Sex Myths and Quickies with Dr. Heather Bartos

I remember my last delivery was a stat C section on a Wednesday night. And I kind of had this, you know, I'm kind of a drama queen. And I had this moment. I was like, going to make this speech about, you know, I've delivered 5,000 babies and this is the one. And. And as I was kind of sewing her up and getting all done, there was another stat C section next door. And the whole room left. It went to the other room. And I was like, okay, well, hi.

Everybody, and welcome to the podcast. This is Generations md. My name is Stephan Evening, and I'm joined here by my colleague, Dr. Sarah Davis, who's also my mother. And today we have a very special.

Guest, Dr. Heather Bartos. She's a board certified OB GYN and the author of the book Quickies. And she will tell you a little bit more. But welcome, Heather Bartos.

Thank you for having me. I am really excited. This is very cool. This multi generational kind of. Although, Sarah, you don't look old enough to have a daughter in medical school.

You're very sweet.

You must have been like 16 when you had her, right?

Definitely.

Well, and I just found out. Stephanie and I just found out that we were co. We both went or she's going. And I went to UT Houston, which is now McGovern Medical School. So small world, right?

Yeah. So tell us, starting from before then, why did you decide to go to medical school school and be a doctor? How did you end up at the school I'm now at here in Houston?

Well, it really starts with a. A pink paintball pellet. I started off in public relations and marketing. That was my first career. And I shot my boss at a company event in the genitals with a pink paintball pellet. And I got fired. Oh, my God. Yeah, apparently that's kind of frowned upon. It was the 90s, a different time. And so I kind of went back home not knowing what to do, and I lived. I grew up in Houston, and I started working in the med center doing diversity and community relations for Texas Children's and Methodist Hospital and some of the bigger hospital systems. And then I met with so many doctors, I decided one day, you know what? I think I would like to do this as my life. And so at 28, I was the oldest woman in my med school class. There were guys in their 40s, but I was the oldest woman at 28. I know. Ancient, right? And so that's how. That's how I got in my class. And I loved UT Houston. Now McGovern I can't get used to the McGovern yet. But we had a very varied class. We had a lot of people that were. Had previous careers. We had a guy in our class that was a butcher in a past life. So his anatomy processions were fire. Like, he was like, this right here would be a flank steak. This would be. You know, it's kind of gross. But we had a lot of former military Apache helicopter pilots, all kinds. And I loved that about UT Houston because it just really had kind of a rich quilting of different personalities.

Yeah, that's so interesting. Wait, and so when you decide you want to be a doctor, then did you have to go back and do all the prereqs for med school?

I did some. So I did some at University of Houston, and I had some from college. So I kind of patchworked it together. And my dad always joked, he goes, just wake up and decide to go to medical school one day. I was like, I guess, kind of like, I did like. I don't know. I really wasn't sure I would get in, and I got in, and I think it was a great fit for me. And from there on out, it was like they say, you know, the rest is herstory. And I loved Houston. I loved training in Houston. There's just nothing like the Texas Medical center to get your teeth wet and everything. I worked with DeBakey. I worked with Cooley. I knew I. Right then and then I did not want to be a cardiothoracic surgeon ever. There were some big names in the med center at that time. There still are. And so I really. I really liked these kind of heroes and medicine. And so I just. I. It was. I never stopped loving it.

Yeah, talk of. I mean, I want to hear about. You mentioned just being the oldest woman in your class. What were some challenges that that brought up? And then also, how did that. How do you think that impacted maybe your specialty choice or just your experience through medical school?

Yeah, I. I always said I really thought it was a good thing. I. I mean, I kind of think that now gap years are cool and everyone takes off time, and I think that's great. Back then, it was very odd. In fact, Southwestern and all the other med schools in Texas really didn't look favorably on people that had other careers. It was really, really a Houston vibe. And, you know, I think it really helped me. One, because I'd had a job. I knew what a W2 was, so I could manage my time, I could manage my money. I remember there was a young I'll call it a kid. Because he was like, 22 and he had no. Maybe he was 20. He'd gone from this Johns Hopkins program right into med school. Like, I think he skipped his last year. And he was so green, so fresh. He had no idea about anything in life. He just kind of like his parents dropped him off off at the front door with a lunchbox and there he was. And I remember thinking, wow, that's great. He's young. He's going to have this long career in medicine. And the first day of gynecology, the resident, you know, we were watching kind of a well woman, and he had never even probably heard the word vagina before and freaked out, fell over a trash can. And the resident, who was a man, the resident kicked him out of the room. And I thought. And that's where the experience will benefit me because that really freaked me out. Like, I was cool with whatever.

Yeah, I mean, I think that is true. And I. It's hard to even, like, quantify it versus age, because I do see people that are coming in straight from med or straight from college into medical school that, you know, are a little bit more mature and experienced. And I've seen people who have taken gap years who, you know, maybe aren't, but I think in general now it is more favorable to take a couple years in between just to kind of figure some things out.

Yeah, I think now they see it as you're a little more committed if you have, you know, done something else and you decide you really, really wanted to be a doctor, which it sounds like. It sounds like you did.

Well, I don't know. I really. I'm thinking about, did it influence my choice of specialty? I really went in wanting to be a pediatric infectious disease specialist because at that time. I know, weird. But the president of Texas Children's and the president of Baylor at that time was Ralph Feigen, who was the king of all pediatric infectious disease. And I'd worked with him some, and I just thought it was cool. It sounded like House, like it was very. And Sarah, remember, this is back in time when er like all that was really sexy and big and, you know, and. And I thought, this will be out to cure diseases and figure out baby osis and these weird things. And then I was in pediatrics and I was sick the entire time. I had everything. The worst immune system for that job. And a gynecologist came to our class. I don't know if she's still there or not. And I'm trying to think of Her. I know her name was Michelle. I can't think of what her last name was. And she was talking about ob GYN and how it kind of spanned a woman's life and how we did everything. We did medicine, we did surgery, we did all the things, and she was just cool. I remember thinking, that sounds fun. And I was a third year medical student at Ben Thomas, and we had to go change the dressings on the people that had the 40s gangrene. So, like, they were like, just, you know, nothing but, like, flesh down in the genitals. And. And the men would sit there and cry. This is 4am Right? We would do this. Men would cry and scream and all this. And the women would just grit their teeth and they would be sweating, but they would just take it. I go, women are better patients. We're better patients. I can't deal with the crying. And that's why I think I decided that women's health was kind of like my. My area. I liked. I liked dealing with women.

Yeah. I was just talking to one of my friends who wants to ob gyn, and she was like, honestly, I think I just never want to see a male patient again. I was like, all right, but tell me a little bit about how you got into the. The women's health advocacy and that aspect of things. Like, now you've. You've chosen that you want to be an ob gyn. What does it look like from there?

You know, it's. It's. You know, this was 30 years ago, so it has changed a bit. You wouldn't think that the field has changed. And really, I always say now that ob GYN is like two separate fields. It's kind of like hematology, oncology. Why are they together? Yeah, they're in. There's so much medicine in each of those specialties that you really could just be an OB or just be a gynecologist. And same with hematology. Right. I mean, there's people that. I'm like, how do you do all that? How you do all the cancers and all the blood diseases? And so I think part of it was. Was in the beginning, you do a lot of OB when you're young and you're up all night and this is exciting and all this. And it was really advocating for pregnancy changes. And I was in the military, so the military paid for my medical school. So after I graduated from Baylor for my residency, I went right into the military. And just seeing young women get, you know, in these. These families grow, I thought was really, really exciting. And you know, things have changed in Texas and the country since then with regards to obstetrics. It's a really poorly reimbursed field. I remember when I first moved to Texas after getting out of the military, the reimbursement for an entire pregnancy, an entire pregnancy delivery and postpartum for, for Aetna. I'll say that they can hear. This was seventeen hundred dollars. And I remember thinking that the anesthesiologist made seventeen hundred dollars for the one time epidural.

Yep.

And I thought, this is kind of crap. And it's never, never increased. I got out of obstetrics three years ago and it had never increased. And I thought, you want me to be on call and usher these women through all of this, be up all night, miss family events? And, and that's what we value women at, is, is that. And, and by saying that's what we value OB at, that's what we value women as patients at. But we know that women are the primary decision makers in healthcare. They're the ones that are inside everything for the family. And so I think kind of as I grew up and grew older, I liked going along with an older population. I, I now solely deal with perimenopause and menopause. And I saw that as a need when I remember looking out to the waiting room and I was solo for my last three years. And so I would leave to go deliver baby, come back, leave to go do something, come back. And this woman that was 40 in the waiting room was just sitting there waiting, probably thinking, this has nothing to do with me. I'm not in this field of my life. And I thought that poor woman and myself as a patient, like obstetrics is for the young. Like you go to the OB GYN's office and there's and Getty's pictures of babies and pots of flowers on their heads. And it's very much that. And I was an infertility patient myself too. And I thought, we're not really getting all the women that need to be gotten. And so really it came down to women's health advocacy for every woman. And now I really pretty much deal with women 35, 40 plus, because it was a missing niche. We weren't getting those women. You were forgotten. Once you were no longer fertile or once you couldn't reproduce, you were forgotten. And so I think that's kind of where my health advocacy has kind of ended up now. Maybe when I another 20 years and I'm, you know, 30, I might be like, hey, you know what? I'm worried about these geriatric women that aren't getting what they need. But I think that's how we grow as doctors, as we grow with our patients. You know, the patients got younger and younger to deliver. And I was like, I could be your grandmother. So I really like kind of growing with people. And I don't know, Stephanie, what field you're thinking about, but I like the idea that I can grow with my patients and I can share things with. Oh, when I went through this, I had this, you know, and to me, that's. That's half the battle of women's health, is giving someone someone to listen to. And I know, Sarah, you're great at this because I. I hear everyone talk about it that we have to be listened to. There's a lot of gaslighting of women in medicine, a lot of patriarchal views of women in medicine, and. And that's gotta stop.

Yeah. I mean, I think it's so important to, like, hear about careers, like years where you have been dynamic, I think, like, in the stage that I'm at. And a lot of our listeners, you know, when they're thinking about their career, they're thinking about being an OB gyn and then they go shadow the OB GYN at the big academic institution. And they're only seeing this one aspect of things and not seeing how flexible it can be and how you've grown into finding this niche and this population that you really care about and how you're also open to. Maybe that's going to change in a couple years. That's refreshing for somebody in my position to hear.

Yeah, I do think it's really great how you've managed to kind of tailor your practice. I mean, do you think that if somebody is going into OB GYN now, I remember hearing that that really, like, you couldn't just do just gynecology. It would be too hard to build up your practice, limiting it like that. Do you think that's still the case? That you really got to start with a lot of OB and a whole lot of patients before you can tailor your practice?

You know, I think there's a. There's a blend there. I certainly. Most people, you train more in OB than you do in gynecology. You know, we get, I think, about two minutes of menopause training as medical students and probably an hour of fertility training. So you just don't get a lot of access to those. Those subspecialties. Even urogynecology is limited. And I think that when, when you get out, you're comfortable with ob, it's what you're kind of used to. And you're young, you can do those hours. You can. You can bounce back after you have a couple kids and you're like, maybe 40, and you're like, this is hard on the body. And if you don't recognize that, that's when the burnout starts to happen. I had a friend who very successfully went straight into gynecology. She did a minimally invasive fellowship for a year. She actually did it at Methodist, Ben Taub. And she worked as an attending, you know, during that time. And then she went on her own and did just gynecology and gynecologic surgery. And I think there is this shift now. A lot of people are choosing to just be a hospitalist for ob, and that's what they want to do, a laborist. And they work eight, you know, like an ER doctor. They work eight, nine shifts a month. And then when they leave, they walk out the door. To me, that misses a little bit of why, though. I chose to go into that field which was kind of taking women kind of from cradle to grave. But I think for. To, for the sake of the field, we're going to have to do something because the reimbursement is not there. The malpractice is very, very high in OB gyn. The hours are crazy high. And the respect, honestly, among even peers, can be kind of lower. We're kind of looked down on by a lot of specialties. We're not really a surgeon. We're not really a primary care. We're not really anything. And so I think special splitting it up, and this was said probably 10 or 15 years ago, eventually they'll just be laborists. There'll be people that see people in clinic for ob, and there'll be gynecologic, gynecologic surgeons. And. And that might be the way it's going to be in big cities. I think in small cities, there's a lot of care deserts where there are no OB GYNs. Idaho lost, gosh, almost all of their OB GYNs due to changes in. In the kind of the conception laws. And so there's a lot of places women don't have access to anything. And so I think those rural doctors still do everything. But I think in the bigger cities, you're finding people are starting to kind of split into little niches here and there.

Well, and then are people able to then jump from one to the other or do you think? Or do people just do one and then, I don't know, just keep doing that until they can't do anything anymore?

Yeah. It's funny, when I was still doing ob, you know, I was up in Frisco and all the hospitalists were mostly people that were 55 plus. They had had practices. They didn't want to deal with the practice anymore. They didn't want to deal with all that. They wanted to come in, do their job, and they wanted to go. And so most of them were older, they were more experienced doctors. I think it'd be hard for a fresh out of residency doctor to have that experience, to know when to do things. In some ways, I mean, I guess internal medicine's done the same thing, Sarah. Like, the hospitalists kind of take care of you in the hospital and then you go back to your internist when you're done. It would be hard. You could go back and train back in, in surgery and everything, but I think most of the time you kind of guess get used to what you've been doing.

Yeah, I guess just talking about the hours of being in OB GYN and the, the realistic life of what that looks like and you know why it's kind of being pushed to separate into these different niches? Because, like, you guys work so hard. What did that look like, fresh out of medical school, like past residency in your life and how you mentioned your journey, having kids? What did, what did that look like?

Yeah, I mean, I got out of residency and I went right into the military. And so I was in a small military hospital in Charleston, South Carolina.

Oh, I went to Crimson. So I was right over there. Yeah.

See, our paths are crossing a whole bunch here. And. And I think it was, it was, it was hard because I was either pre call, on call, or post call. There were three of us, so. And then if someone was on vacation, you were on call every other night. This is back when we had pagers. Remember these days? Yes, yes, pagers. And you answered every call all night long. There was no one to triage that. Nowadays a lot of people have nurse lines and things to kind of say, hey, go to the hospital, do whatever. But we answered every call. I remember getting a call at 2 in the morning from a. From a guy who was trying to help his wife pack for their induction two nights later. And it was two in the morning and he was calling me and waking me up and, and I could tolerate that. Then after a couple years, it started to get really, really, really bitter because you're just Working, I mean, you're never. The pager was never done. Like, it was always going off. And when I went into private practice, when I got out of the military, it was corporate medicine. I know. Shame, shame, bad word. It was all about how much you could produce. It really wasn't eat what you kill. And they would actually print on our quarterly meetings everyone's RV use. That was a new term then. It was about 15 years ago, RVUs up on the board, and they would shame the bottom quarter of who had the lowest RVUs. And this is kind of crazy. Like, this is crazy. And I got pneumonia six months after my second child was born. I went back to work two weeks after he was born. I'd had a hematoma, so I had to have surgery. I had a hemoglobin of 5. Went back to work two weeks later, six months later, got pneumonia. They couldn't figure out what was wrong. I ended up having a PICC line with VANC running for a month. And I went back to work a week after. I mean, I was in the hospital for a week. I went out of the hospital, went back to work the next day with a. With. With bank in my back scrub pocket. Because it just wasn't. It was. If you didn't work, you didn't eat. Like that was it. There was no sense of, oh, take some time off or any of that kind of thing. It was just. It was very much. It was a puppy mill of work. And I remember one month I delivered like 50 women and I realized I didn't know anyone's names. I didn't have any idea who I was delivering. I always like to know the baby's name, the dad's, I mean, the whole works. I knew no one's names. I was just basically a walking zombie. And that's when I left and started my own practice. And that's been 12 years ago. And that was hard, though. I've done all of it. All of it. All the different areas in my own practice was great. I was the boss. Like, it's not how we did things, but the pressure was on, you know, like, are you going to be able to pay everyone's bills? Are you going to be able to do everything? So it's. It's kind of interesting about hours. The hours were there all the time, but they just changed what they were.

Yeah, yeah.

Not to scare anyone off.

Yeah, no, it just. It. I mean, but it's. It's true. And it's. What happened with you and how did you have other Support. How were you able to be able to have kids and have a newborn and keep and working all the time? What. What did that look like?

Yeah, my kids are two and a half years apart. And I had six IVFs to get my two kids. So I went through six IVF cycles while working full time. And I would say, I. I don't really remember how I made it through. I just remember I might have my Last one at 41. And I remember thinking, after my pneumonia, this is how I'm going to die. Like, I was so exhausted and I. There was nothing left. Like, I had nothing deplete. Everything was gone. And when I started to kind of get more into some spiritual and energetic medicine, then at that point, because I was trying to figure out how to fix myself, I was like, I need to figure out something. So I was, you know, trying all these different things, thought about going back to getting acupuncture license. I mean, what was going to work? Because if I wasn't, I was not going to be the only one feeling this way. Everyone was going to be feeling this way at some way. And I still tell women, they go, I'm 42 and this is. I go, yep, there is a year in your 40s where you just want to go away and you don't want to come back. So I always say, like, that year probably was there to then help me usher in the next generation women that I need to usher in. So I was going to say, everything's a lesson. But I guess it was grit. Grit. UT Houston grit. That's what UT Houston students were good at. Pure grit that I just, like, stomached my way through it, and I don't think I could do it again. And When I hit 50, I realized I cannot be up all night delivering babies and be a nice human being that knows what they're doing the next day. Like, I just, I was like, I can't. I can't do it. I can't do it. And there's plenty of obstacle ever babies that, you know, gosh, you probably have attendings over there that are probably in their 70s or 80s. But I was like, it's not for me. Not for me. If I'm going to be in this, the long run, I need to adapt. And that's, I think the biggest message is you have to be able to adapt to what works for you.

Well, is what you're doing now, have you finally found something that has a little more balance and peace?

Yeah, I mean, I really, really do. And I loved every step of my career, I loved doing military medicine. And military medicine is really. It's kind of. I know people make a. Make fun of it, but it really is kind of if. If socialized medicine was perfect, it'd be military medicine. If I needed an mri, I got it. If I needed your drugs, they're right over there. Go pick them up for free. It was really, really eye opening. And, you know, we didn't have crazy schedules. You know, we had. We saw maybe. Maybe 20 patients a day at the most. It was great. And corporate medicine taught me all the things I did not want in medicine. I did not want a puppy meal. People love that. I don't. And there's still. Many of my friends are like, Oh, I saw 55 patients today. Did you pee? Did you eat? Did you breathe? I don't. I don't know how that's even possible. I like to talk to my patients. And so I think, finally, I found when I gave up ob. It's a hard choice, by the way, to give that up. It's like to say, I'm retiring out of ob. It's. It's hard. I remember my last delivery was a stat C section on a Wednesday night, and I kind of had this. You know, I'm kind of a drama queen. And I had this moment. I was, like, gonna make this speech about, you know, I've delivered 5,000 babies, and this is the one. And. And as I was kind of sewing her up and getting all done, there was another stat C section next door, and the whole room left. It went to the other room, and I was like, okay, well, I'll take my leave now. And I kind of walked out the ER entrance to my car, and I. You know, I was like, no. No one gave any. No one cared. My dramatic moment was. Was kind of gone. And. And I mean the same thing. When I gave up surgery, you know, I was like, I don't love doing surgery anymore. It's. I had a couple complications and surgeries years before, and it just never sat well with me. And I could do them. I was a good surgeon, but I didn't love doing it. People that love doing surgery. And I was like, what do I. I love working with women, talking through their issues. I don't want to shut them out the door in five minutes. I mean, Sarah, you and I have a very similar mindset about this with. With our practices, as. I like to know everybody, and I like to know what your kids are doing and what your dog's name is, and. And so I Think finally. It's been a while, but I finally have found I sleep at night. Oh, my gosh. Sleep is so, so amazing, y'. All. I mean, for years I didn't sleep. Sleep is so great. And being around my kids. My kids are 12 and 15 teens. So being around them for that now, it's. It's. It's great. It's great. But you have to be willing to adapt to the new situations.

Yeah, that's what I was just gonna say is that is being able to evaluate what you like and what you don't like and what you need and what you don't need. And I can't imagine how difficult it must have been to give up that part, because I. It sounds like at one part in your career that was what you love so much was delivering babies and having to be like, okay, maybe that's not what I need right now. And what is my career going to look like going forward? I think is a lot is very hard, especially for people going into medicine to do, because you see this path, and you're like, okay, this is my path. And then I'm going to be a surgeon, and then I'm going to do a surgery every single day. And that's what I chose to do. But sometimes you do have to adapt and figure it out. So.

Yeah, and I think you look at a lot of, you know, the. I'll say, the older doctors, the late boomers, the silent generation, the guys in their 70s and 80s, they're going to die in the hospital. Hospital. We're gonna cart their bodies. Well, down in the morgue, I guess. You know, I think the. The younger boomers and the Gen Xers are very much fans of shifting their careers. A lot of people I know. And Sarah, this is you, too, right? Like, people that go into. I have a guy I know that is now creating an AI system for. For finding out sepsis. So he's in tech, and he's taking what, his pulmonary critical care business practice into tech. A lot of people are kind of moving into these different areas so that they're not burned out, but they're still contributing. And I think, hopefully the generations below us are seeing that, and they're thinking, oh, I can morph into something new.

Yeah, well, I think that's a great point. And it's one of the things I tell medical students, too. That's what's great about primary care, is that I do get to tailor my practice to do the stuff that I really like to do, and then the stuff I Don't want to do. I refer out. And so it's. To me, it's like you start with something that's very broad, and then you get to narrow it to what you like to do and what you're good at. And ob GYN can do that as well. But something. If you're a hand surgeon, you better like all the different types of hand surgery. I think some of those things get so very, very specific, and hopefully you enjoy doing it, but there's not a lot of opportunity to shift all that much, I think.

Yeah, yeah, I agree with you. I mean, something like, you know, neurosurgery, cardiothorpe. I mean, those very subspecialized fields. It's hard to, you know, unless you're going to develop a device. It's really hard to kind of use that to say, well, I'm now going to see Men's Health online. It doesn't quite translate. Whereas, you know, I mean, even something like dermatology, though, you can create skincare products. You can go into cosmetics. Like, there's a lot of. You just have to find those people that are ahead of you and say, oh, what do I like about their career? Or what would it. And everyone. I remember being. I remember the first day of medical school class, sitting in that hall, talk at the same hall Stephanie that you sat in, and they go, what's everyone want to be? And, like, 50 hands shoot up. They all want to be debakey. They all want to be something hardcore. And, you know, surgeries and, you know, no one wanted to do pathology or primary care. And then the end, they kind of tell everyone what we're doing. And, like, 90% of the class is primary care. And my class had a lot of anesthesia. Anesthesia was big in my class. So, I mean, no one. One person, I think, did CT surgery. The rest all ended up deciding that that was not the career for them. But it sounded good. And I think that's what's great about trying all the different fields and finding the one that really fits your personality and then also gives you the leverage and the ability to pivot as you. As you grow and age. Because someday we all do it.

Yeah.

Oh, I was just gonna say how you. Stephanie went around to all of her classmates what that first during orientation and did videos asking everybody what they wanted to be. And then she wants to stitch that, like, after Match Day.

Yeah.

Yeah. It's really. It really is. It. I mean, I remember that day so vividly. It was so long ago. And I just remember everyone's shooting up there. I mean, all the guys were like, yeah, I'm going to do something to cut people and do this. And then at the end, none of them did it. I mean, I may. I said, I think we had one neurosurgeon. I don't know, it was something like that. But, you know, it's, it's, it's what people need. Primary care is hot again too, by the way. It is the field right now. The salaries are good. I mean, it's just recently out in Doximity. Everything that primary care is coming back in, in vogue.

I know I'll believe it when I see it.

I don't know.

I mean, yeah, even in my, like, year, I think even now, even second year, people are still wanting to do all the neurosurgery, orthopedic surgery, all of that, which, like, is fine. Again, some people don't maybe do want to do that one thing for the rest of their lives. Not everybody kind of wants to adapt. I think we're seeing that in other career paths too. Like, especially in my generation of, you know, even just like, tech. Like, my brother does software engineering, and now that AI is coming in, he's having to work ahead and now create AI. Like, there's so much change in your career. I think even in every other field, you don't just do the same job for the rest of your life anymore. So that's why it's really refreshing to talk to people like you and have this podcast to open our eyes up to that, because we just really don't see that in the, in the med center a lot.

Yeah, yeah. I mean, the med center is an amazing place, but it's very meds. It's, it's pure academics and it is the die hards, the ones that you will truck out there dead, you know, and gosh, Debakey was, what, 96 when he died? He was practicing medicine on the day died. You have to almost kind of go out and find people like Sarah or people that are just doing things a little bit differently, but they're out there. They're out there and they're worth conversing with, I think. Saying, what made you do this?

Yeah, for sure. Well, we want to talk a little bit about your book. Can you tell us a little bit about what inspired you to write it?

Yeah. So, you know, again with pivoting and adapting, you know, I, I had a podcast for three years. It was called the Sex Podcast. And I never, by the way, I'm not like no one can probably see me, but I don't look like a sexy, like I'm not like, you know, I mean, I just look like an average woman, I guess I should say. And, but it came from the fact that I met women every day that didn't understand their own body and they didn't understand. And a 60 year old woman that after her, well, woman asked me very sheepishly, she goes, how do I know if I've ever had an orgasm? And I thought, oh God, if we have to ask this question, you have not had one, you know, and I just felt, I was like, crystal, cancel the rest of my morning and let me, let me help this woman out. And we talked through it and I realized if one 6 year old woman was feeling that way, there are women all over that weren't, we weren't trained in it. I mean high school sex education is pretty much a joke, right? It's the banana with the condom and that's not what it's all about. And so I realized there was a whole bunch of women that, that didn't know things. They just didn't know. They didn't even know their body parts, some of them. So I started a podcast and gosh, this was in like 2021 and it was all like podcast blogging about everything that patients asked me. So like it'd be about, you know, gosh, will anal sex like make me poop my pants all the time? You know, questions that people really wanted to know the answer to. It wasn't just about anal sex, I promise. It was about all kinds of things. You know, I, there was an outbreak when I was in Denton, an outbreak of syphilis. There still is Denton County. So we had to talk about syphilis because what happens is, is you don't have to worry about getting pregnant at a certain age, but one dirty guy is passing around all the crap. And there was an outbreak of gonorrhea at one of the 55 plus communities. And so all these things we know, we had to kind of re educate women. And so it was three years of that and it was great. I love doing it, but it's cumbersome, as you guys know, to do a podcast all the time. And so I said, you know, what I'm going to do is I need to take all these episodes and turn them into a book that I can hand people that says, hey, here are just quick little bite size moments. Just a quick little learning about this. And so it's called Quickies and it's basically 100 little lessons to Live Sexily Ever after in Midlife. Because that was obviously my audience, but I found that we had teen women reading it. I had a daughter of a. Of a patient who bought five copies to hand to her friends. We had a lot of mad. I had to autograph my patient's book to her husband because he was reading it. Because the men don't have something very similar to this either. And they all want to know. It's like when they pick up the Cosmo into the dorm room and they want to know what the to do. Like, what do they. How do they get better at things? And it launched this summer and really, really pleased with it. It's. It's. It's fun, it's educational, and it's easy to read. It's just really. It's just you pick up what's like, you know, it's toilet book. You can put it by your bathroom and read one little lesson in two pages and you know, everything, you know about monkey pox or whatever it is. And so that's kind of where it started. And the audiobook comes out, I think, next week some time.

So are you doing the audio for the audiobook?

I did. I did the audiobook.

Awesome.

It's. It was a lot of work, and I did it in a closet with my microphone. It was a lot of work. But I found, you know, I always really liked writing. That was obviously, I was in marketing and pr, and I remember my med school essay to get in was this is back in the mid-90s, and Christian Northrop was kind of like the big north star for women's health and, you know, and doing books and this kind of thing. And I thought, I want to be just like her. I want to own a lighthouse in Maine and sit there and write and then go down and see patients, then come back up and write some more. And I thought, oh, my gosh, I'm now in my mid-50s, and it's actually maybe going to happen. Like, I was like, this is great. So it's interesting. And keep your med school essay, because I can't find mine. And I wish I could pull it back out to show everyone that I'm actually doing what I thought I wanted to do 30 some years ago.

That's awesome. Well, can you give us a. Give us an example of some of those little, like, quickie things that are in there?

Yeah, some of the ones. Like, say, for instance. So we have three sections. One's called the Unlearning. So the things that you thought you knew that weren't right. And in there is everything from, you know, I feel too fat to have sex. I, you know, I don't feel good about my body, which I have not met a woman who feels good about her body. I always say the moment I meet a woman who goes, I love my weight. I don't need to do anything with it. I. I'm going to say I met a unicorn, I'm going to slam my laptop shut and I'm going to walk out the door like, I don't need to do it anymore. I've never met anyone. So there's things about there about how to feel good about. Is lingerie a gimmick? Is what is really self care? Is self care crap? Because, I mean, my belief is that self care has become kind of a cheeky catchphrase. It doesn't actually mean that you're caring for yourself. It just means that you're doing what some influencer thinks is important. A bubble bath or wine or those kind of things. So I always call it self respect instead of self care, because you usually will not degrade yourself if you call it self respect. And there's things in there about kinks, handcuffs, should I do that? Should I do spanking? Is that. Is that bad because of the age of consent? Am I less of a feminist because I like spanking? One of the biggest episodes, I put these on YouTube years ago, and the biggest episode, and it was all men, 70,000 views, all men cuckolding. I would never have thought it. I was like, wow. I go, what? What are these views overnight? I was like, my gosh, there were all these men, they were like emailing me about I love cuckolding and all this. And I was like. And people would go, what is that? I'm like, well, now we have a chapter in the book about it. Like, here you go. Here's what you need to know. You know, polyamory is a big one now. All the young women are in ethical non monogamy. And so, like, how does that work? You know, if you want a threesome, how do you make that work? That's like legit, where all the parties feel, you know, cared for, you know, just down to even, like, divine femininity. I had to put in there some kind of spiritual sexuality kind of thing because a lot of women are into that now, too. So it was really just kind of. It's a really wide variety of topics. And There were actually 200 podcast episodes. There's only 100 in this book. So there could be a quickies too, someday. I don't know. We'll see.

Wow, that does sound like. I mean, you really. This was not, this was not a narrow focus. You, you did it all.

Yeah, it really is like all the things midlife women would want to know. And I tried to choose the ones that I thought were the most important right now. I mean, even like aphrodisiacs, like, are they crap? Are they stupid? Like, really, what is that? And it's interesting what people are drawn to. I had a woman that wrote a radio that she was. I really like lesson 47. I go, I don't even. What is less than 40? Let me go look. And I'm like daydreaming. That was the one that spoke to her the most, that daydream. We lose daydreaming when we get older. It's kind of like the Peter Pan syndrome. We lose that. And, and that one really spoke. So it's interesting. It's almost like a test, like, which one speaks to you? And, and I found all different ones. It's not the ones. I think it's often not the ones I would say, oh, swinging, that's gonna be the one that everyone's gonna said. Nope. Not always something as simple as daydreaming.

Yeah, well, just as we're sitting here talking about this with me and my mother here, which is so fun, isn't it? What, what's the difference? Like, through your career, have you seen like a generational difference or even just, you know, from the beginning of your career to now, have you seen a difference in sex literacy and the way people are talking about this? What changes have you seen, whether intergenerationally.

Or just, you know, I, I thought this is where you get this. We get in trouble in medicine. I thought I was going to see the Gen Z group and the young millennials. So the, the really young, like 30 year olds understanding all of this, I thought they were going to know all of it because the information is out there on the web. We didn't have the web. Right, Sarah?

Right. No web.

You know, I used to steal my dad's Playboy and I would look at that when I was like 10. I thought boobs were really cool. Like, I was like, that's awesome. Like, when am I going to get those? And I really thought that the Gen Z group was going to know everything. And I have more questions from the Gen Z group about sexual things than I ever had from any other group. I think one, they're more comfortable about asking the question. So that's changed. They're more comfortable about saying, hey, is this right? But also now think about how, you know, LGBTQAI plus was not a thing, Sarah, for you and me. I mean, it was, but no one talked about it. And this idea of demisexuality, asexuality, gray sexuality, all these different, you know, identities and labels were not a thing. They just, no one talked about it. I mean, it was always in the movies, the guy gets the girl at the end. It was never the girl gets the girl or the girl gets the, the non binary trans. You know, none of that. None of that. So I think it's a little bit more complicated than it used to be. But I think the Gen Z women are better about asking for help and I think they're better about looking for legitimate ways of getting help as opposed to just going on, you know, a crazy website or looking at porn. I think everyone finally agrees that porn for women is not the end all, be all. And so while porn, I don't have a problem with it when patients want to watch it. I think what happens for women is we use too much of our brain, too much of our prefrontal cortex. And I don't know about you guys, but when I, when I see porn, I'm like, is she sex trafficked? She's sex trafficked. What do her parents think about this? Is she of age? I don't think she's of age. She doesn't really want to be doing that right now, dude. Like I, I sit there and I think about all the things besides the sex that's right there happening on screen. So like a big one that I put in the book is audio erotica is big for women. It's a great thing for women. It's a great tool because it takes you out of your prefrontal cortex and puts you back into the creative parts of your brain. So if you're listening to a story about sex, you're not picturing this 18 year old with a bleached anus, which I don't even know if anyone actually bleaches their anus, but apparently it's a thing. You're not looking at it going, you couldn't be you. It can be you with Avatar people, it can be you with whatever. It, it stimulates that imagination part of the brain that makes sex except exciting and accessible for women again. And so I think that young women are looking for those types of things. They're not waiting until they're 45 or 50 to figure out who they are sexually. They're trying to figure it out now.

Yeah, and I think you touched on a really good point of like, now there is the Internet and there's so much more information, but just like everything, every sector of medicine and every sector of everything now there is a lot of misinformation and there is bad stuff that comes with that too, too. How do you manage that? When people come into your office, especially young girls, and ask you questions about certain things that is, you know, pseudoscience or not necessarily true. How do you. And especially in the women's health world, there's just so much of that. How do you handle that?

Yeah, I mean, I think one thing is, is you have to acknowledge that it's out there. Like you have to say, did you find that on TikTok? You know, did you find that? And there's a lot of good information out there as well, as I always try to lead people to, because they're going to look, tick tock. They're going to look at TikTok or Instagram, whatever. I try to find them the right places to go for those things. Hey, if you want to look up something on TikTok, look up these accounts. Don't look up these accounts. But I think the worst thing I can do is shame a woman for looking at bad information. That just is going to shut down the conversation right then and there. So really it's. Oh, that's interesting that you heard that. How do you feel about that? Does that feel right for you? And a lot of times they'll say, well, I really don't know. I just found it and it seemed like it was information. What do you think? And then I can have a chance to kind of alter it slightly or kind of change the perception of it slightly. There's been so much shame in medicine for women that it's every ounce of my being tries to prevent that from happening in another appointment. So you know, when they go, well, I haven't done that because I'm stupid. I'm like, no, you're not. We just gotta get caught up. Let's do that. And so it's, it's really important that we don't further sex shame, shame women, shame men also, I don't see them professionally. So but, but really take away shame out of the health care system, it shouldn't be a player in there.

Yeah, that's. Now that's super helpful for getting people to open up because it is, it's hard enough for people to bring up these topics or Any of that. And then if they kind of, if they, if there's any sort of, you know, feeling shut down or not listened to, conversation just ends.

Yeah, yeah. I think that's so important and important for young people like me to remember to take in my, into my career because especially when you go see a doctor like that is such, you remember all of those little things and especially going to the OB GYN in such a vulnerable state that can really make or break your self worth in some things. So yeah, that's important. Thank you for sharing that. Well, we won't take up too much more of your time. This has been awesome. I always ask all of our guests this, but as somebody who is just starting my career in medicine and a lot of our listeners are med students or early in their education, what advice would you give to us as we start on this long journey towards being a doctor?

Oh, gosh, did I not just give a whole bunch?

You don't. You gave so much.

I feel like I did. I mean, I think I would say this, like I would think I would say be open, be open to, to options that show up and don't be afraid to fail at something. You know, I've screwed up plenty of times and every time is a learning thing. The other thing I will say is this is important is not all patients are going to like you. They're not going to like you. You're not going to get along with everybody and a lot of them are going to write bad reviews. So just don't look at reviews. Just ignore that because you're not going to be a friend to everybody or no one's going to like you all the time. And I think, I don't know about you, Sarah, but I took every review, every patient that didn't like me, everyone that said, well, I'm not coming back here. I took it to heart. And I think if I could go back, I would say, okay, well, you know what? I'm not for everybody and that's okay. So don't waste tears and stress over those things.

That's important. Well, where can people find you? Where can people buy your book?

Oh, well, the book is on Amazon, Barnes and Noble, Target, Walmart, all the places. And I'm on Instagram @Doctor Heather Bartos and my website is heatherbartos md.com great.

And you guys know where to find us @Generations MD on Instagram and Tik Tok. And if you have any questions, you can email us ataskgenerations mdmail.com and we will talk to you next week. Bye, guys.

Bye.