Well hello! It’s been a busy time getting ready for the first-ever Mastermind Retreat for Women in Male-Dominated Fields, but I’m back on the blog with an exciting guest post. This week’s blog comes from Dr. Carol Yuan-Dulair, a board-certified physician in pulmonary critical care, internal medicine, and sleep medicine. She started a sleep service for women that helps them get better sleep and live better lives. She even named the program after her daughter, so sweet! I hope this post from Dr. Yuan-Dulair helps you consider any hang-ups you may have regarding your sleep so that you can secure a better snooze!

– TiredSuperheroine

The Rules Were Not Created for You

I’m a rule follower. Maybe it’s a means of survival in the world of medicine. But for women in male-dominated fields like medicine, often, the only rules you find are those created by men for men.  

To give you an example, I returned to my work as a pulmonary intensivist after just five weeks. This amount of maternity leave is inhumanely insufficient, and I do not recommend it. This ‘choice’ came from a combination of my naivete and the pressure I felt as the only female in my group. For context, when I first told the partners I was pregnant and requested time off in advance, one of them responded coldly, “I wish I could be pregnant.” 

As soon as I got back to work following maternity leave, I realized the inherent conflict between following the rules of a man’s world and being a “good mom.” Heeding guidelines and recommendations, I was determined to provide my child with exclusive breastfeeding for 6 months. The only problem was that the ICU rounding schedule didn’t seem to respect my lactation needs. There was always another procedure, STAT situation, or family meeting before I could sneak away with my heavy, conspicuous pump bag to the lactation room, which was located on the other side of the building. 

Trying to meet a woman’s needs in a male environment

Usually, by the time I got to the bare, windowless room, milk-soaked through my undershirt. There, like Diana Prince transforming into Wonder Woman, I unleashed the biological power of my womanhood. With the pump’s mechanical hum echoing off the walls, I finally caught the glorious sight of filling milk collection containers, which hung off my topless body. As I pumped, I worked, of course, a phone wedged between my ear and shoulder, as ten fingers typed furiously on the keyboard.  

Meanwhile, my male colleagues seemed blissfully ignorant of these challenges. One time, a colleague called to discuss a patient while I was pumping. The pump made a cyclical alternating groan in the background. Hearing the noise, he asked what I was doing. I thought he would realize, not just from the noise over the phone, but because he was a new parent himself.

“I’m pumping,” I answered.

“Where? I’ll come too,”  he said.  

I was shocked.  Not sure what he had in mind, I stuttered, “Why?”  

“I haven’t worked out in a while. I can do some weights too,” he replied. He didn’t have a clue about my challenges as a breastfeeding mom, and unfortunately, some male-centric sleep guidance is similarly inadequate when it comes to addressing women’s unique needs and challenges.

Some Sleep Rules that Could Thwart Your Sleep

There are many sleep “rules” we’re told to follow in order to secure a better snooze. Take them with a grain of salt.  

“Sleep hygiene” consists of a popular set of sleep rules, with a peculiar name, in my opinion. What does sleep have to do with cleanliness? While clean bedding and good air quality are certainly key to a comfortable night’s rest, sleep hygiene as a set of behavioral rules first appeared in the book Current Concepts: The Sleep Disorders, by Dr. Peter Hauri. 

The original version of these rules came out in 1977:

• Sleep as much as needed to feel refreshed and healthy during the following day but not more. 
• A regular arousal time in the morning strengthens circadian cycling and finally leads to regular times of sleep onset.
• A steady, daily amount of exercise probably deepens sleep; occasional exercise does not necessarily improve sleep the following night.
• Occasional loud noises (e.g. aircraft flyovers) disturb sleep even in people who are not awakened by noises and cannot remember them in the morning. Sound attenuated bedrooms may help those who must sleep close to noise.
• Although excessively warm rooms disturb sleep, there is no evidence that an excessively cold room solidifies sleep.
• Hunger may disturb sleep; a light snack may help sleep.
• An occasional sleeping pill may be of some benefit but their chronic use is ineffective in most insomniacs.
• Caffeine in the evening disturbs sleep, even in those who feel it does not.
• Alcohol helps tense people fall asleep more easily but the ensuing sleep is then fragmented.
• People who feel angry and frustrated that they cannot sleep should not try harder and harder to fall asleep but turn on the light and do something different.

Today, if you Google “sleep hygiene”, 175 million results come up. The advice ranges from intuitive: “Get into your favorite sleeping position,” to questionable– “Use your bed only for sleep and sex.” Why is sex okay, but not reading? Isn’t exercise supposed to be bad at night? There’s also a range of caffeine and alcohol advice. But is the cut-off at 2, 4, or 6 hours before bed? It can be confusing and even anxiety-provoking to follow all these rules, which can of course be counterproductive.

Sleep rules don’t guarantee a better snooze

Earlier this year, when the American Academy of Sleep Medicine published the latest clinical practice guidelines, there was a collective sigh of relief over their recommendation against the use of sleep hygiene for chronic insomnia.  The opinion agreed with what most sleep clinicians have observed– that sleep hygiene alone doesn’t work. The academy added: “Clinical care devoted to sleep hygiene as a single-component approach may impact the availability of clinical care devoted to more effective…treatments.”

Here are a couple of my personal observations to add: 

Rules can add to a feeling of frustration.  

It’s frustrating when you’ve done all you’re supposed to do, but you still can’t sleep. My neighbor, Diana, is a successful entrepreneur who owns and operates a medical spa while holding a corporate position as well. Her regimented bedtime routine included getting off all electronic devices one hour before bed and donning blue-light-blocking shades to eliminate a potentially sleep-disrupting exposure. She goes to bed at the same time every night, following a half-hour of yoga and meditation. Once in bed, she tries to fall asleep under an expensive weighted blanket, a Christmas gift from her sympathetic husband. Her routine made her feel frustrated. Not only was she still bone-tired from not sleeping, she felt she had done all there was she could to combat her insomnia. She came to me at the end of her rope.   

Rules foster competition

Recently after watching the movie Space Jam, my son became interested in basketball. Obligingly, I enrolled him in a basketball class. On the first day, the coach gave him A Beginner’s Guide to Getting Started in Basketball. I found it surprisingly similar to the advice I give my patients.

1. Get into the correct gear (I.e., wear comfortable night clothes)

2. Warm up the correct way (Wind down before bed) 

3. Start jogging, cycling, or walking everyday (Daily physical activity helps better sleep)

4. Make sure to have fun (Try not to stress over a bad night) 

Sports statistics depict a measure of performance. Similarly, today’s technology has turned sleep, once intangible and mysterious, into a measurable behavior for individuals. Smartphones and watches measure sleep stats, like sleep time and deep sleep percentages from detected body movements. The data is crunched through proprietary algorithms, and flashes on the screen as sleep scores are plotted into charts and graphs, just like sports statistics. Could this be counterproductive?   

Potential competitors in the sport of sleep include bed partners, social media personalities, and purported averages presented as what’s “normal.” Sleep rules, like a playbook, are followed to a tee, as nightly success is attributed to effort or lack thereof. Competitive sleep is a slippery slope with insomnia waiting at the bottom.  

It’s true that restful sleep is the key to your competitiveness. But fundamentally, sleep is as natural as night following day. It’s as biological as the exhale following the inhale, and as necessary as the breathing that sustains life from the first cry to the last breath. Sleep is intrinsically unique from one person to the next.

Discover your sleep identity to secure a better snooze

Your best sleep is anchored in the knowledge of your own sleep identity. As Lao Tzu, the ancient Chinese philosopher and the founder of philosophical Taoism said:

“Knowing others is wisdom; knowing yourself is enlightenment.” 

Lao tzu

If you don’t know your sleep, then all the sleep rules, sleep hygiene and sleep statistics will be interpreted improperly. Without knowledge of your unique sleep personality, your sleep plan will be distorted, and likely ineffective, putting you at a disadvantage as each night begins.  

“What is your name?” and “Where are you from?” are two questions we commonly ask when meeting someone new.  We have come to understand the answers contain important pieces of information about our identity. We all know there is more to each of us than our names and where we live, but these facts offer a frame on which to hang our stories. Two equivalent questions to ask about your sleep personality are your circadian rhythm and your sleep hours.  

Circadian rhythm

Circadian rhythm is the natural rhythm of sleep in relation to the 24 hour day and night cycle and societal norms. One’s circadian rhythms can roughly be categorized as a tendency toward “early” or “late.” You may be familiar with the cliche of the early bird, or for those who favor later hours, the evening lark.  

Perhaps you know your circadian rhythm already or have a gut feeling about it. If you’re unsure, think back to the last time you were on vacation. What time did you go to bed, and when did you wake up? Being away from noise, stress, and the day-to-day grind, sleep on vacation can present in its most natural form. 

Sleep hours

The amount of sleep your body needs nightly should fall somewhere between 7 and 9 hours. Numbers outside that range can still be normal but may warrant a medical evaluation to rule out potential sleep disorders.  

If you want to be more precise, You can do an experiment called a “sleep vacation”. During a two week period, when you have a flexible schedule, pick a consistent bedtime, and don’t use an alarm to get up. For the first few days, sleep may vary as your body tries to adjust. Keep going to bed at the same time, and you’ll eventually establish a pattern that tells you the number of hours of sleep you truly need.  

In my experience, most people are familiar with their sleep identity. With varying degrees of success, we’ve been at it every night for our whole lives, after all. The problem arises when we get our sleep identity mixed up with various rules and expectations. Untangling this mess requires reinforcement of what truly matters, often with my help.  

When you know your sleep identity, the goal becomes matching your real-life sleep schedule as closely as possible. Execution can be tricky.  

What do I have to give up to secure a better snooze?

Sometimes, you need to be honest about whether you’re prioritizing ample sleep.

“I just want to have more energy to do the things I need to do,” Tiffany told me one day in between patients. A nurse practitioner with an affable bedside manner, Tiffany is a mom of three with a history of gestational diabetes. She is also a talented baker. Earlier that day, I nearly drooled on her phone when she showed me pictures of the Frozen-themed cake she made for her daughter’s first birthday.  

I immediately knew what she needed to get her energy back. I suspected she knew it too. She told me about her guilty pleasure going home to a quiet household after a long workday. It was just before the older ones got home and while her toddler took a 4-hour afternoon nap. In that time for herself, she loses track of the hours, as she researches cake recipes and responds to inquiries. Then, Baby, their youngest, wakes up.  

Will she ever get enough Zzz’s?

As it turns out, after her refreshing nap, Baby doesn’t go to bed until after 11 pm. And Tiffany forces herself to stay up late, crashing as soon as Baby goes down for the night. Then, in less than 6 hours, she drags herself out of bed at the sound of her 5 a.m. alarm.  

Tiffany knew she needed more sleep. At least an hour if not two. She used to have a lot more energy when she could sleep 7 to 8 hours before having kids, or even just before Baby came along. Yet with the knowledge and insight, she was not about to give up her “me time.”  She didn’t want to wake Baby up from her nap either, in order to get Baby to bed earlier at night. She was also hesitant to delegate Baby’s nighttime routine to her husband because she thought it was important that he had his alone time as well.  

Are you serious about securing a better snooze?

In pursuit of our best sleep, there may be sacrifices. It might be our control, beliefs, independence, me-time, or just plain time– there is no silver bullet. There’s also no right or wrong answer. Your choices will determine the best path at the time and in any given circumstances. The secret to securing a better snooze lies in following the unique blueprint that fits your goals and priorities.    

Because Tiffany chose not to give up her me-time and independence, she continued to “run on fumes” as she called it, for months after we spoke. Gradually, Baby grew out of the daily long afternoon naps. In the meantime, Tiffany, alarmed by her weight gain and mounting glucose levels, started heading to the gym after work. These changes led to an earlier bedtime and more regular sleep for the family. Tiffany’s energy level improved. 

“What about the me-time after work?”  I asked her one day. 

“Arghh…..” Tiffany expressed displeasure with the trade-off she’d made. “To make it up to myself, I stay up later on weekends and bake after Baby goes to bed,” she explained.   

The rule-follower in me was dying to bring up issues of social jet lag and total sleep deficit, but I stopped myself and nodded knowingly. Then cheekily I asked, “Got any pictures?”  

This post was brought to you by Dr. Carol Yuan-Dulair, critical care and sleep expert. Please check out her tips and program at https://www.bhaisleephealth.com/ !

Hi there! The Save Lives, Enjoy Your Own Podcast continues with an episode on doubt, and how to deal with it. Can you face down your doubts as you enter a competitive, male-dominated field?

In this episode, you’ll hear about the flavors and subtleties of doubt that can arise when you’re not entirely sure you belong in your field just yet.

I love to share the story behind the story in this podcast. This medium allows me to take you behind the scenes to hear about the things that didn’t make their way into the book. The book contains excerpts from interviews of women across various surgically-oriented specialties. Throughout the book, they share their experience and their tips to succeed in medicine, and they are pure gold.

The podcast to face down your doubt

Check out the podcast anywhere you like to stream or download. I’ve liked Apply podcasts and Overcast, and you can listen on Spotify using the embedded player below.

I would absolutely love to get more reviews. If you can find a moment to drop a favorable review, it would let me know you like what you hear, and help others to find the podcast, too! By leaving a review, you’re increasing the podcast’s clout. You can leave a review via your podcast app. Thank you so much for listening.

I hope you face down your doubts and win!

As I mentioned in the episode, you can sign up for my email list for periodic updates on ways to thrive in a male-dominated space.

If you’re raring to read the full book, Save Lives, Enjoy Your Own: Finding Your Place in Medicine, you can purchase a special signed edition here. And if you read and loved the book, please leave a review on Amazon to let others know it!

I appreciate you!

This week’s blog is a guest post from Allie Cooper, a freelance writer with a passion for financial wellness and mental health. Here’s her post on debt, and how the construct of gender affects the accumulation and management of debt in our society. Here’s her post on debt & gender equity. Enjoy! -TSH

Despite varying financial behaviors, debt between men and women is comparable in nearly all categories. For instance, men hold just $125 more in credit card debt than women as of 2019, although women have more credit card accounts than men. On average, men generally carry more debt than women: 20% more in personal loans, 16.3% more in auto loans, and 9.7% in mortgage loans. Taking all kinds of debt into account, men carry 21.7% more debt than women.

The exception is student loans. A recent study reveals that of the total $1.5 trillion student loan debt in America, women hold two-thirds. Even as evidence points to women being just as capable – if not more – at credit and debt management than men, the disparity in student loan debt persists. But the issue of educational debt involves more than just healthy financial habits: it involves systemic and cultural issues as well.

More women attend college than men

Fifty years ago, 58% of college students in the U.S. were men. By 2017, that proportion flipped, with 57% of bachelor’s degrees going to women. In today’s digital landscape, women dominate the online education space, as well, especially when it comes to higher education. According to a Business Women Media report, online learning is ideal for women. Online learning platforms remove some of the traditional constraints to attaining education, like location specificity and time constraints. It can provide a more flexible opportunity for learning.

The rise of remote learning comes at a time when many kinds of work can be performed remotely. More than ever, following the pandemic, companies are looking for flexible workers with digital literacy. Online business administration programs help learners become well-rounded professionals who can go into a variety of positions, including human resources management, accounting, operations, data analytics, and marketing. Taking these courses allow women to gain credentials, making them more appealing hires. Ultimately a wider range of opportunities increases women’s earning capacity, helping them pay off debt faster.

Women earn less than men

Unfortunately, degrees and qualifications still aren’t enough for women to achieve equity in the workforce; there’s still a considerable pay gap. A man with a bachelor’s degree still out-earns an equally credentialed woman by approximately $26,000 per year. Women in finance earn just $0.76 for every dollar a man earns. Even in jobs that employ more women than men, women are still paid less. For instance, diagnostic technicians make up two-thirds of the workforce, yet they earn $19,000 less than men every year.

The pay gap hinders women’s financial empowerment, and makes it harder for them to pay off student loans. One way to combat the pay gap is to negotiate. In a previous post, Dr. Barbara Hamilton discussed the importance of negotiation. Encouraging transparency and knowing your worth can help protect you from falling prey to the pay gap.

Reduced family support affects debt & gender equity

Financial education begins at home. Unfortunately, studies show that parents talk about money differently with their sons and daughters. In a Fast Company post, columnist Jared Lindzon highlights how 61% of boys are taught about credit scores as children, compared to only 46% of girls. He also points out how this disparate treatment extends beyond mere lessons; girls receive less money from their parents compared to boys from elementary to high school ages.

A recent survey showed that as a trend, parents save more money and are willing to spend more on their sons’ college education than on their daughters’. Indeed, these kinds of home-grown biases can impact lifelong earnings and financial health. As a result, girls tend to take on more student debt to cover their educational costs. A greater awareness around financial literacy and opportunity can help remedy these issues for girls in the future.

As society progresses, so should women’s standing within it. We need to recognize the interplay between debt & gender equity in our society. It’s only through equitable terms and opportunities that women can be more financially free.

Leave a comment below to share your own experience with educational debt, the gender gaps that persist today, or both. -Tired Superheroine

Allie Cooper is a freelance writer with a passion for financial wellness and mental health. She enjoys helping others become more financially savvy and spends her days reading about the best ways to achieve this. When she’s not working on a new piece, she’s often tending to her indoor garden.

If you’re not sure how to optimize your student loans, be sure to get your free consultation with Student Loan Planner. They’ve been a trusted resource in my online community, and have now advised on over one BILLION dollars of student loan debt. You can get more information about them and their mission by clicking here.

This is a guest post from my former medical school classmate, Dr. Yana Barbalat. She and I entered med school together as twenty-something year old sprites, and we have reconnected many years later over our love of sharing a positive message about working in our respective surgically-oriented fields. Here she is to share her own personal story. It makes my heart sing! Here’s her take on thriving in the world of urology. -Barbara Hamilton, MD

What’s it like to enter a specialty rife with dick jokes?

Tired Superheroine asked me what it’s like to be a female in the male-dominated field of urology.

It’s empowering, fun, and challenging at times. Being a female in urology makes me a minority in most professional situations and that’s a place where I happen to feel comfortable and thrive.

The origin story of a female urologist

Since I was born, I have been a minority. My family is Jewish and when I was born, we lived in Petrozavodsk, Russia. There were very few Jews, and antisemitism was rampant there. Thankfully, we immigrated to the United States by the time I was 8. As a kid in America, I found myself a minority once again, first because I did not speak any English and second, because we were poor. I dressed, looked, and sounded different which made elementary and middle school difficult, to say the least. But during those years, I built the resilience and work ethic that would serve me well.

As a young physician in residency, I was a minority once again. I had two children during residency, with the first one born two weeks into my intern year. For about five years, I was the only female surgical resident who had a family. At first, my goal was to blend in and not draw any attention to myself. I did not want to be judged poorly because I chose to have kids so early. But the reality is that residency was really difficult for me, not just because of the physical exhaustion but because of the constant mom guilt. Sometimes, I remembered an elderly lady who told me that urology was not a field for a woman with kids.

Doubts about entering the world of urology

There were many nights that I would walk the hallways in the hospital and think of switching into another field. But with the support of my husband and my parents, who never believed in feeling bad for oneself, I held on and focused on the future. I learned to sleep less, be more resilient, and feel less guilty for not being the perfect mom. Proud of what I was accomplishing, I found my voice and began to advocate for myself. I started to share my experiences with others. I told junior residents and medical students to have children when they thought the time was right, not when others felt it was appropriate. And for my own sake, I stopped feeling ashamed of working four days a week, with the fifth day OFF,  not on “administrative” duty.

Overall, I am really glad I picked urology. It’s a fun field with a lot of inappropriate humor. We use cutting-edge technology and cool gadgets- from lasers to prostate staplers, prosthetics, and robotic arms. As a woman, I bring a unique perspective to the table and I am somewhat of a wanted commodity because many female patients want to see only female physicians.

In a place to elevate & improve the world of urology

Being a woman also puts me in a position where I can advocate for women’s health in Urology. Pelvic pain, female sexuality, and recurrent urinary tract infections have traditionally been considered the less interesting topics in urology. Care of the female patient can be more time-consuming, and the visits typically don’t result in any procedures or surgeries. Adding to the challenges of caring for my female patients, the data on the management of predominantly female conditions is not robust. With more women going into urology, topics in female urology are being brought to the forefront, studied, and discussed more at meetings and events.

What are the challenges of working in a male-dominated field?

But being a minority can be lonely and can also put you at a disadvantage when negotiating equal pay and career advancement. Studies show that women in practices with other female urologists are more likely to be paid the same as their male counterparts, as compared to women with all-male partners. I think women in male-dominated fields should connect, mentor one another, and most importantly, support each other.

Hope this story of thriving in the male-dominated world of urology inspires you!

Push yourself, connect, ask for help, and don’t be afraid to be different.

I’ve been thinking a lot about worthiness. People talk about this in self-development circles, and I find it an interesting topic to explore when it comes to medical professionals like doctors. We are drawn to this service profession for different reasons. Some reasons are as unique as we are, while others are common. But my guess is when it comes to feeling worthy, you might be doing it wrong. I was. You see in medicine, many docs suffer from an arrival fallacy. We think we’ll be happy when we complete med school. Then, if that doesn’t happen, we’ll be happy when we finally get out of training. But sometimes the goalpost keeps moving, stymying our happiness. I think we do this with worthiness too. Here’s what I’ve figured out about worthiness in my medical career so far. 

Selecting for those who want to prove worthiness

Medicine selects a lot of high achievers, and there are plenty of reasons to achieve. For me, it was looking for the best way to ensure a secure position in the world, where I’d always be needed. Being able to help people in my work was an obvious bonus– I could learn to help people with my skills, giving my work a greater sense of purpose. I thought a medical career would impart a sense of social and financial security. In times of COVID-19, we learned just how insecure our positions can be. Nonetheless, I suspect medicine selects for competitive, driven folks, some of whom wish to prove themselves. And we think, when we become doctors, we’ll have arrived. We’ll be unquestionably worthy.  

Training is like cutting your teeth… on a meat tenderizer

Then, we go into training where we are beaten down a bit. We are corrected by everyone from our senior resident to the cleaning crew. I’m not exaggerating; it can be emotionally taxing. Meanwhile, we are just trying to keep up with the amount of information we must absorb and retain. Many of us don’t feel worthy at this stage. I certainly questioned my worthiness in the setting of my own training program. It was a competitive, grueling ride, and I often considered myself the dumbest one in my class. It’s an occupational hazard of surrounding yourself by smarties I guess. 

I shipped off to fellowship and on to my first job. After caring for some of the sickest transplant patients in the world, I felt like I could handle almost anything. Maybe I felt worthy. I felt grateful to land in a position at all, after a long job search in a tough job market. I felt lucky they took a chance on me. Now, it was my mission to prove my worthiness, in a new environment, with new rules.

Women’s worthiness in traditionally male spaces

Personally, I’ve noticed this worthiness question lurks under the surface. It’s sort of always there, affecting my interactions and my experience. I wonder if it’s an unexamined question for women like me, especially in male-dominated fields like mine. We have to prove we belong here: that we are just as dedicated as the guys. That we won’t take too much maternity leave. That we can be trusted and won’t have untoward complications. When we do hard things, it can tax our worthiness meter. 

Finding my worthiness

I’m working on finding my worthiness seven years after medical training. On the one hand, I know I have a tremendous worth. I save lives for heaven’s sake. And I make my bosses and the hospital plenty of money while I’m at it. I’m worth… millions or priceless or whatever. But I’ve seen physicians tie their self-worth to other people’s metrics, or other people’s expectations, and I think that’s a problem.

I lost two physician co-workers to suicide last year. Just at my institution. For one of them– the clearly intentional suicide– I wonder if his sense of worth and purpose were TOO wrapped up in his identity as a surgeon, and as he circled the final lap, preparing to hand off leadership of the program he’d built, he lost his reason to live. I think about him all the time. I wonder if our sense of self-worth makes us vulnerable to that biochemically-driven, clinical depression that can take us into a deep hole, beyond where rational explanations can save us. 

Why worthiness?

My foray into worthiness has come from delving into the semi-spiritual. Some believe we can create our biggest dreams by believing in our innate worthiness: we have a divine right to realize whatever we could imagine. It might sound far-fetched, but you can do this by believing in your worthiness. So it’s a concept worth at least exploring, whether it gets you that dream life or not. In my view, it’s worth just feeling… worth it. 

It means not questioning yourself all the time

As our kids run around the park, I chat with a gorgeous young mom, who tells me about about her days as a stay-at-home wife. Practicing my worthiness makes me more open to conversations like these. I don’t ruminate about how she cooks her kids 3 meals a day, and I could never do that. Her experience interests me. Here at the park, we are just moms. And there’s no one best way to be a mom- whether you stay at home or work outside of it.

I decided if you’re at the park having fun until dusk, you’re a good mom, and that is all. There are no organic snacks on my person; in fact, my kid is ravenous and eating all of hers. Just being with our new friends is fun. In the past, I might have ruined the moment with my sense of unworthiness. She’s a trophy wife, and no one would ever consider me that. In the past, I sometimes felt like being a doctor was my whole identity, especially when meeting someone new. I’d worry they would treat me differently, or pepper me with questions about their family’s ailments. This time, we chat about our vaccine status, and she asks, “Are you a doctor?”

I nod. “What kind?” 

“A radiologist.” 

My new friend asks what life was like in the hospital through the pandemic. Then, we move on to another topic. I am just myself, and she’s good company. I’m flexing my worthiness with all the people, and it’s a work in progress. 

You’re worth it

In my new course, I’m sharing my highest-yield lessons to succeed in a male-dominated space. It’s called Broke to Breadwinner and Beyond. This course is for women in medicine and STEM who (may) go into debt for graduate school and training, only to experience the massive learning curve that comes with earning money and figuring out what’s next. This course is about building career capital at work, so you can get the credit you deserve. Finally, it’s about setting the stage for your financial future. Get a free preview of the course by signing up right here!

Hey there! I’m so excited for Women’s History Month and our upcoming virtual SIR meeting- the Society of Interventional Radiology meeting- that I’ve been swamped! I’m speaking 4 times the week of SIR, not to mention the virtual shadowing and student-led sessions I’ve been doing. Sorry for the absence last week, it’s been a whirlwind. This week, I’m sharing an idea I’ve wanted to write about for a while: my money mindset, in a nutshell, which has to do with making it like a fun game. Gamify your money!

Really, this is parallel to my work as an interventional radiologist. Many of us who enjoy our jobs, may see some aspects of the job almost like a game. Not to trivialize how important the work is, when you’re in someone’s organs, arteries, and veins, but I’m driving where I want to go under image guidance, and it’s like a video game. This is just like finances. You need to take the time to craft some sort of vision for what you want financially, so you can navigate there. Sure, if you overthink it, it could be scary, and the stakes are sometimes high. If you screw up your investments or your taxes, you could see some real consequences. But in general, I think you’ll be more successful if you learn to gamify it. Let me explain.

1. Look at your financial future as a puzzle to solve- but one with infinite solutions.

This is what I do, and it motivates me to keep learning and looking at what other successful people are doing. That’s why learning aspects of personal finance has become fun for me. It’s so empowering to learn and implement a trick or strategy that could help my money grow.

2. Look at money as a tool for self-growth.

Did you know that our culture is imbued with a ton of baggage around money? Do you think it’s wrong to want more? Have you considered how much good you could do if you wielded more money? I adore looking at money as a means to learn more about myself, my values, my past, and my future. Money is a tool in many ways, and in this way, it’s so valuable.

Check out Dr. Bonnie Koo’s podcast. I binge-listened to it on my way to work, and I think she is absolutely killing it! Maybe it’s my feminist mindset, but her latest episodes had me riveted.

Listen to this episode on The History of Women and Money. It’s fascinating what rights women have had in ancient societies, and how recently we’ve recouped them.

3. Gamify your money

Did you know that the more you learn about money, the more fun it can be? After learning about the history of the stock market and of Vanguard in J.L. Collins’ book, Simple Path to Wealth, (I actually listened to the author himself read it on Audible), I felt really empowered. And I think you should too. Unless you’re nearing retirement, you have a relatively long time span to invest, and time works in your favor.

Now, when I look at my accounts on E*trade, seeing a green or red (gain or loss) for the day doesn’t affect me much. But I log in to see the investment there growing, and to research different ticker symbols. There’s a wealth of information there. Beyond learning, I can optimize my investments in small ways, like re-investing dividends I receive. Click on this E*trade link to get a cash bonus to help you get started with investing there. It’s user-friendly and fast! I remember decades ago how my dad had to call up his broker to place a stock order, but now you can order with a few clicks. Pretty rad.

4. Push yourself.

I did this recently by speaking at the annual White Coat Investor Conference on Physician Wellness & Financial Literacy. I synthesized the money mindset and the 5 most important money moves I credit with making it to a net worth of a million in my early career. You can see my preliminary notes as the talk came together here. What an experience and an honor to speak alongside a mentor of mine, and the godfather of personal finance bloggers, Dr. Jim Dahle. I really had to push myself to synthesize my best hacks for a broad audience of healthcare professionals.

I encourage you to flex your courage with your money. Pick an area of study, and dive in. If you’re at the beginning of your journey, read on student loan optimization or emergency funds. If you’re further along, look at the money in your accounts and the potential it holds. Realize that money lying in a low-interest checking or savings account is losing buying power every day. Investing entails some risk, but that knowledge (about inflation) certainly helped to motivate me!

By the way, you can still register for the WCI Conference, now an on-demand virtual experience, featuring hours of expert material. If you register via this link, I include personal coaching and a book bundle too!

5. What do you really want?

Think about it. What kind of impact do you want to have in your career, on your family, on your community, and in the world? Maybe it’s my recent birthday, but I’ve been thinking about the years I have left, in this one life (depending on your religious beliefs). It’s a big question, but you know yourself best.

I want to use my time and efforts to empower women to live their lives as fully as I have. And I’m going to keep pushing for more. More impact, and more empowerment. Because when women wield more money, I know the world is going to be a better place for us all.

Let me know what you think of these tips to gamify your money. And please share your own strategies in the comments below.

The next phase of my mission involves the launch of a course, The Broke to Breadwinner Method. It’s for women in medicine and the STEM fields who want to fully own their career potential, and use that to build an empire. I’m so excited. Click here to get a FREE preview module 🙂

Talk soon!

Barbara

I have some secrets to share. There are too many to list here, but I have to let you know. Even as a successful female attending, I don’t always feel that way. And in the past seven years, I have hit some bumps in the road. There’ve been moments where my reputation was in jeopardy, and my very job was at risk. This breaking-into-the-boy’s-club thing isn’t for the faint of heart, but I know you are strong enough to handle it. Here are some secrets of a successful female attending. (Shh!)

Some things I’m sure of, as a successful female attending: 

Women are not the “weaker sex.” Womanly strength has covered my local interventional service when other vulnerable people needed coverage. 

Here’s a secret: men are human too. They get sick, they break bones, they have heart attacks, and statistically, they don’t live as long! So I don’t agree when women are treated as second class citizens in the workplace. I.e., the pay gap. 

Super secret: women pull their weight. Did you know, when i went on a 10 week maternity leave, they needed to bring in multiple locum docs to cover me? It turns out I was working quite a lot, and the guys covering didn’t want to work that much.

Here’s a secret people have yet to catch onto… the benefit of living in modern times (aside from covid) include readily available childcare, house cleaners, even a spouse who works less than or more flexibly than you! I take advantage of every one of those things (don’t tell anyone). 

You know what shouldn’t be a secret anymore? 

That not all women thrive as stay at home moms. That many women are tremendously talented and driven beyond the walls of the home. It’s not 1970 anymore. Women are literally half of the talent pool. It’s no secret I’m tired of hearing about women working twice as hard for half the recognition.   

You know what’s still a secret to some? Negotiating isn’t greedy when you’re a woman. It’s a requirement. When I renegotiated my salary for the first time, I was called the G-word. Greedy. I’m serious. I survived, and so will you (if it happens, though it shouldn’t, ever).

And while I’m sharing… here are some mistakes I see y’all making.

Be honest with yourself. Do you:

1. Discount, dismiss, or forget the accolades you’ve received? (Write ‘em down!) 
2. Make yourself small for the ‘benefit’ of others?
3. Ruminate on criticism, fear, imposter syndrome, or all of the above?
4. Listen to other people’s limiting beliefs about you?
5. Think money is dirty, or something for other people to take care of? 
6. Internalize misogyny or benevolent sexism? (I have, and probably still do)
7. Overthink a lot of things?
8. Think you lack what it takes to address inequities you face? 
9. Lack self-compassion? 
10. Deny the agency that’s available to you, now and in the future?

There ya have it. These don’t need to be secrets or liabilities anymore. 

Consider this chat like the moment of “real talk” reserved for the ladies’ locker room. 

I’ve worked through some of these obstacles, and I can tell you, life is better when you do. And it can be incremental, like a work in progress. 

In the coming weeks, I’m going to introduce a brand new course offering. It’s all about building your career capital so you can build your empire. It’s a mix of career coaching and personal finance, from the perspective of a breadwinning boss. I have learned to save lives and enjoy my own, and I want that for you, too. In many ways, I’ve told you “what” you can do to empower yourself as a female physician. Now, I’ll show you how. If you’d like a sneak peek at the course with a FREE intro, click here!

Hi Friend. Every few blog posts will now be dedicated to catching you up on the podcast I’ve been working on. These are short little episodes, 5-15 minutes. You can listen on the go and get a dose of divine feminine energy with me as you walk into your male-dominated space. Here are the new episodes, which relate to chapters 1 and 2 of Save Lives, Enjoy Your Own, the book!

It’s so interesting to think about finding your people. What does that mean? I explain what I mean by it in the book, and you’ll get a taste of it here. It’s easy to think, especially in the medical and STEM fields, that your people might look a certain way. In the male-dominated fields, we see a lot of stereotypes. In my field, a typical IR is male. They might be white, Asian, or South Asian, but they’re usually not female.

Over time, I’ve come to enjoy surprising people- by smashing their expectations. I exist in my department almost as an act of defiance. It’s been a while now that I’ve felt at home there- in my office, and in that interventional suite. It might take you some time to feel at home when you are finding your place in medicine. In the book, I talk about why this matters… why not just settle on something with more regular hours, so you can get home to your family? Because the meaning of your life is greater than that found inside the confines of your home. And how do you find your people when you feel like an outsider? I share some clues you might encounter that lead you toward your people.

Basically, these are people you can get nerdy with.

I hope you enjoy a listen, and let me know if you like this new medium!

This week, in honor of National Women Physicians Day, I bring you part two of my pregnancy journey. In case you missed part one, you can read it here. As I gestated month after month, I had to figure out how maternity leave worked, and who (aside from my husband) would care for my child when I went back to work. Looking back, it’s a blessing we got through that period of change. I’m grateful that in the end, I survived human resources (HR) and natural childbirth.

Unanswerable questions like: will I retain my health insurance coverage?

I say survive because it was not a seamless experience. Please note, this is my experience with a former radiology company that no longer exists. While I was on leave, I wanted to confirm my health benefits would remain intact. Seems like an obvious “yes” over a 2-minute phone call, right? Nope. My HR contact, the head of the HR, in fact, and a mother of three herself, could not give me a straight answer. It was pretty stressful. To make matters worse, she repeatedly used the word “terminated” to refer to my employment as I transitioned to leave. “I’m not quitting,” I assured her. “I’m the breadwinner of the family. There’s no question about whether I’m coming back.” I clarified this point, hoping she’d stop talking about my termination.

But on she went. “Are you f@#&-ng kidding me, lady?” I wanted to yell at her. But she was so nice… just oblivious. She seemed to be well-meaning but some of the terms she used were just tone-deaf. She droned on about how I might need to pay for COBRA, depending on the length of my leave, though I told her the amount of time I intended to take. It was bewildering. And not comforting. My husband and my new baby would be relying on that health coverage. Not to mention me, the pregnant person, staring down the largest medical event of her life thus far. In the end, there was no interruption of my health insurance, and no need to buy expensive COBRA coverage. But there was uncertainty. 

Uncertainty meets frustration with human resources

As I prepared for my medical leave, I felt confident in my place as a valued and respected doctor in the practice. I’d pulled more than my weight in the years leading up to my pregnancy. So I was not bashful about asking, “Is there a maternity leave policy?” No. There wasn’t. A nationwide radiology practice had no parental leave policy. And I’m not talking about paid maternity leave. They didn’t have any written policy on how it would work, whether a pregnancy worker would retain her health insurance coverage during leave, for example. Apparently, I had 5 sick days to use before my state disability went into effect. I didn’t realize we even had sick days up to that moment (apparently, they are required by law). I had to figure these logistics out as I went, getting mealy-mouthed answers along the way. 

Lame excuses from human resources…

States have different pregnancy laws, and this was my former group’s excuse for not having a parental leave policy. So despite my intimations that they should create one for the next individual affected, they never bothered. As I mentioned, this company I speak of no longer exists. Maybe it wasn’t forward-thinking enough. One thing I’m sure of is that in 2021, companies are operating in a world where more women are breadwinning than ever. They must have these policies in place. And FMLA is not enough. 

FMLA is a loosely constructed federal protection, which holds a woman’s job for 12 weeks if she and her employer meet certain criteria. A company must have a certain number of employees and a worker must have worked at that company for at least a year. Well, since my radiology company had taken over from my last employer less than a year prior, I wasn’t even technically protected by FMLA. 

Thankfully (?) it’s a huge cost and pain to recruit doctors, and my job was not in jeopardy. In fact, they needed multiple locum docs to cover what I’d previously done. I’m certain that coverage cost a pretty penny. Let’s just say everyone was eager to welcome me back. 

A pleasant surprise following maternity leave

Prior to becoming a parent, I’d worried that my becoming pregnant might be a liability to my career, how I was perceived, or how I was valued. But I must say, it had a paradoxical effect. As I prepared to return from leave, my Department Chair asked me to step into a new leadership role. I became Chief of Interventional Radiology.

It goes to show that there are places that value the contributions of women, even if they don’t do everything right. This felt truly deserved, as I’d been largely leading the section through my early career. Despite that, it was certainly the largest title I’d held up to that point. So I became “mama” and “chief” in the same season. 

One thing I want to share, in case you’re planning a future pregnancy, is the concept of short term disability. If you work in certain states as an employee, you’ll automatically pay into a state disability fund. But if you don’t live in one of those states, and you’re planning a pregnancy, you should buy your own SDI policy.  

Disability Insurance

Calling pregnancy a “disability” may be objectionable to some, but it is the current manner in which pregnant workers may qualify for partial income replacement in the period surrounding pregnancy and childbirth. 

Two types of disability insurance are pertinent to the pregnant worker:  state disability insurance (SDI) and/ or a purchased short term disability insurance policy.  

No federal disability insurance or benefit is available to those giving birth or adopting at this time. 

State Disability Insurance (SDI)

Employees working in California, Hawaii, New Jersey, New York, Rhode Island, and the Commonwealth of Puerto Rico may be eligible for state disability benefits related to pregnancy and birth. In some states, this benefit is called temporary disability insurance or “TDI.” Workers in these states contribute to the state disability fund during each pay period. 

To qualify for SDI, short term disability benefits, a medical practitioner must certify a disability is present.  A pregnant worker or new mother must meet an income threshold in the year prior to qualify for state disability payments. The monetary benefit she receives will reflect a percentage of weekly pay, based on a sample period during the previous year, with a ceiling. For example, in California, the maximum weekly benefit in 2018 was approximately $1170.  There is a waiting period of 7 days before one may claim SDI benefits. Refer to your own state’s department of labor webpage for further details. 

A warning about approaching human resources!

An employer may have their own requirements for initiation of a medical leave (like taking sick days before leave is initiated).  Ideally, parental leave parameters should be outlined in the employment contract.  If not clarified at the time of contract negotiation, this kind of inquiry may be perceived as an announcement of a pregnancy.  Be prepared to clarify this point.  

Short Term Disability Policies

If a worker does not qualify for a state disability benefit, or if this benefit is insufficient, short term disability insurance may be purchased.  An employee or self-employed individual may purchase short term disability insurance for this purpose only before she becomes pregnant.  The option to purchase such a policy will usually occur during the enrollment period for other employee benefits, such as medical, dental, and life insurance plans. Speak to your benefits coordinator or human resources department to find out more about the options available.  Short term disabilities start after different amounts of time which is important to consider when purchasing if one is planning on using this for maternity leave.

For more pregnancy and post-partum resources, head to the SIR’s Pregnancy Toolkit, where you’ll find information about radiation safety, general tips and tricks from those who have been there, and other resources. 

And about the birth. More surprises!

Oh, and I mentioned that I almost had an accidental home birth! It’s true. After a week of riding waves of nausea and misery, I was feeling pretty good one night, when I had a late-night snack. I wolfed down a tuna sandwich and Sun Chips, and within the hour, they were back again. I was in labor. Specifically, a stage of labor called transition. Most women transition in the hospital. I was transitioning at home.

I could hardly speak. “Call. Thunga.” That’s all I could utter, one staccato word at a time. My husband had no clue what I was saying. I was asking him to call my colleague in anesthesia. I needed an epidural, now. A freight train was moving through me, every few minutes. I’d been trained to record the interval between contractions, but I could hardly manage this myself. My husband quickly packed the car. It was the middle of the night, and it was time. 

These were telltale signs of the onset of active labor. We made it just in time to be leisurely greeted by the staff on L&D. I was a primipara, a first-time mom, so they didn’t take me too seriously. I began bleeding as I changed into my hospital gown for the nurse to check my dilatation. My cervix was fully dilated, and they rushed me to the delivery room. My water burst with a strong contraction, as though someone had pelted me with a water balloon. It was 2 am, and I was relieved my OB made it in time to catch the birth. 

Like a force of nature

I’d hoped for a natural birth, or natural-ish. Epidurals could slow labor, I’d heard, and I didn’t want to be in labor for days. As it turns out, I was way too late for an epidural. I’d planned to bounce on an exercise ball to pass the hours. But our suitcases never made it out of the car. The power of unmedicated birth felt like a freight train. It’s a power I’ll never forget.

I’d survived human resources… and natural childbirth. 

I’m 37 years and 10 months old– an age at which I can no longer take my fertility for granted. As my three-year-old blossoms into a chatty delight, and even when he challenges me, I’m beyond grateful for him. In the first couple of years of my parenting journey, I couldn’t fathom having another child (though it seemed like anyone and everyone felt free to ask about my plans for a second kid!). I was still learning to mother the first. But lately, I want my boy to have a sibling. I’ve been thinking about my own pregnancy journey, as I contemplate going through it again. Pregnancy is not for the faint of heart!

Are you ready? 

Before we made a decision to proceed, I’d ask my husband this question: “Are you ready?” He would nervously laugh and say no. It’s not that we didn’t want to go ahead, but the thought of opening ourselves to the possibility of a pregnancy felt like jumping off a cliff. It would change everything– and are you ever really ready for that? So even though I knew he wanted a kid/ kids too, he would nervously laugh and say no, whenever I’d ask. Finally, we were as ready as we were ever going to be.

It started with a miscarriage… sort of

The first time I got pregnant, I felt pregnant. The hormones circulating in the ether weren’t quite mine. It was the feeling of progesterone. I’d felt something similar on oral contraceptives before. It was a bit of a dulled feeling, which left me just a little calmer, compared to my usual energy. My close friend who’d given birth the year prior suffered bleeding throughout her otherwise healthy pregnancy. So when I didn’t suffer any bleeding myself, I assumed we were doing well. I figured I was having a normal pregnancy. I even scanned myself at work, glimpsing the flutter of the baby’s tiny heart. Or so I thought. 

When it came to the first official ultrasound a few weeks later, all we saw was a sac with some membranes. It looked like cobwebs. The image, projected on a large flat-screen TV on the wall surprised me, and I began to cry. 

When my beta HCG didn’t fall to zero, it raised the alarm bells that something else might be going on, like a molar pregnancy. I underwent a D&C to make sure there was no retained tissue or other abnormality. In the end, there was no evidence of mole, and we chalked it up to a blighted ovum.

Pregnant again

Months later, I became pregnant again, and this time, it was smooth sailing. There was nausea but no vomiting. I was able to work pretty normally. I used an acupressure band on my wrist and chewed anti-nausea tabs. To mitigate my symptoms, I’d sit during procedures when I could, like for thyroid biopsies, as an example.

For fluoro-guided interventions, I added an extra piece of lead around my waist to double down on radiation protection. Confidentially, I got a fetal dosimeter. After the first pregnancy misfire, I wasn’t ready to announce my pregnancy to everyone just yet. 

More unexpected news: pregnancy is not for the faint of heart.

At an early ultrasound for nuchal translucency, the technologist noticed that my cervix looked short. Even as a radiologist, I didn’t realize we could catch a short cervix so early in pregnancy. And so began my high-risk pregnancy. From then on, I reported to the local high-risk OB for frequent cervical measurements, in addition to my usual prenatal appointments. I felt cared for, but concerned. Why did this happen? I had no risk factors for this condition. Would I have a pre-term baby? The thought was terrifying. 

Meanwhile, my husband had seized a golden opportunity: he signed on with a traveling jazz ensemble called Postmodern Jukebox. He would be away for 4-8 weeks at a time, for three tours during that year. It was a scary time, and I tried not to dwell on the thought that I might suddenly need an ambulance while he was on the road. Thankfully, that horrid vision never became a reality. 

High-risk pregnancy and my life

In order to reduce the risk of pre-term birth, I was placed on bed rest. I could get up and make myself a sandwich, but I was not to walk around the block. This severely restricted my activities, and I became essentially housebound.

To make matters worse, the summer in the Southwest is scorching. I’d be homebound while the temperatures soared into the one-teens, occasionally hitting 120 degrees in August. I floated in my pool, whose waters rose to over 90 degrees. I was floating in water nearly the temperature of amniotic fluid. For hours, I floated there, reading about birth and baby care. 

High-risk pregnancy and my career

Thankfully, I did not have to go on disability. At the time, I was already doing a week of teleradiology here and there. That became my gig for five months. I sat at home, reading diagnostic images. My doctors would not allow me to work in the hospital, with its long hallways, barium studies, and other procedures that would keep me on my feet. It was no longer safe.

I was so grateful to be able to continue working, as I’m not sure how I’d have managed otherwise, mentally and emotionally. The structure work made me feel I was still contributing to the practice, rather than a burden on anyone. Who knows who I’d be a burden on, but I think it’s just human nature or doctor-nature to think that way. 

As I dictated hour after hour, I imagined my little baby was listening to me, getting smarter, or at least learning the sound of my voice. While other women fretted about going into labor in the operating room or in front of a patient, here I was, sitting at home at a pretty early stage of pregnancy. For someone so used to living at the hospital much of the time, it felt strange! 

Supporting pregnant employees is probably not for the faint of heart either

I will say, everyone at my (former) company was extremely supportive of the high-risk nature of the pregnancy. They had no maternity leave policy, but that’s a story for another day. 

I’m so thankful I was able to keep working in a telehealth capacity. If I’d needed to take a longer period of disability, I suppose my long-term disability insurance may have kicked in. I’m not sure. 

In the end, I got steroid shots just in case baby was premature. I was elated to make it out of the 20-29 week stage and into the thirties, where baby would have a fighting chance. Doing what I was told, with medications and precautions, we made it to 38 weeks and zero days. He was perfect, and I got my greatest wish: avoiding the NICU. 

Pregnancy is not for the faint of heart

That last week of pregnancy was tough. I suffered waves of severe nausea so strong, I presented to my OB and broke down crying. Previously wanting to try natural childbirth methods, I sobbed, “If this is what birth is like, please put me OUT. I can’t take it!” 

She sweetly smiled with a glimmer in her eye and told me, “That means he’s coming soon.” 

I worked from home through that week, taking an hour off here or there as needed. 

The pregnancy experience is really what you make of it. In many ways, I was tremendously supported, and other times, I was disappointed by my experience. It was anxiety-provoking and lonely. I was a prisoner on house arrest, in my gilded cage. But would I do it again??

Tune in for part 2, and I’ll share how I nearly gave birth at home. By accident. 

Is that TMI? Maybe. But I’m betting some of you might wonder what the gestating journey can look like in a surgically-oriented field like IR. No matter who you are or what you do for a living, pregnancy is not for the faint of heart!

xo

By the way, if you want to hear from me weekly, make sure to jump on my mailing list. I’ll share all the gems I’ve learned in my first 7 years in practice, and show you how to slay in a male-dominated field.