153. How to Build a Sustainable Life in Medicine

We have to reclaim our identity beyond our work, beyond our role as a physician and connect with our needs, our rhythms, our desires, that life that we want to live. And ask, who am I when I am well rested?

Are you a woman in medicine, feeling overwhelmed and disconnected from the personal fulfillment that you desire? You're in the right place. Join doctors Joanne and Erin as they rewrite the rules for women in medicine. Let's begin.

Everyone talks about burnout, yet only a few of us are talking about the what's next? I'm excited to interview my co host, Dr. Joanne Sotelo, physician coach. And we're going to be talking about what does it take to create a sustainable life. Joanne, I'm so excited to dive into this topic and first of all, I would love for you to even define what does it even mean to be sustainable.

Thank you, Erin. And I'll start with what it's not. We're not going to be talking about spa days or it's not about doing less. It's not about being lazy or lowering standards, even though there's space for that. But when we talk about sustainable living, we talk about how are we aligned with our energy in this season of our life rather than against this, which is kind of where we're always saying so often, I'm so tired, I'm exhausted. Those are words I hear so often with the women in medicine I'm coaching. It's being a woman who knows her boundaries and acts on them, keeps them, protects them. It's figuring out how to be restless as a lifestyle rather than when it becomes kind of that, that emergencies in survival that we often get into. It's finding support with Erin and I talk so much about in terms of community or one on one if, if we need to. I like to think about it also, like one of our coaches, doctor, she's not a doctor. Lauren lahaven. Like, she talks so much about, if I say yes to this, will I stay true to myself? And I use that in terms of like a filter when I'm making decisions because it's not about can I do this or not, would I be good at this or not? But will it keep me in alignment with what's important for me right now? Right. Like I always say in this season of our lives, it's about keeping our peace, whatever that means to you. I know that a lot of us want more peace. I think that's something that we need to hear more as women in medicine is choosing a pace that you can maintain for a long time because we're so used to just going, going, going, more patience, more work, saying yes to all the things, staying late. And it's not about necessarily cutting it all off. It's then just saying, okay, what's kind of like if you're training for a marathon, it's not just about how fast can you go, but that long distance to keep it sustainable. We have to find that pace where our heart rate is under control and we're not in pain. So it's the same thing in our lives. And then defining that life that honors that true self, your humanity beyond productivity. And this is so important because, like you mentioned opening the episode, we talk about burnout, and we love talking about what to do if you're in burnout, what to do if you're getting there, what to do right after. But it's what we're talking today is how to go beyond that so that we can. It's like sustained, practicing better, thinking clearer, feeling more confident, more energetic. All those things that we want versus when it's just survival mode and we're in burnout, that then we just say, oh, I just need to take time off, I need a vacation. I need to just cut things out. And using whatever you've struggled with. It doesn't need to be burnout. But we've all had times when we're super high stress. We've all had times when we're in that overwhelm and then go back and use it also as information of, where did I start abandoning myself? What are some of the things that I can get back to? Where have I. I think this is a phrase that Erin uses over function. Where were we multitasking when we know that that's not good? Where did we set boundaries and then they. We let them get dissolved or not accepted. And. And then how is our identity tied to how much we're doing versus our identity tied to how we feel, our overall well being, mentally, emotional, physically. And that's where then designing a sustainable life should be. I gave you a very long answer.

Well, and to me, it almost sounds like you're saying it may be possible for our listener to create a life that's burnout proof or more burnout proof?

I don't.

I mean, these days in medicine, I. I don't think that there's any guarantees, but wouldn't that be amazing to have a life that is much more able to be burnout proof, or you can be burnout proof in more circumstances than is typical, which, when we talk about those rates being 50% plus or minus for the last several years, especially for women in medic, pretty significant. Okay, so designing a sustainable life. So the next part is you've alluded a little bit to this, but why is it so imperative for women in medicine to design a sustainable life?

Some of the things that I'm going to say we've talked about before because it's kind of the root of a lot of the things that we talk about in this podcast. But I want to start with the belief we need to believe that this is possible. Please listen to that. You need to believe that having the life that you want that's sustainable is possible for you. It might not be overnight, you might need to make big decisions, but it is possible to have a life where we feel we're working hard, we're doing. It's not like you have to retire or like go on a six month sabbatical or vacation. You can still practice medicine, do other things that you want and still think of am I staying true to myself? Am I in alignment with my values and what's important to me right now and am I making decisions on a regular basis that supports that life that I want? So again, believe, we need to believe that that's possible. And I'm talking to myself as well because sometimes I like, I say these things and I'm like, oh yes, but I'm building a new practice right now so I don't have time for that and I have to be like, think about that again. Or I'm thinking, oh, when you know, I'll be an empty nester next year. So maybe next year my youngest graduates. Like yes. And are there things that you can start adding right now? Because some of the things that we've talked about that as women in medicine we struggle with is of course we're very busy. That double burden that we talk about, that we're busy at work, we're say yes to all the things and then we come home and, and we are like that second shift that we talk about. There's a social conditioning that we from our hearts, it's a beautiful thing. But we tend to say yes, we are caretakers, we want to be helpful, we're more flexible, we're more agreeable. Again, it's a beautiful thing, but it can lead to that chronic over functioning or feeling guilty about saying no. The perfectionism that we talk about. There's also something that I like to talk about which is the kind of that identity part that comes like our worth comes from all the things that we do of being needed, of having all these skills being available, but at times self sacrificing. And it's okay for part of your sense of self coming through that I know that, you know, that's part of a driver for me. And we also have to say and how is this getting in the way of other things that I need to do for myself or other big decisions that I'm making right now? So being careful there, it's not black and white. We just need to be very aware. Of course we've talked about how. Right. Like the gender changes. We don't always like to make it black or white in that sense, but it is different. Right. Like men don't have pregnancies. Right. Like it literally. Right. Like childbearing. I don't know how say that in a nicer way. And it's not a hundred percent like this. But a lot of women have more of the caregiving roles. Some of us are a little bit older. We've. We're out of the taking care of young kids and now we're taking care of elderly parents. I know that that's a big part of my drain in terms of not just time but energy mental and emotionally. So usually those still at this stage and right. We might, we might want to say it's different but if we look at statistics, a lot of these roles still fall to women. And we've been also programmed to ignore our needs. We don't always know when we're hungry, when we're tired, when we're fatigued. We just keep on pushing. And we need to get back to our emotions, how it feels in our bodies and taking care of even our basic needs. This is the foundation for that sustainable, more invigorating life that we want to live. That's more in harmony, that's more fulfilling, that it's bringing us more joy. And it is possible, I go back to that belief that we all, including us, need to believe a little bit more.

That's so powerful. And when you talk about we are so good at ignoring our own bodies and our own basic needs. And as a healthcare provider, as a woman physician, you may still need to ignore those things sometimes. And I wonder how can we be better at tapping into those when it's not necessary? If you're a surgeon and you're in the or, you might need to ignore your basic needs. But when you're at home with your family, how can you eat a meal when you should stay hydrated? So some of it is being able to switch. I Think between doctor mode, healthcare provider mode, and I'm not in that mode right now, when I'm at home or when I'm on vacation or time off, can somebody else step into that? And it can be really uncomfortable to not take that lead role, to sit back and go, who else can do this? And yet with practice, we can make it happen. So, Joanne, you're so good about sharing. What can we do to make a more sustainable life, even when we have such a demanding career?

And the first step is similar to what you were just saying. We have to reclaim our identity beyond our work, beyond our role as a physician, and really connect with our needs, our rhythms, our desires, that life that we want to live. And like I always say, we need to figure out what are better questions to ask ourselves. So instead of asking, can I do this? Can I do this? Well, can I do more? Because the answer is going to be yes. But rather, what if we ask ourself, who am I when I am well rested? What do I no longer want to tolerate? Where do I need to set a better boundary? How do I want to feel in my daily life? Yes, we can choose how we want to feel. Again, it might not be a hundred percent, but if we have that intention ahead of time, it's more likely that we're going to feel brighter, calmer, with more energy, more joyful, rather than the automatic stress and tired that so many of us feel. So that's the first one. The second one, it's, again, audit your energy leaks. I love using the analogy of energy being like a gas tank in a car, if I'm saying that correctly. And there's things that, right, like we pour and then we use and we pour and we use, and every now and then, the tank might go sideways and more leaks out, and then there's things that poke holes in that tank. So it doesn't matter how much you're pouring in, you're not gonna feel full. So that's work that's very important for you to kind of figure out. And some things are inevitable. And maybe just for a time being, I was sharing with Erin before we started recording that my younger son was playing lacrosse and broke one of the ligaments in his knee. And now he's going to need surgery. So I. I have to reset my schedule. And I know that I'm going to be spending a lot of time with him and I'm worrying about it, and. Right. Like, that's an energy leak, which is appropriate. But if I just keep on worrying, worrying, worrying, about it. And then I start worrying about other things. That's something that I might be able to look at and kind of try to figure out how to not make it that much of a leak. But then we have people who are energy vampires. We have other things that we say yes to out of guilt. We have all this pressure of how we want to show up at work. We're trying to meet all the external expectations and all the internal expectations. And some you might want to keep, but some things might be worth really editing and then saying, is this something that I need to do? Or can someone else do it and delegate or just completely eliminate it? So choose. Create that energy inventory for yourself and be honest with what really needs to stay. And that it's not just your to do list, but considering also the mental and emotional drains. So that's the second one. The third one is to have systems that support you. And Erin talks about this a lot in a beautiful way of are there things that you can pay for to help you? Are there things that you can do to avoid the decision fatigue that you can plan ahead of time or get more organized so there's not that external chaos that drains us emotionally? So those are all really helpful. Like, I love Instacart. I hope if you have Instacart where you live, use it. It's okay if the avocados are not perfect. You save time and energy.

Yeah. I don't know if I'll ever walk into a Costco ever again because of Instacart. Such a time and energy saver. Absolutely.

I cannot remember the last time I went to Costco. And then. Right. Like, Erin does this very well too, of having time either Sunday night or Monday morning where you set and you get organized and you get your planner and. And you figure out your week. And it's things that we sometimes minimize. But the accumulation of all these details can create such a big change in your life and how you feel. And. And again, I'm always about saving energy, not just physically, but mental and emotional. And then talking about that the next step is protect your peace with boundaries. And I can go on. On a million tangents here. So I'm just gonna say it because we've talked about Boundari much. Figure out where you need them and set them. Contrary to what we read, I don't believe that all of them need to be set out loud. There's boundaries that you can set internally. We were recently talking about the holidays and I like if it's Thanksgiving dinner or Christmas or New Year's and there's a conversation that you don't want to be in, get up and go help at the kitchen. You don't need to make a statement about it if you don't want to, but those are boundaries to that. Protect your energies to protect what's important. And then always I'll finish with the one that we finish with so often, which is let's have community. Let's have that support that we need. We're not alone in a lot of this struggle. So it's important for us to talk about this and kind of integrate all of these things that we're talking about, to allow yourself into this identity shift, which is what I was saying earlier of really believing this is a life that I can have and not being so attached to our definition of success and worth through work, but rather that's important and what else do we want? And that's, I think, a lot that we can do. But if we. Even if we just pick a detail here and there and we start creating shifts, your life will follow and you'll start feeling better and then celebrate it so it wires in your brain and then you can live that fulfilling life in a sustainable way.

So good. I love that, Joanne. And Joanne, I'm just going to pull a few highlights from all of my notes here. What a powerful session we've had here. And you shared that sustainability is about choosing a pace that fits this season in your life and we can't sprint for the marathon. You shared that it's important for women in medicine because we are conditioned to ignore our basic needs, our own bodily functions, and we need to maybe work a little harder than the average person to reconnect with who we are, especially outside of our chosen career. And lastly, some of the things we can do. Some of my favorite takeaways are, number one, believing that it's possible to have a more sustainable, enjoyable life and asking better questions. You always challenge us to do that, like, who am I when I'm well rested, putting systems and support in place and always that leaning on your community. So beautifully said with that, we can't wait to see you in the next episode. And if you think this episode would be helpful for somebody you know, don't forget to share it. And that way we can get in front of more women in medicine who might be wanting to create their own more sustainable life. We'll see you in the next episode.

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