in Albany, New York, but I do go back and forth between New York and Vermont at the present time. I'm a native Vermonter.
And yeah, I'm excited. I am spoiler alert, I am turning forty three on July thirtieth this year. Yes. Yes. Yeah. How about you, Jesse?
Jessie (01:55.394)
So I am Jesse Mahoney and I'm a board certified pediatrician and now I'm like a triple certified coach. We'll talk about that. and I am coming to this call from Nicasio, California, which is in West Marin, where Eric and I last saw each other in person about a year ago. And I run now a business full time called Pause and Presence, which is
Virtual coaching and retreats and I give a lot of talks, keynote talks, and work with a lot of institutions really around physician wellness, which is kind of a garbage bag term. So I would say it's really figuring out how to live your best life inside or outside of medicine. For some people it's still inside, and for other people it's outside, and sometimes it's in your current job, and sometimes it's pivoting to a different job. And I do a lot of coaching.
On transitions and pivots, as I have pivoted, and I left my clinical job six and a half years ago, where I had worked full-time as a pediatrician and physician leader for Kaiser for 22 years. And I have been doing this full-time since, but I also love to coach on relationships and parenting and burnout and enjoying medicine, and I've been doing a lot of leadership coaching.
as this year as well and I do I help people, you know, with some business coaching. I like to do it all because I like variety and I also think it all overlaps. And as you know it does overlap. Whether you're coaching on fertility, you're also coaching on all the other things because they are all I really believe inseparable.
Erica (03:42.86)
Yeah, I I always say for me and my work, like fertility is just the access point. Like it's gonna affect your marriage, it's gonna affect your work, your boundaries, you know, it's so it's it's fascinating. And I I love how influenced I have been by you and your work and how like when when I went to your first retreat, one of my goals was to eat more slowly and to eat more mindfully. And like that is something that like that's so cool that you can go on a retreat for a week and then come back and change a habit that like really influences how you
experience your life and that that's just like one example of like we all talk about these experiences. I just need a week away. I need to like go to the mountains. I need to go to the beach. I need to need to do a drink on a cruise ship or whatever it is and forget it all. But then at the end of the day you're left with your life. And so how can we have coaching be this vehicle for like living more deeply, living more mindfully, having better relationships, liking ourselves better as humans, that's self compassion. Like I think it's so amazing.
Jessie (04:36.928)
It you've actually made me think like what is the access point? Like why do people come work with me? And I think it's the approach, right? It's the mindfulness, self-compassion, possibility, like inspiration hope approach that weaves really all those things together. Because I think when we really just dive like only into coaching, and I know that you integrate the physiologic piece of it as well, especially in fertility, right?
That you do get this same transformation. And even going on vacation, you don't get the same transformation, right? It's intentional and it's integrated and really interwoven. And as we talk about our years, I think that's gonna come up as a theme for both of us probably as well.
Erica (05:19.746)
Yeah, no, I think you're right. Yeah. So we were starting to think about questions that would be fun to talk about in our like birthday episode 2.0 in 2026. I'd really love to know, Jesse, like what you're proud of in this last year.
Jessie (05:35.258)
question. and don't I I can't remember if we talked about this in our previous episode, but I spent a year, a couple years ago practicing being proud because I realized that I wasn't necessarily proud. Not that I was doing things I wasn't proud of, but that I had actually never paused to be proud and notice like what I was proud of and what I had done. And so I actually now kind of like to think about this question. It's not just just what I did, but what I'm also proud of.
And you had also mentioned that you wanted to talk about this. So I will say I am proud that I finally did my TED Talk, which was something I really wanted to do and made it happen. And I think we'll talk a bit about it, but I will say that it was much harder, not in the sort of stretching point of view, but just the like dynamics of actually making it happen and actually getting there and actually doing the practice and actually all of the actualies.
and you know, it's also much more expensive than one would imagine, but it was super important to me to share the what would love do question. And so I was like, when the opportunity came up, I was like, yes, I'm just gonna do it. It was not at all at the best time. and I will say that this it happened right three days after on the heels of something else I'm proud of, which doesn't really have anything to do with me, but I'm still proud of it.
that I have twin granddaughters and they were born on Wednesday and my TED talk was on Saturday. and I was like, maybe I won't give it, I'll go help. And I was like, no, like I'm gonna do this first, and they will be here hopefully for a long life, and I can see them at five days old rather than newborns. And it was so while I'm not I I part of me says I shouldn't be proud of that. I did birth their dad, I guess, so I can be proud of that.
But but for me also one of the things I'm really proud of is how I navigated that birth story, I'm gonna call it. And it was not your typical birth story and one that most pediatricians would would have a lot of challenges with, which I did. but I feel like I really navigated it in alignment, though I worked on it and was were was really thoughtful about what I wanted my relationships to be with all the people and
Jessie (07:53.848)
who I wanted to be and what I would be proud of later. And so I'm really proud of of how I handled it. And I think a few other things from the year, which are less sort of things that I did, but I think I have spent a lot of time this year speaking up and being more in alignment and just it's a little bit of like not caring what other people say, but a little bit of a twist differently. Like it's really like if it matters to me, I'm just gonna do it.
And even if it's uncomfortable or even if it makes waves or ripples and that's been hard because I don't like making waves and ripples. and sometimes I do it by going away and doing my own thing, but this time I was really willing to do that.
Erica (08:41.006)
So I'm curious, to can you give an example of of something where that came up, like something where you're like, This really matters, I'm taking a stand?
Jessie (08:48.428)
I I can no, I can't give you the specifics because the the end outcome has not happened yet. I was asked to do this really big project for a big healthcare system and they had an idea of how they wanted it to be. And I just knew that like for the long term outcome and the long term benefit of the physicians, that it shouldn't be that way. And so I was willing to not do it.
if they weren't gonna do it, and I don't wanna say my way, but in a way that that felt aligned and that wasn't sort of these are the things we want, but these are the things that are gonna make the biggest difference and have the biggest long term impact, if that makes sense. And so I really actually I I won't say tug my heels in because it was actually the opposite that I just stood up tall and said, well, you know, I don't recommend doing that.
And if I am going to do this, it has to be something I'm proud of. And I just sort of had this idea that like it to me it felt risky, right? Because this was something that part of me just said, just do it. It's a great opportunity. Like, and I knew that a year in I would be mad at myself. And so and it so far it turned out fine. Like they were like, those are good points. You know, I think a lot of it has to do with when you're not in the defensive space, but you're in the proud, like this.
matters to me space. and and I will say that sometimes it's speaking up and then sometimes it's not saying anything. Like in my family, it was letting other people be them and recognizing that though I really wanted to say things, that it was better to just let other people do their thing and think about what I wanted in the long term, if that makes sense. I mean I think it's pretty cool.
Erica (10:36.76)
Well, I think that, you know, coming back to the birth story experience, like you kind of ha need to put your ego aside and you need to be right. Yes. Because, you know, it's w especially when we're so trained in medicine to be like, There's a right way and there's a wrong way and like these things are acceptable and these things aren't. And
Jessie (11:42.314)
Erica (12:42.112)
Okay, sorry about that. Fingers crossed. We are we are actually on a tornado watch here. So yeah, so okay. So we were talking about we were talking about when to speak and when not to speak and the fact that I I was saying we have to let go of the ego and we have to, you know, we're taught in medicine that there's a right way to do things and there's a wrong way to do things, and we have to zoom out and think about okay.
Jessie (12:47.373)
Goodness.
Erica (13:09.708)
Maybe that's not true. Maybe the relationships are where it's at here. Maybe p you know, we always talk in in medical in the medical world about autonomy and patient autonomy. What does that mean when it's your family member? Family member autonomy, you know? And like so I think that's really interesting because I I watched you navigate that journey.
Jessie (13:27.021)
Yeah.
Erica (13:29.516)
Really well. just a second. Now my T V has turned on. Okay, we're gonna need to edit this. Just a second. I'm so sorry.
Jessie (13:37.016)
Yeah.
Jessie (13:43.243)
CD.
Erica (13:46.83)
Okay. Okay. So again, refocus.
Jessie (13:51.214)
It's all good. I actually like the tornado is throwing different energy into our into our birthday episode. It's awesome. And we can edit it. It's not a big deal. We'll just clip the middle.
Erica (14:01.454)
Sorry, as long as there's just not an actual tornado we'll be fine.
Jessie (14:05.078)
Right. Yes. Well in which case we can re record.
Erica (14:08.081)
That's right. As long as I'm alive. Okay.
Jessie (14:10.06)
Yes, as long as you're alive. Yes. I love it.
Erica (14:14.036)
Yes. Okay. So we were talking about when to speak and when not to speak. And and just like watching you navigate that situation. I think that, you know, the other thing that comes up for me is you're like, well, I'm proud of my grandkids, but I'm not I'm not directly responsible. Like I have seen you embrace their role as the the Lita, right? You call yourself Lita, like the the the grandmother role over the last two years, if two ish years. and you've been so present to them in you know in a way that you
Like held space, you asked them what they needed, you showed up, you had fun, you got on the floor and played with your grandson, like all those different things. And like that, those every single deposit into that relationship bank, you know, now that they have their you know new additions and everything. I mean, it it's all one continuous story. It's not just like an my gosh, this surprise happened and here we are. Like, I mean, the timing is interesting because the universe kind of gave you an opportunity to say, okay.
Like, what do I do now? Do I cancel the TED talk? Do I focus on this role? But I think because you have shown up with so much love. Again, the topic of your TEDx talk is like, what would love do? Like you were able to say what would love do? And actually give the TED Talk first. Right. Give the TED Talk first and then and show up with love for yourself and for your people. I mean, that that to me, if you think about like,
Jessie (15:24.258)
The T Talk first.
Erica (15:36.692)
I'm I'm proud of you for that. You know, like I'm proud of how you lived in that way.
Jessie (15:41.57)
My gosh, well, you brought up something that I hadn't thought of. I'm super proud of my Lito role. And we haven't actually I'm talked about it, but I have I have totally up leveled in my Lito role in a way that's really authentic and aligned. And I've been doing some things that, like, the way that I grew up, one would never do it this way. And it has brought me so much joy, and I'm about to do it again next week, which is
My three-year-old grandson who has these two little twins who get a lot of attention and i because they need it, their seven months. And so I actually have started flying down to San Diego, picking him up and flying back to my house and bringing him with me. And having him stay with me for a few days and then returning him, which to me feels like totally extravagant and ridiculous.
And yet it's very clear to me that the parents of twins couldn't possibly drop him off or pick him up. And he clearly can't fly alone. And from this sort of aligned place, while I it's fun to be there, there are three children, there's lots of adults, there's all kinds of chaos. I have to stay in a hotel. And this isn't on them. It's just like what happens when you have a busy family life and they have their jobs and their setup. And this has been so much fun.
And so, and literally my grandson now looks up at the sky and he's like, Is Lita on that plane coming to get me? I mean, I've tried it three times and I'm like, my son said, What you know, he's gonna get used to this. And I was like, Well, first of all, fine. if you plan ahead, it's not that expensive to go to San Diego and back because it turns out it's cheaper. Well, it's about the same as a hotel room for a night or two, but I get to be in my space with just him and we don't have to go out to eat. I don't have to rent a car, I don't have to, you know, use your car. It's like
Just this really beautiful aligned connecting thing. And for me, it that was kind of a step out because it just seemed like a crazy thing to do the first time I did it. And then I was like, We should do this all the time. What are we thinking?
Erica (17:48.398)
That's so special. I'm so glad. And it takes like thinking outside the box and getting giving yourself permission to do things differently. That's so cool.
Jessie (17:56.61)
And I see the twins briefly on either end. So I've seen them, right? But they, you know, they don't necessarily need me in the same way. They're breastfeeding and they're, you know, doing all that stuff. And and like this just feels like something I can do. And I know it won't last forever also. So it's sort of like and if it does, that's also okay. but I'm pretty sure it won't. So I'm really proud of of sort of the creativity and maybe that's something just being creative and authentic.
that I've really leaned into and I will say this was my fifty-sixth year and and I think the idea too that we can just keep growing and changing is pretty powerful. And then the last thing I think I would bring up here is that I'm proud of is blends together, but like letting go but also asking for help. And like being okay with both. Like getting go of things that I'm ready to let go of and asking for help with things that I kind of want to do or want to make happen or
whatever reason, like they haven't happened, and to not say like I need to be mean to myself and just get to it, but to get help and figure out like, well, do I really want to make them happen? And if not, let it go. And if I do, then figure out what kind of help I need to do that.
Erica (19:08.736)
that's interesting. I think that I think the really interesting part for me is that discernment of like what goes in what bucket. Yes.
Jessie (19:14.508)
Yeah. 'Cause sometimes it's like it hasn't happened and you need help, but because you're frustrated, you're gonna let it go. And instead of saying like, No, my future self will really wish I had done this thing kind of like the Ted Talk honestly, right? Like my future self will really wish I had done it, even though part of me was like, Yeah, I should just let this go. Like it just is too much time, effort, money, coordination, you know, you have to apply and do all this stuff and then you you know
So I literally practiced my TED talk with people who came to r the retreats. They got the preview because I was like, I gotta you know, this is gonna hear it. It was actually really fun. and but again, I think just recognizing what goes in what bucket. So tell me what you're proud of.
Erica (19:48.458)
Do you want
Erica (20:01.122)
Let's see. my gosh. I mean, then every year I feel like there's so much change. I keep being like, okay, like when when is it gonna like when is the change gonna stop? And I I mean, I don't mind it. It does feel like other people, when I look seem have much more stability and less change. Like my sister and I always talk a lot about that, like how quote unquote stable her life is and how like sort of my life is always changing, which is exciting. I mean, I will say I think this has been like the chrysalis year and then the the butterfly. Like we've talked about that analogy a lot before. And
For so long it was so uncomfortable, but I knew things were happening under the surface. But there was a moment when I was like, okay, like, like now, now this is it. And I I think that what happened was I really did embrace self-kindness for the first time. And you know, one of my mentors, Dr. Una says, like, be do have. And so like sometimes we have to start with like the identity. Every single day I say I'm kind to myself.
And there was a moment or you know, in in the fall where I was saying this to myself every day, but then looking at my actions of like going to work at my employee position. And all of a sudden I just realized like, like, I know we do things for practical reasons, but like Erica, you are not being kind to yourself in it and not in a judgmental way, but in a like a very objective, like, like I know you want to maintain this job for so many reasons. However, like you really are not. If you are to say you are kind to yourself every single day.
the the next right thing is to not remain in this employed position, which you know, that was really hard. I I cried as I talked to my work partners about it because I love them like sisters. I needed to resign from my fellowship director position, which I know is like very prestigious and, you know, I love education. And at the same time, I just knew there was such misalignment that it was becoming exhausting. And I was being so much kinder to other people than I was to myself. and so I did.
December 30th, I sent an email and sent in my resignation and took four months to obviously see the effects of that because we have a four-month notice. but what that did was that actually opened up space in my life to be present with my mother, who almost passed away from you know, medical issues in the spring. I did not anticipate that at all, but because I had created that transition.
Erica (22:19.456)
I was able to be at her bedside for most of that time, which was just so incredible. which also links to other things I'm proud of. But like sometimes we have to move for things to move. And then, you know, I'd also made the comment in passing, like, I don't think I'm ever gonna date anybody if I'm living out of a suitcase. You know, and I had said to you last year, like, and not that I was like actively trying to find somebody, but I just I I knew that at some point I would want to find a partner.
Yeah. And that I'm like, okay, do I do it in Burlington? And they're half the time. Do I when I don't have, you know, my children, do I do it in Albany? Like all these different logistics. But something was saying to me, like, when you're in one place for three weeks out of a month, like you're gonna feel much better in your body and in everything. So I unexpectedly started dating somebody who sat next to me at an orchestra concert in March and
still very early, very much enjoying my time with him. and that that was another unexpected gift, but I also think came out of the self-kindness to be like, I'm not a machine. I'm you know, I I can't continue not being kind to myself. I have to practice what I preach, I have to be kinder. And then from that opened up these other really amazing parts of life.
Jessie (23:31.744)
I I wrote down and starred this question, What would be kind to yourself this year?
Erica (23:36.174)
yeah. That's a great question. Yes, yes, yes. so let's think about that. I mean, I think continuing to listen to my body and my intuition. We talked about that last year. I wear the bracelets that you gave me every every now. I have one for trust and one for intuition and now one for for love. really listening and like this intuition thing is so strange. Like
My kids have been trying to get me to get a dog. And and I, you know, my older one's 13, my younger one's 11. Like I recognize that there's not too much time I have love with them in my home, all these things, all these things. I had a cr contract in my hand for a dog that seemed to make sense on paper. And my gut was like, don't do it. Not the right thing. Not the right time. And I again I was like, okay, this makes no sense, but like, okay, I'm listening. Like something is off about this. And then the next week my mom got super sick and I thought to myself, like,
How would I have managed a new dog, a puppy, really? Yeah. And my mom's illness. And so I think it's, I think a lot of kindness is to create the pauses and the spaces to listen. And then once we listen, we get data, then we it's our choice to decide what we do with that. We might choose to remain in a situation that is suboptimal for different reasons. We might choose to listen to our hearts and take a risk and do things. But I I think that for me, it's that.
What would kindness do? Kindness would continue to listen, continue to rest. That's another thing I'm super proud of from this last year was getting the coaching I needed where a coach just looked at me and she's like, I know you're here for XYZ reason, but we're not even going to touch that with a 10-foot pole until you slow down and you rest. And again, she said this with kindness. She said this with love. And she actually had me start blocking out time on my schedule where I could not look at my to-do list, where I could not, I had to like be she actually said, Erica, you need to suck.
Is what she said. You need to be of no good to no other people. And I think she had to say it in such dramatic language. And I was like, okay, I am going to be not useful to anybody. I had to start like two hours, you know, like once every two weeks. Like it was very but even that amount was very scary. I'm like, what's gonna come up if I'm not just like busy all the time and productive? And then from that rest has grown me believing that I deserve the things that other people have in their lives, like you know.
Erica (25:56.128)
white space, time of non-productivity. you know, and hey, dating. I mean, you can't really date from a space of like, I'm gonna work you in in this hour-long block that I have, you know, like that's not gonna work. So just embracing that like it's safe to rest, it's safe not to be productive all the time. You deserve aspects of life that are fun and playful and non-productive, that's been a real realization. So continuing to listen to that, understanding I have responsibilities and
How can I welcome that rest, welcome that energy in? I think is is a very kind thing for myself.
Jessie (26:29.414)
Yeah, I wanna comment on that one actually because before we start recording, I was telling you that I'm resting right now. and maybe being not not being non-productive, but less productive is my is my agenda for a little bit and that it actually doesn't feel good because I'm I like to be productive and like that's my my highest productive energy. So but it it is acting like that chrysalis where everything melts down and I know it's essential.
but because it's unfamiliar, it doesn't feel good. And so I actually fully believe it's safe to do that. I deserve it, and I don't like it, which is a whole other level because it's unfamiliar. and yet it's a little bit like saying I want to live my whole life in systole and I'm just gonna skip the diastole part, which you know is necessary, right? and even someone like me who knows all that.
It doesn't mean that you're gonna like it or it will be fun necessarily. Like I think it takes practice. It's a little bit like the connecting with what you're proud of. That was really hard for me to do. Now it's fun. So I'm guessing that the more I do this, the more fun it will be.
Erica (27:38.058)
yeah, totally, totally. And I'm like, look at me. I went a whole two days without looking at my to-do list or like look at me. And you know, I just I think that we can embrace that. And again, sometimes it's super not comfortable either. Like I'm not saying I've like arrived or whatever, but I but it's an a muscle that I'm much better at exercising now than I was a year ago. And I didn't realize how much that was gonna be the key to me just feeling so much more human and so much more.
like in my own body and not in just in my head and my to-do list all the time. Wow. So that's been amazing. I think the the coach that I just referred to was like, we're gonna make you rest. Forced rest. She's a a financial coach, and that was one aspect of life that I really felt like I've been avoiding, probably related to wounds in my divorce and and and other otherwise. And so I addressed that kind of head on this year and really did.
work with her, which we know, like coaching again, you it's the access point. And that was really powerful to to really intentionally spend time every single week getting the money house in order, getting having actual financial goals, which I really hadn't had up until then. I was like, you know, I was making smart decisions, but I wasn't really like heading in a direction. And I feel like that has been very empowering for me on in many levels to address that part of life finally, you know, in my 40s.
Jessie (29:01.75)
Yeah, I love it. Wow.
Erica (29:03.626)
And then also I also wrote down as thinking about this, like really under like welcoming in the space for my friend, my female friendships. I I, you know, I have a core, well, it's not even a core group, it well, I I do and I don't. I have a core group of friends in Burlington and it's like a beautiful group. And then I have isolated friends from different aspects of my life, like a best friend from college and a best friend from you know, medical school, and then another, you know, like I have like these isolated friendships and
I thought, my goodness, I spend we go four, five, six months without even talking to each other. And like, why? Just because we live in different places doesn't mean we can't carve it out. And so I now put it on my calendar. If I haven't touched space with a certain friend in two weeks. And and and what that also translates into is time, like actually looking at the schedule ahead of time and prioritizing. I have these times in my life when I'm not on call and you know the parenting schedule is such that I have a okay. So then let's say what weekends do you have in the next
six months and and and consequently I have done some amazing things with friends, my girlfriends, you know, that I don't think I would have done if I hadn't recognized that this this part of my life is vital to my my my vitality. Well, you know, and to my my living the best life that I can. So it that's been a really wonderful prioritization that is an upgrade from last year.
Jessie (30:21.142)
Yeah. And I I have actually been doing a lot of work on that too. I love that the birthday twins work on the same thing. So even though we're like different generations, we're still working on the same thing. Not generations, decades. but but this idea of recognizing, I think that it has to be an intentional approach. And that's sort of the alignment of just saying, like, this is important and I'm gonna take time to do it.
even if it's uncomfortable, like I'm in a new space, like the new friend part is uncomfortable, but and also making time and being intentional about connecting with old friends. And I think that we think somehow these things are just gonna happen. And they did just happen way back in our training, but they don't continue to just happen. especially, you know, when you
In your case, you get divorced, you move, you do these things, like there are friends that go with the marriage or friends that go with living in a different state. There are friends that go with different parts of your life. And so those relationships become very intentional or have to if you want to keep them. I also love that they can look very different. Like I think we used to think that like your friend has to live down the street and you see them all the time. And my realization these days is that those aren't like I can see a friend once a year.
And we if we still have that deep connection. I actually saw a very good friend on Monday that I hadn't seen since I moved. and she has gone through tremendous things since I moved, which is one of the reasons. But like it was as if we had seen each other yesterday. and then we were very intentional and we set up walking dates for the next like once a month, for the next few months. They're on the calendar. We're gonna make them happen because it felt so good. But again, like those kinds of friends, there's no judgment. It's like these things happen.
came up and and here we are for each other and how it was but we were both like okay when's our next get together like let's plan a thing and you know I put it on my calendar I blocked my schedule I was like no this is gonna happen and we went five months in advance. I mean I know that they probably won't all happen because something will come up but that was also on purpose. And I think so many of us feel sad that we don't have intentional connections and yet
Jessie (32:35.148)
having them, even if they're just text connections, that can be really powerful.
Erica (32:39.158)
Mm-hmm. Yeah. And I think it's still okay to be choosy. Like, I'm not gonna I'm I'm such an introvert. I'm not gonna like have twenty friends on to like, but there was one person I met recently, it was at a actually a track meet, and we reconnected like similar s social situation, divorced, etc. And like she's such a bright light. And like then we started sharing book recommendations and there was like this regularity. Every week we get to see each other. And then we're like, Okay, well, the track season's over. We're not gonna stop this now, you know, we're gonna keep this going. And she just bought a house and
Now I have this new relationship that she's super excited about for me. And so, you know, I think that when you've when you have that residence, you have that energy. And like you said, like you experience a bit of that good thing. You're like, I want more of that. It kind of like, you know, in coaching school we learn that we do things to seek pleasure. And like it's very pleasureful to spend time with our female friends who get us and don't judge us and lift us up.
Jessie (33:28.472)
And I love your comment that more is not better, right? It's it's the quality, not the quantity. And for some of us that might be two good friends or three good friends. For some people they need all this stuff. And others better worse. It's just knowing who you are and kind of finding the sweet spot, which might change. Like as your kids are busy doing other things, it's there's more and at other times there's less and it there isn't a right or wrong way again.
Erica (33:52.876)
Yeah, it's like listening. But then I think one thing that what like a frame shift that's been important for me around this is to say this is not optional. This is like part of my whole health system. Like this is not like this extra thing, maybe I'll dabble in my female friendships from time to time. It's like, no, no, no, no, no. Like that's not the right framework that works for me to make this integrated into the fabric of who I am. And so
Yeah, I do have lots of dates on the calendar with people and and weekends bookmarked for various things, especially when we're talking about call schedules and things like that. You just have to to do that. But I think that's it's that's been an upgrade. And I'm so glad you're experiencing that too.
Jessie (34:26.84)
Yeah, that's fun. So we talked about sharing this idea of what we know now that we didn't know last year. Do you wanna do you have any thoughts on that that's different than what you're proud of? To me it's a question that gets at a little bit different things.
Erica (34:41.292)
Yes, yes. I mean I think that so surrender as a deep experience. I think that when I went to I went to this physician coaching summit in November of last year in Arizona and I did this like trust fall and I it was scary. Like I actually like and I don't like Heights Jesse, like I had a harness up, I didn't know anybody. I like climbed to the top of this pole that had like these, I don't know.
Jessie (35:02.881)
I mean that.
Erica (35:10.146)
things on them and you balance and then all of a sudden you jump and then you try to catch this thing, nobody gets it. And then you truly like fall into space. And so I at that point said I release all negative attachments like as I was falling and I truly believed it. And and that was a very powerful, I would even say like spiritual experience for me to be like, okay, I know I have things that are holding me back from my fullest life. It was around the time I made the decision to resign from my
And play physician and and et cetera. And that was really amazing because I returned to that moment several times and like on a cellular level, that was surrender. And then, you know, I will say when my mom got really sick in April and that was really scary, and I truly did not believe she was gonna make it through. She was so sick. And, you know, my family, we all, you know, my very nuclear family, we leaned on each other. But that was also a tremendous exercise in surrender to say, like, okay, like.
know if she may not make it through. what do we say? What don't we say? How do we honor her wishes? That was very important to me that like how she was cared for, you know, reflected the decisions that she wanted to make. And so that time was very much a time of surrender in terms of like truly not having control over so many things and and and letting it go. So I think that what do I know today that I didn't know a year ago? I think I understand surrender, not necessarily cognitively, but like
experientially in terms of like what it really does mean to turn something over. and I think this go ahead, go ahead.
Jessie (36:43.358)
You just said at the cellular level, which I think is the d is the distinction, right? It's not just in our heads. We know like, I wanna let go of that. But when you actually let go of it, you also let go of it physically.
Erica (36:56.78)
Yeah, that's so true. I think the dating, I mean, you you you know I intentionally was single for the last two years, was not expecting to date and like opening that door. that's that's been that's been really interesting for me to welcome in that energy, welcome in getting to know another human in that way, inviting him into my life. you know, again, it's it's early, we'll see. I love spending time with him. I but I think most importantly, like I love who I am.
In the context of this relationship. And like I I can just tell like what a different version of myself I am. in ways that are that make me again make me feel proud, but also what do I know today? I know that it it is safe to open up that door because I have that deep self-trust that is gonna continue to guide me. And again, you know, that's it can be vulnerable, it can be kind of scary sometimes, and it's okay because because I have that self-trust. so that's that's new knowledge to me.
Jessie (37:55.03)
You've surrendered to the not being in control of the relationship thing, right? It's sort of like just surrendering to whatever happened.
Erica (38:02.734)
Yeah, that's right.
Jessie (38:05.624)
Part of relationships, right, is surrendering. Which none of us like to do.
Erica (38:10.254)
None of us like to do it. And then surrendering to the whole job, like, okay, if I'm not employed, then you know, what does that mean? But then also like knowing that I need to let go of that to be able to grow the coaching practice, which is my passion and and all those things. So I I I do think that is the theme, really, is like in all the different fronts is that surrender to say, okay, you know, I may not know what's on the other side, I can make my plans, but I can also know what isn't serving me and to let that go and see what else, what what comes.
Jessie (38:39.963)
Yeah. Yeah. Yeah. That's good. That's good.
Erica (38:43.567)
Yeah, yeah. What about you, Jesse? What do you know today that you didn't know a year ago? Understanding that we have like five more weeks until our actual birthdays, but still, yeah, yeah.
Jessie (38:51.436)
Yeah, I have time to learn more things. I'm focusing on achievement. I think the idea that it two things come to mind. One is and it it kind of relates to to surrender, but not really. It's really like that I can be patient and I can take my time. and that oftentimes, you know, the patience actually reaps more than you would by
by going through, pushing through things. and that like oftentimes when you're not focusing on on an outcome, which I think is so much of what we do in medicine and even just in that high achieving woman perspective, it's like, I'm going to do this or I'm going to do that. and the example of the TED Talk is actually a great one because I had kind of I was parking it. Like I wasn't sure I was going to do it. I wasn't sure I had time. It felt like
It you know, I had I kept I felt bad because I kept saying I was gonna do it and then like the timing wasn't working, et cetera, et cetera. And then all of a sudden it lands in your lap. And I think sometimes when you're patient and you just stop like trying to make things happen, they actually do happen. And that that of course goes right back into the trust. but I think that for me that is just remembering that patience and the pausing.
whether it's just sort of pausing the an energetic pause to you then create space and these things land. Like when you decide not to date is when the the date showed up, right? and so I think this idea that we can be patient and we don't have to be focused on f making something happen. I feel that so often the messaging, whether it's in medicine or in business and in life, it's like, no, you have to make it happen. It's you're r you know, just get on it. And
I actually find that most of the really great things that have happened happen when I stop doing that and when I'm satisfied with where I am or when I'm resting, or when I'm just not in that achievement focused energy. it just it it does come back to trust, trusting yourself, trusting a universe. it doesn't come in the self-doubt like pushing outcome focused energy.
Jessie (41:08.288)
And then I think the other one for me relates a bit to your self-kindness, where you brought up that you were proud of it. but mine was more of a lesson that I really had to take care of my physical self above all. And not even from a place of not kindness. sometimes it feels not kind to do it. I actually had a stress fracture in my heel and I couldn't walk for like three months. I couldn't, I mean I could hobble around my house.
But I couldn't do go outside and do the things I wanted to do. And it was during my three months where I was supposed to get to hike and do all the things. And I really just had to like take care of myself, physical self first. And that also involved a lot of similar discomfort to what I'm feeling now when I'm like not busy again. and I think it's this idea that like it one of the things, and you know, it's funny because I kind of teach this is like taking care of your energetic self and being kind to yourself. But
You don't do that, like the other stuff doesn't happen and you just get out of alignment. And so whether I wanted to learn that lesson or not, I got some messages there. and I'm now again for my summer kind of really focusing on the the phys my own physical health piece. And I think it that that's probably something that I also recognize is like for me.
I have busier seasons and less busy seasons. So I don't have to focus on it every day. I don't have to be amazing about doing the things every day. I mean, I don't want to let it all just go, but but that there are times where you're like, yes, this is a a season of of really regrouping and resetting and seeing what needs refilling and what needs attention. And it doesn't have to be all the time, but that if you lose that piece, you know, I always say like if the physical piece isn't taken care of.
A lot of the mindset work doesn't happen, like they go hand in hand.
Erica (43:03.714)
They do. that's so beautiful. And I don't know if I share with you that I fractured my spine in February. Did I tell you that? No. Yeah. So we really are living parallel lives. I slipped on ice and and had to transfer process. Anyway, the whole point is that I similarly have had to rest and did not necessarily want that. you know, as I going to go skiing with friends and then had to say, okay, let's stay in the lodge instead. Okay, first world problems, but like still, you know. So I hear you on that. And I think that.
I love what you said about just the pace of grace and like how different seasons call for different energies and paces. And I think we forget that in medicine, which is like sprint mode all the time and achieve and oriented all the time. But when we can actually do that, I mean the paradox is then we have more energy for the times that are more intensive and then we this sort of rhythm of resting. but it's something we definitely have to learn because I was not taught that. And I think I've I've I'm learning. I have learned a lot over the last year and I continue to learn.
That it is actually good for me to recover.
Jessie (44:02.606)
Well, and actually nature does that, right? And and and and but we don't learn from that. And the heart does that, we don't learn from that. And so it's like, I mean, sometimes it takes a lot of years for us to do it. I think the other piece around that sort of patience and taking your time is there are a lot of projects that I had that were like almost finished. and when I let go of just being like, you should have finished this before, I'll give my Martha Beck certification as an example. Like I left it to the very last day.
Erica (44:04.945)
it does.
Jessie (44:32.586)
And to turn in all the stuff. And I did, but then I was like, well, maybe I just won't do it. Like I can be the one who just doesn't care. And I was like, actually, no, I I did all this work. I should turn it in. That's actually kind. And so it was just sort of dropping the story about why I left it to the last minute. I actually had a lot of good reasons. I did a lot of other things. Like it wasn't at the top of the priority list until the last day. and I was able to do it all and get it turned in and pass and get my certificate.
But I was originally I was like, why would you have done this? Like, what are you thinking? You know, and I was like, just drop that story and just answer the questions and and trust yourself. And there was a little bit of funny part to it because I also I think, you know, I just had kind of forgotten that like I'm actually a highly efficient, highly educated, trained person who can whip out a final exam in a couple hours, even if someone else thought it would take a long time. Like I could do this.
But my brain just had all those old stories of of that. And so it was great learning for me that like it doesn't matter. It's not that I didn't I learned what I had wanted to learn and I actually learned a lot from doing it in that moment, right? Like just as opposed to sort of spending time reviewing it and perfecting it, which I did not do at all. And it turned out it was more than adequate. More than adequate. and I
Erica (45:51.885)
Like we
Jessie (45:55.852)
I'm doing that again. I just did I did a yin yoga certification and part of it was teaching a class, which I already taught the class, but part of the homework is like explaining your sequencing and yada yada. That is not how I teach yoga. I teach it intuitively, but I had done the training, so I just taught the class. So I I did have to sit down afterwards and write down like what I taught. But I can't actually explain like why I did it except that it's intuitive. But I decided I'm just gonna turn that in, I bet it's fine.
Like I don't have to get an A plus and honestly that is how I'm gonna teach it in the future. And I I did the course, I learned it. Like they're just so there's this sort of part of this is like B plus work, but it's not just that. It's like just sort of letting go of that judgment and just being fine with how it turns out.
Erica (46:45.314)
That's amazing. I mean, I see you like saying, okay, this is in alignment with how I do things, both with the with the the example you gave earlier about the institution and then this. And like, you know, so you're first of it's like, well, it has to be aligned with me. So like these external rules exist, but like as long as I'm ish in it, you know, like it's gonna be it's gonna be okay. You know, and then and then also the the awareness, the metacognition of I actually have stories. Like how many of us have done things for years just being mired in the stories?
But then you're like, number one I have stories and number two, I can drop the stories. Like I think that is a super cool industry. So
Jessie (47:18.2)
Yeah. That's been fun. Yeah. so yeah, it's been a fun year. And I honestly, because we're several weeks out from our next year, you this podcast recording has gotten me to think about it. Like I'm not yet, but it's in my mind that, like, I should be thoughtful about it. And you know, I'm always very thoughtful about the beginning of the calendar year, but I feel like it's also a nice way to say, like, for me, it's like in my fifty-seventh year.
Erica (47:20.238)
Yeah, it's been fun.
Jessie (47:46.786)
What will I wish I had done? and I guess one thing that comes up right to mind, so I'll throw it out there, but I this needs more thought. this particular thing doesn't need more thought, but all the other things need more thought, which is this idea of having fun. and I have shared a yoga class about this recently and written about it, but it really has hit me passionately. So I want to share it with you. And I think as like a birthday wish, it's a beautiful thing.
there was a woman in my Martha Bach coaching group who had stage four cancer and actually died during our training and didn't finish it. but her daughter reached out to us at some point afterwards and she had made this incredible montage about her mother, who by the way was lifelong learning until her very last days if she was in a training at the end of her life. And her mom said a couple days before she died that she that we had so much fun.
And the daughter, who was, you know, in her mid-20s, was like, Yeah, we had so much fun. And she put this in her montage about her mom. And when I heard this, it just hit me in this way of like, wow, well, when I have two days left to live, that is what I want to be able to say. And that that is what I want my children and grandchildren to say about me. Yeah. And and I had a pause and I was like, Would they say that now? I'm not I don't I won't say no, I'll just say I'm not sure.
But I don't want there to be like any doubt in anybody's mind that we had so much fun. And then I don't want to be like, yeah, she worked really hard. Even like she made a difference in the world. Well, I want to make a difference in the world, but I want to have a lot of fun doing it. Like, and I want to be known as somebody who people think of as like, wow, that's fun. And I will say it, I think that the work I do now, I'm having so much fun. We're having fun recording this podcast, right? So it's not like that you're out, you know,
reveling all day because I think making a difference can be fun. But the energy around it feels just like something that I definitely I want to kind of integrate in a way that it's not just a thought or a fleeting thought. I have started saying it all the time. I'm I I constantly now with my grandson say we're having so much fun and he's like yes we are but but it's also because we are
Erica (49:44.27)
Yeah yeah. Yeah yeah.
Jessie (50:07.348)
And so I'm partly just reminding myself that like, yes, I am having fun, or I'm having fun recording podcasts, or I'm I have fun teaching yoga. Like to me that's fun and creativity. So it's one owning it. But I think if we don't call it out, other people may or may not see that about us. And there's a power in sharing that as a passion and an intention for the world.
Erica (50:21.41)
Yeah.
Jessie (50:31.586)
Like I was not raised in a way that you should focus on fun and pleasure. Like that was indulgent. And so to me putting that out there in the world and allowing people to do it, I think that's where we get people's best ideas and best highest, wisest, most creative, curious selves.
Erica (50:49.774)
Totally, totally. And I, you know, I as you know, I'm divorced and like part of it was like I just live this straight and narrow and like academic medicine and blah blah blah. And then there was a new year, I think it was New Year's, and I decided to kind of get a bunch of like, you know, decorations and like you know, those blow things that make noise and and I really went all out and I I remember it was a couple of years ago and I had this thought, which I now code as mantras, I bring the fun. Like I used to think that the fun was for other people.
And I am fun and I bring the fun. And and now that is again, you know, every day I might feel a little differently about this. depending on what's going on. But like I fully do believe that like I bring the fun and it's it's it's wonderful. So I I offer that to you as you as we both embrace this new identity. and you do. I mean like I will say, you know, and I will I will text you later about all the ways that I I I experience your fun energy and have for years.
Yes. Even like I can see your print, like the print of your dress right now. Like that is a fun colorful print and it it brings me joy to see that.
Jessie (51:56.328)
Yeah. You're right. Actually, I do embrace fun. And you know what's interesting about what you saying that is is also the calling it out and the noticing because I think so often we already have what we think we want. And it would be really interesting, like to ask my children what they think. I think they would be plus minus, like I am fun, but not always. And I'm not sure I always want to be fun, but I do want them to be able to say it.
Right. So to me it's also just a reminder of like noticing how you show up that way, being aware. And I I've had this new thought in the last few days, and this also feels like a very relevant birthday wish is that letting other people see you and share. So like you sharing how you you find things that I do fun is so powerful. I have gotten it's been so fun. I have gotten presence in the mail in the last week and a half.
Erica (52:43.426)
Yeah.
Jessie (52:51.06)
of art from people who've come on retreats that they painted of things here that they like framed and sent to me. you know, poppies and sweet peas and things that I had around that they had painted or in their little notebooks, I think, and then like given them to me with a thank you and like really being seen. And to me, that boy, like that tells me that it was fun. It wasn't just serious. It wasn't just meaningful. Like they're all colorful flowers, which
Clearly is a theme. but I I just love that like sense of of fun. And I think we can allow other people to share what they see because I have discovered recently that other people see things in you that you want to be there, or maybe you're you're trying to grow, but you don't really feel confident in it. And then when someone sends it back to you with their comments and feedback, you're like, wow, actually, maybe people do see me this way. Maybe the work is less. Maybe the work is
Owning it.
Erica (53:51.254)
Yeah, they help us connect the dots and then just like gratitude, they say savor the gratitude. Maybe we can savor that feedback and and and like use it as a mirror to see how we already are that way in many senses.
Jessie (54:02.274)
You know, I think that's such a beautiful idea of what one might want for their birthday. I was like asking the people you love to to share with you like what they think is fun about you or what they love about you or what not what you can improve, by the way. I don't want to hear that.
Erica (54:19.682)
No feedback.
Jessie (54:21.314)
Yeah, no feedback sandwich. But but to me it would be that kind of being seen and I think from the people that you love and who care about you, how powerful is that? That could be a really cool exercise.
Erica (54:31.798)
Yeah. I think and I think I'm gonna ask for that this year. So thank you for that.
Jessie (54:37.324)
Yeah. Wow. Look at all these amazing ideas that come out of an annual birthday episode.
Erica (54:42.216)
I love it. I love it. Well, thank you, Jesse. It's always so wonderful to spend time with you. I can't wait for all of our listeners to have a front seat to our conversation and reflect on their breakfast as well.
Jessie (54:52.856)
Thank you. This was such a delight and and perhaps we'll be here a year from now recording our third annual episode and who knows what we'll it will be about each time. It's been really fun. And I do want to encourage everyone listening to go back to the last week of July and both of our podcasts. either one and take a listen to last year's episode. Cause I also think like an annual episode is always so much more interesting in contrast to
what we said and you listened to it before this. I did not, kind of on purpose because I then feel like it's gonna color my thoughts. But but I think in just reflecting on the two, you can also see from the outside like how much things can change. And that can be inspiring for your own journey.
Erica (55:26.252)
Yeah.
Erica (55:38.968)
Totally amazing. Well and I will I will put the link in my show notes and I think you can do the same so people can reference it quickly. Okay.
Jessie (55:47.758)
And I will put Erica's links will be in my show notes and my links will be in her show notes. And we both thank you all so much for listening and come join us for something because we have a lot of fun. And we will reconnect with all of you next year, if not before.
Erica (56:01.954)
Love it.
Erica (56:07.99)
Yes, amazing. Until the next time, my loves. Bye.
