89. Dr. Sarah Stombaugh on Residency, Motherhood, and redefining Balance

Hey Doc—

This week’s episode is one of my favorites yet because it’s a full-circle moment.

I’m sitting down with my friend Dr. Sarah Stombaugh—family medicine physician, obesity medicine specialist, private practice owner, coach, podcast host, and mom of three.

And fun fact: she’s the reason I started Dr. Toya Coaching.

Yep. You’ve heard me mention her before. The woman who looked me in the eye and said, “That’s not a medical practice. That’s coaching.”

And here we are. Two years later. Full circle.

In this conversation, we walk through Dr. Sarah’s incredible journey—from meeting her husband in med school and navigating the couples match, to having her first baby the day before residency graduation (yes, really).

We talk about the chaos of postpartum, what it was like to parent through a pandemic while her husband was a critical care fellow, and how she finally built a life that honored her values.

It’s a story of boundaries, self-trust, and creating work that actually fits the life you want—not the other way around.

You’ll laugh, you’ll probably tear up, and if you’re in a season of questioning what’s next, this episode will remind you that you can design something better.

Dr. Sarah Stombaugh is a family medicine physician and diplomate of the American Board of Obesity Medicine. Graduating from Creighton University Medical School and completing her family medicine residency at University of Chicago, Dr. Stombaugh practiced outpatient primary care in Evanston, Illinois before moving to Charlottesville, Virginia with her family.

Upon moving to Charlottesville, Dr. Stombaugh opened a private practice weight loss clinic, in which she sees patients in-person at her downtown Charlottesville office and by telemedicine throughout the states of Virginia, Tennessee, and Illinois.

In addition to her clinical work, Dr. Stombaugh is the host of the "Conquer Your Weight" podcast. Through this platform, she shares valuable insights, expert opinions, and practical advice on weight management, contributing to the well-being of a broader audience.

Dr. Stombaugh believes in empowering both individuals and the medical community in order to promote an evidence-based approach to the treatment of obesity.

For more information about Dr. Sarah, you can visit her website and connect with her on Facebook

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Join my Email list to get tips on navigating motherhood in the medical field.

If you are going through a transition -- becoming a parent, leaving a job, figuring out how manage it all, schedule a strategy coaching session and get clarity and strategic next steps for the life and career you want.

Strategy Coaching Session with Dr. Toya

Transcript

Dr. Toya: [00:00:00] Hey Doc, I am back with another wonderful guest, my friend Dr. Sara Stombaugh. She is a family medicine physician, an obesity medicine physician.

She's a private practice owner. She is a coach, she is a podcast host, and she's a mom just like you and I'm so excited to have her here. Welcome Dr. Sara.

Dr. Sara: Thank you so much for having me. I'm really excited to be here with you today with all of your listeners and to share my story.

Dr. Toya: Yay.

So let's get right into it. So tell me, how many kids do you have?

Dr. Sara: I have three children and right now they are three, five, and seven.

Dr. Toya: Wow. I can't even believe it.

I remember when you were still nursing your baby and she's three.

Oh my gosh.

Dr. Sara: She just had a birthday, so we just celebrated a couple birthdays in our household.

Dr. Toya: I can't even believe that. Okay.

And how long have you been married?

Dr. Sara: 11 years.

Dr. Toya: Oh, that's a long

time. So did y'all meet in med school? What, when [00:01:00] did y'all meet?

Dr. Sara: We did. So my husband and I are both physicians about, we met the day before medical school at the medical school bar crawl for all incoming first year medical students.

And we were very fast friends. Interestingly, neither of us were particularly interested in dating, but the connection was pretty magnetic and we were dating within, certainly within two months, but maybe a little sooner than that.

Wow. Wow. Okay. So did y'all get married during medical school?

We did.

So we met right before medical school. We got engaged after second year, right after boards and, or you know, step one. And then got married between third and fourth year of medical school. So then fourth year went through the match together, both as a couple, but then as a married couple as well.

Dr. Toya: Gotcha. So y'all did you mean you did couples match? Correct.

Okay. And how was that?

Dr. Sara: good actually we were really intimidated by the process. My husband, [00:02:00] he's very niche at this time, but went into anesthesia initially, myself into family medicine and our medical school. We went to Creighton University Medical School and our advisor was like with a couples match, you'll need to apply to more programs.

We applied to far too many programs. And interviewed at far too many. I think that was the. You know, the biggest challenge was that we almost, it ended up being 19 or 20 programs that we interviewed at, ended up matching, or not matching up, but ended up ranking on our match list. And it was too many, obviously I'd rather err on the side of too many than not enough.

But it was, it was, it was good. There were challenges that came up with that. I think either of us may have had slightly different match list if it had been either of us individually, but ultimately we ended up at a program that we were both really excited about and met a lot of great criteria. So we're, we were so pleased.

Dr. Toya: So I [00:03:00] wanna talk a little bit more about that what challenges did you have for some resident that's listening what were some of the things that were particularly tough?

Dr. Sara: Yeah, I think for us being married was already having made the commitment to marriage that was really important. I think that conversation had happened at some points much earlier in medical school in terms of what our future looked like both in medicine, but then also the future of he and I and you know, if this was moving towards marriage and when that would happen.

And I think that piece really stands out to me as important in that I know a lot of people who couples match that then, separated from their partner with whom they matched. And that is a really big potential sacrifice to make for someone who is not a lifelong partner. And so I do think that commitment piece is really important and so.

While it was really just, we had been planning to get married anyway, knowing that we had already made that commitment to one another and that our commitment was there first was really powerful then [00:04:00] in going into the match and, and making that decision. Throughout the process.

It was really such a good opportunity to have to reflect on the pros and cons of a program. I think every individual going into the match is going to have their pros and cons lists. They're going to, you know, write down all of the facts about what's the salary and what's the pay, what are, you know, what are things I like or dislike about the city or the people.

And having all of these pros and cons. And we had it in a, a Google doc together where we were both this very living and breathing document where, each of us actually had a couple of interviews that were so. Bad, you know, programs that we dislike so much that we had said to the other person, like, I don't even think you should, like, I don't know that it's worth us going there.

So it's actually a really good lesson, I think, in marriage communication from very early, having to navigate that type of, obviously very intentional challenge, but having to navigate that together, communicate, and then decide [00:05:00] what are, what are our top priorities and what are the ones that are non-negotiable for us as individuals, for us as a couple.

Weighing those pros and weighing what was important for him, what was important for me, and really having that opportunity to reflect on it with someone who also had a really big stake in it, you know, his skin in the game was really significant.

Dr. Toya: And what was the discussion, if any, about when y'all would start having kids?

Dr. Sara: We, my husband, I think, has always known that he wanted to be a father in that way.

That like, he loves children, he loves being a father. He really, we had a conversation, I think during first year of medical school, so, you know, we're dating, we're not engaged. And he's like, I think fourth year of medical school would be a really good time to have kids. And I was like. What boyfriend, you know, that is, I think we have some steps that I would like to take before we move in that [00:06:00] direction.

And, you know, and that spoke to how serious he was, I think about our relationship and what his intentions were. And, and it made it very clear to me. I always knew that I wanted to be a mother, but it wasn't, I don't know that I knew I would love it as much as I do. I think there was this idea like, oh, of course I'll do that.

I identified with someone who had become a mother, but it didn't, it didn't drive the same passion in me as it did for him. And so I was like, well, I, it's hard to imagine doing that in medical school. Like, you know, if you have a baby in fourth year medical school, then you have a 1-year-old during first year of residency.

And that doesn't sound easy. And so ultimately. In going to residency. So we went to the University of Chicago, living in a big city. We were close-ish to family, you know, about two and a half hours away. But that's not down the street. That's not someone who's babysitting in the evening. That someone who can pop over in an emergency.

And so we didn't have family support immediately in that [00:07:00] city. And so as we were in residency working through that, it became very clear that having children during residency would be, I didn't love the idea of it. It sounded really challenging to me so my husband again, like super excited about having kids going into my third year and final year of residency as a family medicine physician.

He was like, well, I, you know, I, we could have a baby right after residency. And I, I agreed. I thought that sounded like a good idea. And so, we started trying and I got pregnant right away, which is of course such a blessing and I know not the situation that everybody finds themself in, but such that it was literally the first cycle that I had agreed to start trying.

And my son was born on a Tuesday. My residency graduation was the following day, so I actually missed residency graduation, which was like, it was such a challenge. They had to almost like lock me in the room because I'm like, I could get [00:08:00] dressed up, I could take my, you know, 20 hour postpartum body and baby, and go to this graduation and I,

Dr. Toya: Oh my God.

Could you imagine? I'm just thinking about like the

downstairs situation.

Dr. Sara: Oh, totally. Especially after your first, I mean, after my third, I think I could have done anything twenty hours postpart but yeah, after, after my first especially, it was, it was rough. And having had the baby, then I was, I wanted to stay in the hospital room.

But you can just imagine, the postpartum hormones and crashing down with missing this really important event. I was sitting in my hospital bed, FaceTiming one of our other residents who was basically projecting the program. 'cause this was 2018. So pre, pre pandemic, presuming everything, you know, there were no sort of online options for this.

So, one of my best friends who was a. Younger resident in the program was FaceTiming it for me. So I watched the whole graduation and I was sitting in my hospital bed, my husband was there, we had our [00:09:00] son and just sobbing like ugly alligator, like ha, just, I mean, it was, it was so, so bad. And the nurse walked in with a nurse trainee and they kind of give a look of like, you know, what is happening in this room?

What's going on? And I can't even, I can't talk and cry at the same time. So, you know, and trying to like honey, like tell them what's going on. And he was like, well, it's actually, it's her residency graduation and she's really, she's really sad to be missing it. And, the, the nurses were so sweet. They're like, you're gonna be such a good doctor even though you didn't go to residency graduation.

I was like, I know, but it was, you know, it's a, it's a big deal. But all of that to say, so he was born like right.

Dr. Sara: Could not be born any sooner. It was right at the end of residency and then we had our kids sort of every two years thereafter.

Dr. Toya: Oh, that is hilarious. Just try not to like, laugh out loud to ruin your audio.

Yeah, I could [00:10:00] just imagine. So, being pregnant during that last year, how was it? I mean, you were a chief, so maybe it wasn't too tough.

Dr. Sara: You know, I was one of those really annoying pregnant women, especially with my first two that I felt great and so I had a little bit of food aversion, but no real morning sickness.

I was, really dedicated to going to the gym and so I was really active in getting my steps in and. It was actually fine. It, there were certain challenges. We took these monster OB calls when I was in family medicine residency that were Friday at 7:00 PM till Monday at 7:00 AM and that was challenging just in general.

I don't know that pregnancy actually made it any worse, but it was just That's challenging. Plus nonpregnant. Right, exactly. It's just a, it was just a challenge and so doing, I never had the experience of doing that non-pregnant. Right. So like I don't, I don't know what it would've been like non-pregnant, but it was.

It was tough. Those weekends were [00:11:00] sometimes really, really long and, but actually it was, it was fine. My son was born a week late actually, and so I was really terrified. We didn't do any vacations during third year of residency because I needed to, I saved up all my vacation and used it at the very end of residency.

So I actually ended right around Memorial Day just because I was worried to be born early. And I would've had to extend my residency, which just sounded like a pain. So that was challenging because I wasn't able to, to take vacation or anything, or you know, I guess chose not to take vacation during that final year of residency.

But it was, it was actually like, surprisingly, okay, if I had been pregnant with my third, my daughter, I was, had super bad morning sickness and it would've been challenging, but it was actually, it was okay.

Dr. Toya: It's fine. These girls, man, is there data about that? I don't, oh, I have a client right now who is.

In the hospital like every week with a girl. Same with me. Okay. And I was fine [00:12:00] with my son.

Dr. Sara: We have, so we have a son, boy, boy, girl. And the boys were like super easy pregnancies. And then with my daughter, I was like, I don't know what this is. Like, it's like, yeah, yeah,

Twins. It's a girl, it's the devil. Like, I don't know what's in my body, but I'm so, I was so sick, to the point where my then 2-year-old was potty, well not even 2-year-old. 'cause I guess he was two when she was born. He was like, you know, 18 months, a little bit before two when I was pregnant with her and he was potty training and I was spending so much time throwing up into the toilet that he didn't know what a toilet was for.

He thought that toilets were, and he would walk up to the toilet and he would spit in it. I was like, that's not what we use this for. We, you need to sit on the potty, not spit in the potty.

Dr. Toya: That sounds, I'm not laughing at you. Yeah, no,

Dr. Toya: Wow. Wow.

That is alar. Aren't they so sweet though?

Oh, that like, I love her. How, how they watch [00:13:00] us and they're like, okay, well this, this is what you do. Let me go ahead and throw up in there. Oh, I'm so sorry. That sounds terrible,

Dr. Sara: It's, you know, it's all right. And I was already in private practice at that point.

Right. And life was, life was easier.

Dr. Toya: Life's okay. Okay, good. All right. But before we get more into that terrible situation, how was postpartum with the first,

Dr. Sara: it was challenging. So I had my son June of 2018, and then I was starting my job. It was like technically August 30th of that year. So had. 10, I think it was 10 weeks before I went back to work.

And it was, it was a really a lonely time. So my husband was still a resident. He was a, starting his fourth year and they, in anesthesia, have a lot of calls. His fourth year was not any lighter, in fact, University of Chicago did not previously have a trauma service, and they had just initiated a trauma service in May of [00:14:00] that year.

And so he had started taking some additional calls and it was challenging. I had a husband who was working 60, 70, 80, 90 hours a week, because we all know that 80 hours isn't always 80 hours. And, being postpartum with my very first child, I did have family that came, you know, for a week here or another week there, but it was, it was lonely.

My son was a little bit, colicky is a strong word, I, but he was, he was fussy. I was brand new at. The whole experience. And, and then my husband was working these really long hours. And so even like overnights for example, we, and again, this is like a man who's super supportive, like loved being a father, and if you are working 80 hours a week, you cannot be up all night long with a newborn baby.

So there was no paternity leave that was pre that being implemented for fathers. And so he didn't have [00:15:00] any time off. He had five days off after my son was born. we had planned on it being a little bit more, but my son was born a week late and so he just had this week off before my son was born, which was fun, but didn't, it didn't help in terms of once the baby was actually there.

And so there were a lot of really big challenges that came up. Going back to work. And I wouldn't even say back to work 'cause it was starting my first right attending job, a new job to going to work as at a new job. Luckily we had the world's most wonderful nanny fall into our lap, and we had hired her in May of 2018.

So I was actually still pregnant when I hired her. And she was used to working with physician families. Nice. And she was such a wonderful support. And having that anchor in our household was wonderful because it was, it was a rough couple of months there. So tell me, how did you even find her?

Through a Facebook physician's mom group. We, it's like the [00:16:00] Chicago Mommy Physicians, physician, mommies of Chicago, whatever it was. And another physician had posted, Hey, my daughter's starting, I think it was preschool or school. And we won't need this nanny as of September if anyone's looking, you know, unicorn nanny available.

And we interviewed her and basically hired her on the spot. And so she, she was with us for a few years, for three years until we moved to Virginia.

Dr. Toya: Nice. And tell me about the decision to have her start in May.

Dr. Sara: Oh, she didn't start in May. She, we hired her in May, so I hired her. While, while I was still pregnant and she started in September.

Dr. Toya: Got it, got it, got it. , I tell people all the time, Facebook groups, man. That's, that's where you go.

Dr. Sara: That is actually where we've had four nannies now, in the last few years. And, but two really good ones, the really good ones, we have found on Facebook groups.

Dr. Toya: It's a great resource.

, Not just your physician mom groups, but your local, regular mom groups as well, can have [00:17:00] like a wealth of resources, especially for a new mom. So that's cool. In that time, how did you handle the loneliness? Like, how did it affect you and do you think looking back you would've done anything differently?

Dr. Sara: That's a good question. I'm really grateful that I had. I had, you know, I did have family that came for periods of time and so it was really lovely to have them. I did realize pretty quickly that A, just as a mother and with breastfeeding and some of those things, I'm like, I have no idea what I'm doing.

And so I did engage in that time in some mom groups. So I was involved in a postpartum moms group through a local like yoga and parenting center. And so I did that weekly, which was really good. I had a lactation consultant that I was working with, and so I had people that were popping in and then I spent a lot of time outside, so I would put my son, he hated the [00:18:00] baby carrier actually, which was so frustrating to me.

But we did have a pram and I put him in there and walked outside a lot, and so we were in such a cute area of the city that I was able to. Pop into coffee shops and boutiques and not always deep and meaningful connections in those situations, but sometimes just human interaction. Was really powerful.

Some fresh air even, you know?

Dr. Toya: Exactly. Being cooped up in the house, I mean, it's what COVID was, right? We all know how that felt. Okay. So when you transitioned back to work, tell me about that transition. 'cause you already didn't really have a whole lot of support from your husband.

You did have a nanny, but how was. The time to not just go back to work, but at a new job where you don't even know anybody.

Dr. Sara: You know, interestingly it was, it was okay in that, because I was building a patient panel from start, I didn't, I did walk into a full [00:19:00] schedule on day one, and so it was pretty full right from the beginning.

They were long overdue to hire a physician. But what I did not have was an in basket full of, you know, 2000 patients worth of questions and lab results and refills and all of that. And so it was actually pretty doable. I had worked out my patient hours such that I was done most days. So I saw patients Monday through Friday and then, I guess either Monday through Friday or Monday through Thursday and Saturday, so every other week I did a Friday or Saturday alternating, and then we saw patients on Wednesdays until 8:00 PM

I shouldn't say that, but I saw patients till 8:00 PM The office was open Monday through Thursday until 8:00 PM and the different physicians worked different evenings. So there were some evening hours there, but I actually started later on that day, which was okay. Which was nice. So I was generally working 8:00 AM until 4:00 PM Monday, [00:20:00] Tuesday, Thursday, and then Friday or Saturday and then Wednesday, one till eight.

And I'd kind of gotten into a good routine where, right. I'm young, so I'm, I was pretty efficient in our EMR in terms of how writing notes and following up on things. I could do that quickly and without having that huge burden. I had stuff coming in from the patients I was seeing, but not having a huge burden of a backlog of patients or, you know, I wasn't taking over While there were physicians who were had retired, it wasn't like I was managing the in-basket of a physician who had retired, for example.

So that that made the workload actually very doable. We had a really good support staff and I was actually. At that point feeling like, wow, I really hit the lottery in terms of what my job looked like. They were supportive ish about pumping. in that they were willing to carve out time for me to do it.

I did have to build on additional time [00:21:00] later in the day to make up for the time that I was pumping. Which I went through many different rounds of, is this legal or not? And the short answer is,

Dr. Toya: I was gonna say, it doesn't sound legal.

Dr. Sara: The short answer is, it is actually, because I'm a salaried employee and not an hourly employee, and we were paid based on collections and so, pay would have decreased if I saw fewer patients, basically.

Dr. Toya: Interesting. Well, but wait, how were you salaried? But getting paid on collections, because if you're salaried, any salary plus bonus. I see. I see.

Speaker 4: Anyway, I won't go off on that tangent. Yeah, we could talk about that for two hours. I know.

Dr. Toya: Okay. Alright. So work itself wasn't too bad. And how did you feel about being away from your son?

Dr. Sara: In some ways it was actually, it wasn't that hard, which is a really interesting thing to say in that being alone, being with him had [00:22:00] been a really, it had been really challenging. I was isolated. I didn't feel mentally and professionally stimulated.

And we had found this wonderful nanny who I was like, she's, she's doing such a good job with him.

Like, maybe even better than I would be doing, you know, she was teaching him as if he was a 2-year-old at the time, and it, it felt okay. I felt like it gave me this opportunity to miss him in a way that. I hadn't missed him, and sometimes I'd even like, wished for time without him.

Which, I feel bad even saying, but I think a lot of your listeners would understand that feeling.

And so that opportunity to feel like I was connecting with others that professionally it was really professionally satisfying. It was seeing sometimes really complicated cases and thinking really hard and doing that research. And it was really rewarding. And then when I came home, A. because I had, didn't [00:23:00] have this huge burden of work that I was doing outside, and I actually drew very strict boundaries about, and I had done that back in residency.

It's like when I'm at home, I'm not, I'm not charting, I'm not studying, like when I'm at home, I'm at home. When I'm at work, I'm at work. And so that boundary allowed me to be really present when I was at home. And so it, it actually was pretty like doable. It was going to say easy, which is totally the wrong word, but it felt very doable.

Dr. Toya: I love that you said that because I think it's an experience that more people have, but they don't admit to, because the overwhelming consensus is, I don't wanna leave. How can I leave this sweet baby and How, how do y'all do this? And we are over here. Like, it's quite -easy actually.

Alright. So when did you decide to have your second, and how was [00:24:00] that decision? Because at some point your husband would've finished residency. I, I was, he was in residency

Dr. Sara: for, so he, he did a four year residency and then he did two fellowships and so Wow. He was in training.

Luckily they were one year fellowship, so it was six years total of training. Okay. But we did have our second, in his PGY five year, so his fifth year of training, so during his first of the fellowship. So we, I, you know, it's interesting, we always knew we wanted to have, we had agreed on having between two and four children, so there was always a plan for a second.

And I actually don't remember. We must have made a decision because I was. I think I was on birth control and I actually, I got an IUD, I got two IUDs and they fell out, which is another story for another time. There is a real risk of expulsion.

Dr. Toya: Let it be for this time. Tell me what happened.

Dr. Sara: Yeah, so, you know, it's interesting.

I, I'm [00:25:00] petite ish, you know me in person. But I'm, I'm five seven, so I'm not like this tiny little thing. And I had just had a very average size baby, seven pounds, 10 ounces. And I went in to get an IUD and my ob gyn did the sound and was like, you have a tiny uterus. Like it's shocking that your uterus is as small.

Right. And so he actually went back and did an ultrasound and put the IUD on under ultrasound guidance. So we saw, right, the ultrasound, we saw the IUD and I was like, it was there and it. Couple of weeks later, I was doing a string check on myself because, you know, I'm a doctor and that's what you do.

Dr. Toya: Oh, you'll, you'll be surprised how many doctors I know who refuse to do it.

Dr. Sara: Really? Oh, that's funny. Yes. no, I think it's important to be familiar with your body and You know, I wanna know all the things. And so I was, I was checking and I felt the, it was a, para guard, and so I felt the, the [00:26:00] hard tip of the IUD. I was like, oh, that's not right. And so I went in and they confirmed it was, basically in the cervix.

And had worked its way out of the uterus and. They're like, well, that's weird. Let's do it again. So they pulled it out and put a new one in. And at that time, again, under, under ultrasound guidance, because we had done an ultrasound to confirm the location of the first one, even though I'm like, I could touch it.

Like, I know it's not where it's supposed to be, but they did the second one also under ultrasound guidance. And the next morning I was breastfeeding my son, and I felt something like poking me in the vagina, which is such a funny way to describe it. And I reached down and it was just sitting, it was just there, it was just sitting in the vaginal vault.

Like it was just there. And so,. but I, I did go on, I did go on oral contraceptives then. And so there must have been

That's probably a good idea.

There must have been a very intentional decision to stop. And, but I actually don't remember. It was just, we wanted to have a [00:27:00] second. I, it must, it was only 15 months later, which I conceived my boys.

Their birthdays are three days apart, so they were born, well, three days and two years, but Yeah, June 16th and June 19th. And so I conceived my second when my first was about 15 months old and, and then had him in June of 2020, which you can imagine was a very different story compared to June of, of 2018.

But yeah, my husband, and that was actually. Crazy. My husband was not only still in training, but he was a critical care fellow in the pandemic and in some ways a really amazing and unique opportunity to learn critical care.

Dr. Sara: In a way that a lot of people may not have had the opportunity to do.

And also just really big implications for what that meant in me having a baby. For us, me being pregnant, potentially getting sick for like him being able to be in the delivery room and [00:28:00] actually everything turned out okay. But it was, it was rough. I mean, March of 2020 through June of 2020 was, I think, for many of us, but one of the most challenging and terrifying times of my life.

Dr. Toya: Do you mind telling us a little bit more about how that was.

Dr. Sara: Yeah, absolutely. So in my practice there were 10 physicians and one of them, was originally from China, from Wuhan, China. And in January of 2020, she started sharing some of the stories that many of her friends as she moved to the states in high school.

So sharing stories that many friends and family members that were still there, people she had grown up with what they were experiencing. And it was terrifying. And I'm not sure what about that triggered me. I was like the first person doing all the crazy COVID shopping. And so I, you know, my son was born June of 2020.

He was actually also about a week late. [00:29:00] and so I was what, like 20 ish weeks pregnant? I guess we could do the math on it, probably more than that. And I went to Costco and I just went crazy. and I, not crazy actually, completely. It was a very calculated, I had you know, Excel spreadsheets of how we were going to get our protein needs and how we were going to get our vitamin C because I didn't want to get scurvy while there was a food shortage.

And so I had done all, all of the preparation. Oh, I was ready,

I was ready. I had about, at least a, a month of food for the three of us. Saved. And then, because I was so worried about myself and being pregnant and what that would mean, I bought six month worth of diapers for our you know, our unborn child.

And I also bought six month worth of formula for this child because in case I died and there was a formula shortage, like I wanted to be able, and like full time, my brain was just like, I got, I got it. Like [00:30:00] I have a full, so we had six months of diapers, six months of formula. you know, and I was planning to breastfeed and I did ultimately breastfeed my child, but it's like, you know, if I, if I die, they're gonna need formula.

And if there's a formula shortage, I don't want the baby to die. And so, you know, I had this totally wild plan. Wow. And, so all that to say like, starting January of 2020, really recognizing the potential global impact of this disease and, and being incredibly well prepared for it. I will say. And, but then.

The implications of what that meant. March of 2020. So my husband being a critical care fellow, being exposed daily to COVID he did have pretty good PPE. And we had also bought all of the non re like, the PPAR. Well, we had N95s, but like the, the respirators, my husband had that more aggressive respirator because we had, we had planned Right.

I knew that this thing was coming. And so he [00:31:00] was able to purchase that on his own. So that he had it. And so he was like in a full, like he had, it was the respirator. I'm like looking at, he used to keep it on our bookshelf as Okay. A, like as a, I don't know, some sort of sick memento. But yeah, it has like the side respirator.

Oh yes. Things okay. And I'm so embarrassed that I can't remember the exact name of it, but p and i, whatever. And anyway, so he was prepared, so he had adequate PPE, but we didn't know at that time what was the risk to pregnant women. You know, what would that look like? Was I at risk? Was our, you know, at that point, 21 month old son, so our oldest was about 21 months old.

What was the risk to him? And so we lived in a, two flat in Chicago. So there were two apartments in one, and we had the first floor in the basement level. We did have a. Door that closed off the two of those. And then there was a back staircase in the apartment that had separate entrances, [00:32:00] even though it was the same unit.

And so we ultimately decided to isolate my husband from us. And so he lived in the basement. He had a mini kitchen down there. He had a full bathroom. He had the laundry room, so he was responsible for doing all of our laundry, which was like the one blessing of that. And then, but he, he lived downstairs ultimately for about two months during the pandemic, a little over.

And we didn't see him. It was, you know, I did essentially stepped into this role of what felt like single motherhood during that time, in that I'm still a full-time working physician as a family medicine physician. I did lay down a really, big ultimatum in terms of the role that I was willing to play in this pandemic being six months pregnant at that time.

And they were asking physicians to go into the COVID care units and had ranked the outpatient physicians in order of like, one to, I had to think, or 130 of family medicine physicians in our organization. [00:33:00] And they were ranked based on age. And I was number one on the list because I was the youngest attending family medicine physician being just two years out of residency.

And I said, absolutely not. I'm six months pregnant. I'm not like, you can fire me. I'm not going into the COVID wards. A my husband's already in the COVID wards. We have a child at home. I'm pregnant. Like, fire me. Like I'm, I'm not doing that. And so there was a lot of really big fears there, both in terms of job security for myself.

You know, in terms of the risk of getting sick, in terms of just not being able to see and connect with my husband in a face-to-face way. We would like zoom each other, you know, and like FaceTime each other even though we were. You know, sometimes 50 feet apart within the house. Or just like a floor apart within the house.

And that was incredibly challenging. Knowing that then two implications in terms of the delivery. Both. If I got sick, what would that [00:34:00] mean in terms of being separated from my baby? If he had been directly exposed to COVID patients, which of course he was because he was in the COVID care units, if he would be able to attend the delivery.

And so, ultimately if my son had been born on time, my husband would not have been able to be there. they weren't doing any inductions for any reason. You know, the study with 39 week inductions was, well, and alive. And they were not practicing that because it was considered an elective procedure and those were banned at that time.

And so I actually even had to, to fight to get an induction at 40 and five, which is when I ultimately have it. But I was like, this baby needs to come out. This baby is gigantic and. And ultimately my husband was able to be there and, we didn't have COVID, you know, neither of us got it. So my son was fine.

But it was hard. Right. Our oldest couldn't come see us in the hospital. My parents couldn't come see us in the hospital. And

Dr. Toya: How long did you stay?

Dr. Sara: [00:35:00] Two days I ended up staying.

Dr. Toya: Oh, wow. Full. Oh yeah, they, well, I wanted to go too, but I left at 18 hours of life, like as soon as they were done. Oh, interesting.

We were

out of there.

Dr. Sara: I think, but you were earlier in the pandemic, so I think there's a Wait, when was your son born? May 3rd. Oh, May, So a month. And it was changing, right? Like week to week? I feel like the guidelines were changing. This is true. And the risks were changing.

And so at that point we felt pretty, we felt pretty like, safe being in the hospital. And so we, we stayed there. . So, and honestly then by having our second, so at that time we had kind of liked the quiet of the pandemic, so we still had our full-time nanny. So she was coming every day and watching our then 2-year-old son and I had this newborn son and it was actually, he, and he was so easy.

Like he, he breastfed easily. He [00:36:00] slept well. And so it was a very lovely, we were outdoors a lot. I didn't have strangers coming up to us in the grocery store and like touching him. 'cause why do strangers touch babies? It's so bizarre to me. I don't even understand that. And that, I think there was also just that huge, like sigh of relief

Of while we still felt vulnerable. I think in many ways the, the worst of the vulnerability had really passed, in the way that I was feeling, you know, early June in May. Yeah,

Dr. Toya: And had your husband gotten paternity leave?

Dr. Sara: No. So he, he also did not have paternity leave then. He had, he did have two weeks off, and so he did have a little bit of time.

It was a planned vacation plus, basically some post-call time that he was able to roll into that. And so he did have a little bit of time there, but, yeah, two weeks, so a little bit.

Dr. Toya: So did he [00:37:00] continue to separate postpartum? Like was he downstairs or he came?

Dr. Sara: He did not, and I'm trying to remember.

I think we were just at a point in the illness where we had a really good routine and I actually going, going back, I started working in some COVID care and so both he and I had gotten into a routine of, we would leave the house in scrubs, we would go to work and change into different scrubs. I think a lot of us will resonate with the story.

Right? And then leaving work, we would toss the dirty scrubs. From work into the laundry there, we would put on our personal scrubs and wear those back home. Back home. We would change, you know, again, we had this in the garage, exterior hallway. So we didn't have an attached garage, but ....

Change in the exterior garage, go directly to the shower, take a head to toe shower, and then, be with our families. And so at that point, that was how we both handled it. It's so crazy. We all did the same thing. Right. It's, [00:38:00] it's really wild to think back on and. I, in hindsight it's not, it's not as scary, but I can still sometimes feel some of those moments come back up

Of what it felt like to be in the midst of that.

Dr. Toya: Tell me some more detail about you being ranked number one on the COVID ward and the refusal, like how did that go with your job?

Dr. Sara: Yeah, so it was just ranked based on age and so there were no other health conditions taken into factor and they were seeing such a surge because we were in a city of Chicago at this time and really significantly impacted by the pandemic early on.

And we were seeing such a significant surge of patients that there was a call for additional support on the inpatient team. And they had said, you know, we. We need people to step up and, which is kind of wild in that we still had a very busy outpatient clinic. Maybe [00:39:00] not in terms of patients coming to us face to face, but I mean, carrying a load of almost 2000 patients in my panel at that time, the number of patients reaching out with, oh my gosh, my friend's, friend's brother was doing this, and am I at risk for COVID?

And getting those questions, being inundated with those type of questions. We were, we were really busy, just navigating the changing guidelines day to day and patients who had a lot of chronic care needs that still needed to be addressed. And so I ended up having a conversation with our department chair who was kind, but also like every physician was coming up with their own excuses, and some of them were very legitimate.

Like, oh, I have diabetes, or I have obesity, or, you know, I have a aging parent at home and everybody. And I shouldn't say that like, but the people, there were many people who had reasons that they felt that it was unsafe for them to be in the COVID wards. And, [00:40:00] and the threat, the threat that's probably the correct language.

It wasn't meant as a threat, but the, The conversation was if people do not volunteer to step up, you will be voluntold that you need to go and do this type of work, and this is the order in which we will be assigning people to those roles. I see. And so I had had a conversation with our department chair saying, Hey, I'm, I am six months pregnant right now.

I do not think it is a safe decision for me to be in the COVID wards. And he was kind and understanding ish, and basically said, you know, Sara, everybody has their... Everybody has their reasons and like, I can't take you off of this list. And so if it comes to that, you have the opportunity to take an unpaid leave.

And you know, I will understand if you need to do that, and there will, there will be no repercussions for you taking an unpaid leave, which is so icky to even [00:41:00] think about in retrospect. But at the time I said, that's fine. I,

Dr. Toya: yeah,

Dr. Sara: I'm, I will, I will not be moving forward in that way. And I do have to say, ultimately, there were other outpatient physicians who did step up to fill those roles.

People who did not have risk factors that people who had also support at home, you know? Who didn't have a spouse also in the medical field also in those roles. And I, it, it didn't end up coming to that, but the plan had basically been i'll, take an unpaid leave. This is not something I can risk myself and more importantly, my unborn child in this situation.

Dr. Toya: And I mean, you gotta do what you gotta do, man, because I was lucky in that in California we got four weeks off before, so I was off for 36 weeks, which would've been like April, when things really started to heat up. So I was out for the most uncertain time when we were having a [00:42:00] lot of preterm labor, a lot of p proms with COVID, and it wasn't as much national news because people were dying, so, pregnant women having their babies early. I feel like never got attention nationally, but they were definitely 100% of effects that we saw very early on before the vaccine and things. So you, definitely did the right thing. We had this-- That made the news actually locally. This woman who ended up in the ICU pregnant with COVID, and was like on death's door and they like saved her 'cause my hospital was amazing or whatever.

But, it was all that to say it was a very big risk at one point for pregnant woman. And so good for you for standing up for yourself and making that decision. What a crazy time. Okay, so y'all made it through COVID happened, you how that postpartum was isolating, [00:43:00] but in a different way where, you know,

Dr. Sara: it felt like self care.

You know, my, my child was easier. My, my body felt better. I felt more confident in what I was doing. I had our nanny coming every day and both, predominantly while she was there to take care of my older son. She also, like, if I needed a nap in the middle of the day, she and my other son was napping, you know, she'd, she'd watch him or,

It was easy. It was just, it felt really simple at that time. And so there was, it was actually kind of nice.

Dr. Toya: Nice. Love it.

Alright, so you have two kids now, you're going back to work. Had you always planned to have a third?

Dr. Sara: No. that, that decision happened after moving to Virginia. So we, I went back to work at the same job in Chicago, September of 2020.

And that was when just [00:44:00] everything had changed. So summer of 2020. The hospitals were seeing a lot of financial challenges. Our hospital had made the decision to offer every physician and every RN in the entire system, an early retirement package, and, including myself. So at 32 years old, I was offered an early retirement package.

And it was based on, you know, years of service and et cetera. So mine was not that generous that to the point where we actually really sat down to do calculations of, is it worth me staying in this role? The other piece of that, so my husband then summer of 2020, was going into his final year of training in his second fellowship, knowing that he would be done in the summer of 2021, and we, were starting to look for what his job ultimately would be.

So I came back September 20 to an environment of. Knowing we were likely leaving. So my husband had been [00:45:00] interviewing at other jobs around the country and this retirement package having been offered and actually accepted by all of the RNs in our office, except for one. And we had a lot of very experienced and wonderful nurses who it was a generous package.

And they accepted it. And so we went from having a really robust support staff team to a, one RN left in the practice, and there were 10 physicians. So 10 full-time outpatient primary care, family medicine and internal medicine, and literally one RN on support staff. Of course, we all had medical assistants.

We had a front desk. But in terms of what was happening. Our nurses had been our triage. So our nurses had been the ones to triage every phone call that came in, every message that came in. And we collectively were responsible for about 20,000 patients. And now one [00:46:00] RN. And so there was a very, hold on.

Why did she even stay? Oh, I know. She was just young enough that she wasn't at a point where she was ready to retire, why she didn't look for another job. I, you know, God bless her for staying. At least we had one and it, but it was really, really challenging. So I went from what had been, you know, as I described, what felt like a really dream job to coming back from the pandemic, our support staff just being decimated, and the outpatient, the load outside of the patient care was profound.

And so now all of a sudden we have patients sending messages that aren't able to be triaged because there's just simply not people to triage them. And so we had messages that were going unread for 4, 5, 6, 7 days and sometimes really significant, messages. People like, Hey Doc, my blood sugar was 470, what should I do?

That [00:47:00] message going unread. that was actually the breaking point for me was I was able to, sort of back-- Typically we didn't see those type of things, but you're able to access the RN box and see what was in there. And I, had a patient message that said exactly that and had been unread for a few days and I was like, this is not safe.

And there is medical malpractice waiting in this in basket and a physician's going to fall for that. And it's not going to be me. I am young. I'm at the beginning of my career. I don't think my patients deserve this level of support, you know, even just beyond myself. And that, you know, that selfish piece of it.

Here are very vulnerable patients in the middle of a pandemic, reaching out with COVID questions, with other medical care questions and just getting no response back. And so I took over triaging all of my own messages and so, you know, went from getting fully triaged messages to now messages that I'm acting on from the very beginning.

And my clinical [00:48:00] load increased significantly on the order of one to two hours additional electronic medical record work per day. And so I went from this job that felt very doable pre pandemic and I felt like I had really good boundaries to then this just routine of hours upon hours of work every day.

I took a really major pay cut at the same time because we were. I had previously been on a guarantee, and coming off of the guarantee, my salary was calculated based on the previous 12 months of productivity, which included a 12 week maternity leave and, March. Don't love of a pandemic. Do that. And, and I mean, my, my salary, and this is a fulltime 1.0 FTE family medicine physician salary was cut to about $130,000.

Wow. Full-time salary. And it was devastating. I mean, we're living in the city of Chicago, right. It's, which is very expensive. We have a full-time [00:49:00] nanny who's beyond full-time. She was typically working about 50 hours a week, and, and my husband was still in training, making training money.

Dr. Toya: Right.

Dr. Sara: And it was, it was incredibly challenging.

And so I went from this job that felt like it was compensating well to now, $130,000 annual full-time salary like that. It's insane. And just that additional burden of, like I said, of one to two hours of additional work per week. And I just pretty quickly, it was like, this job is not, they do not value me.

They do not understand, they're not making moves quickly enough to support their physicians. And when many of us were stepping up to take that kind of support of, well, let me triage my own in-basket so that my patients don't die, or, you know, suffer severe morbidity, there was no motivation then to hire the additional staff because the work was still being done.

And it just [00:50:00] really quickly changed to an environment that felt like they don't care. Like they don't care about me.

Dr. Toya: That is the worst feeling. Like when you are giving so much and then you realize, oh wait, they don't give a shit about me.

Dr. Sara: And even beyond that like feeling, so there was still COVID.

We had these urgent cares that were understaffed and so we were, all the young physicians were required to spend time in the COVID Urgent Care. And so once a week I was going to the COVID Urgent Care to Work, which like may have been fine except that I had a very full clinical schedule.

And they were literally canceling patients and rescheduling them off of my personal schedule or my, you know, my clinic schedule so that I could go work in the COVID Urgent Care. And it was like that cog in the wheel, like I literally felt like a totally dispensable person.

Dr. Toya: Interesting. [00:51:00]

When you said that you stepped up to give good patient care and in stepping up, kind of fix the problem enough for them to not hire people, that is such a common. I don't know, trap that we fall into. Of wanting to be the physician that we wanna be. Be excellent, give excellent, care, but then filling in the gaps so that they can say, well hey, the work is getting done, patients are getting seen, so why do we need to hire anybody else?

And it's the refusal. 'cause obviously they know what's happening. It's the refusal to see the extra work and then be compensated for it. That is usually so like demoralizing. And sets you up like, well I'm doing all of this so my patients get treated, but then if I leave, who's going to, who's gonna treat them?

So it is a difficult situation to be in. So when did you finally say, enough is enough. [00:52:00] I'm out.

So. I rode out our time there. So amidst all of this then my husband is interviewing for jobs, so he's looking at jobs locally in the Chicago area. He was looking at jobs around the country and he's now, so he's cardiac and critical care anesthesia, which is a fairly niche specialty.

And that he needed to be in basically a major academic center, where they're doing those type of cases. So he's either in the operating room for those cases or he's doing the postoperative critical care management for cardiac, thoracic and vascular cases. And so all of this is happening while he's interviewing for jobs we're otherwise getting sort of fed up with living in the city of Chicago.

It's. There's huge restrictions from COVID, which again, a virus that I have huge respect for. And the playgrounds were literally under lock and key. I mean, they padlocked all of the playgrounds in the city. They were still padlocked when we moved in [00:53:00] August of 2021. So we couldn't take our children to the playground.

You know, we're spending 3000, I think our rent was 3,200 and this is like pre pandemic prices for our apartment. Right. And it to live in the city where we have no access to playgrounds. We have all the museums were shut down. The ones that were open, you'd have to get tickets for months in advance.

And, everyone was booking up the tickets three months in advance. So you were like stuck in a city where you couldn't do anything. And it's like, why are we paying this much money to live in a city? Right, exactly. What could very easily be a mortgage? Mortgage for a plenty nice house.

A huge house. Yes. Right. Exactly. And like for what now? For a job that is not. Like giving me what I, what I want out of a job. And so we moved to Virginia in the fall of 2021 and knowing that that was happening, [00:54:00] it made it, it put an expiration date on what my time there would look like. We did financially need me to continue to work.

So there was not, there-- it, I don't wanna say it wasn't an option 'cause of course everything's an option. But it didn't make sense and I, chose to stay in that job for the remainder of the time and seeing, the light at the end of the tunnel. A lot of positivity that came with that a lot of really big challenges though too, in feeling the guilt of what will my patients do without me?

Because I know that I am not, that there aren't other wonderful physicians in our practice because. Wonderful physicians, but just the level of care that the organization was able to provide at that time with the lack of support staff was, was rough. And you know, what will my patients do without me?

And so there was some guilt that came up during that time as well. But just recognizing, I don't know what the next step is, but it's not this.

Right? It's not this. So when did you decide I'm gonna [00:55:00] open my own practice?

Dr. Sara: It was a while. So I, you know, fall of 2021, we were kind of finalizing our plans. My husband had been made a verbal offer, but you know, it's at the University of Virginia and I feel like with any big academic institution, yeah, the contract, written contract took a while to come out.

And so we were really hesitant about moving forward with making concrete plans f or what our life looked like, because there wasn't any sort of signature on paper. So that ultimately happened in February of 21. And from that point, you know, I, I interviewed for a couple of jobs local to us in Charlottesville, Virginia, and did introductory interviews and my heart was just not in it.

And so I enrolled in a women physicians coaching program with the idea of just exploring like what could be next. The idea of opening a private practice was not really on my radar at [00:56:00] all, and I knew that the idea of employed practice just did not feel great. Even just thinking like my role as a mother, I was spending, I was leaving for work, you know, at 7:00 AM and getting home at 6:00 PM like, it just, I was like, I don't know what I'm doing, but this isn't it.

Right. And so into the spring had had these kind of half-hearted interviews, knew we were moving. And then it kind of settled in that summer of I want to open, I want to do my own thing. And so exploring whether that looks like direct primary care because my background's in family medicine. I guess we haven't talked about it in the podcast, but a big part of my practice has always been obesity medicine.

I went into residency knowing that I wanted to practice obesity medicine. I did all my, CME for obesity medicine during residency and immediately after getting family medicine certified, got obesity medicine certified. So even part of my previous practice, that was a portion of my practice, sort of unofficially, of [00:57:00] course, I was talking to people, you know, at their physicals and routine type of visits and discussing weight with them.

But then had patients that I saw for. You know, for, specifically for weight management. And so then deciding, do I do just go all in on obesity medicine? Do I go all in on direct primary care? What does that look like? And ultimately decided to, to open my own practice, which is a direct care model. So direct pay membership model, but specifically for obesity medicine.

And that also coming out of, when I look at the previous job, beyond some of the challenges that we've shared, feeling like I couldn't really support patients in the way that I wanted to in a 20 minute visit when patients were back to back to back all day long, sometimes very medically complex patients coming in.

Medically complex, behaviorally complex. And when I look at the care of obesity, I always felt like I was just leaving a lot on the table. I [00:58:00] felt like. We had these conversations where so much more could have happened had we just had 10 more minutes or 20 more minutes to be able to really delve into some of those things.

And so the idea then in starting my own practice was how do I create both for myself, how I want to practice medicine, how I get to have very clear personal and professional boundaries, but then also for the patients, what kind of care do I think they deserve? What kind of support do they need? What would it look like to be a patient who feels like if you have a question, you have a doctor that you can reach out to and you're going to get an answer, like maybe within minutes, but certainly within hours.

You know, how do you, how do I create that? And with that inspiration is where my current practice came from.

Dr. Toya: Amazing. Amazing. Tell whoever's listening , a little bit more about. Where they can find your practice and all that. We are not done yet. I don't wanna talk about your daughter, but I want

Since we're already [00:59:00] talking about your practice. Go ahead. Yes.

Dr. Sara: So my practice is named after myself. I started that way and planned to change it. I never did. So it's Sara Stombaugh MD., personalized weight loss. I am physically located in Charlottesville, Virginia, and I see patients by telemedicine throughout the states of Illinois, Tennessee, and Virginia.

And so you can learn more about me at my website, which I'm sure you'll include. Yes, I

Dr. Toya: will. Okay. So you've moved to Virginia. You are like, okay, I'm gonna start this practice. When did you decide, yes, I'm gonna have this third baby?

Dr. Sara: So pretty quickly after we moved here, we had started trying for our third child.

I, we'd agreed on two to four. Right. And we had two boys. And so I was open enough to a third child that I thought, you know, whether it's a boy or girl, I'll be happy. But, you know, let's try for our girl, which is, you know, ultimately how we. I, won't say that my husband would have like, probably more than four kids if I was on board with it.

But, ultimately how I [01:00:00] felt good with, with moving forward with that decision. And so we tried pretty quickly after moving here, I think in, September of October. Fertility has like, like I've shared, not been an issue I've struggled with, and I'm, I'm so grateful for that. But I did get pregnant really shortly after moving here, in early October of 2021.

And I did have a miscarriage for that baby. And so I had been launching the practice, my articles of incorporation are October 26th of that year, had a miscarriage a couple of days later actually. So it was all happening sort of at the same time. And then, The, you know, two cycles later decided to start trying again for, my daughter got pregnant with her in December and had her in September of 22.

And so I feel like I was pregnant with her for like a year because of the miscarriage. Yeah, Like, I've been pregnant for a really long time. But, you know, had [01:01:00] decided that we wanted to do that, knowing that that was really important to me. And then like, I'll figure out this business thing, but having this kid right now is, I wanna have, I wanted to have my kids close together.

Dr. Sara: We were ready and I knew, I knew she would be my last, I knew that, even if she was a boy, she would've been my last. And so it's like, let's just, let's just do this thing.

Dr. Toya: What. Made you decide to wait the two cycles. Like I know how that conversation goes as an OBGYN.

Dr. Toya: But I wanna know, what was your experience on thinking when you had this miscarriage, how you dealt with it, and then how you decided, okay, I'm ready to try again.

Dr. Sara: You know, it's interesting. It was really early. I was probably about six weeks in change. and I, in having the miscarriage, it happened really easily. I've been someone who's had labor [01:02:00] like physically easily. I've had labor very quickly, like I've had babies really quickly. Like one push and like,

Dr. Toya: yeah, a

Dr. Sara: nine and a half pound baby comes flying outta my body.

And so it was a really physically quick process, which I think then emotionally wrapping my head around what had happened was like, took more time. You know, I, I have many friends for whom their miscarriages had been like a very drawn out thing over days or even weeks if they've had to go in and have, you know, a DNC or procedure for that.

And so there was the blessing of like the speed with which it happened because physically it was not challenging. But then, like I said, the catching up with it emotionally and it was really, it was really tough, right? and it's something like so few women get to talk about. I was, I'm always someone who's been very open with my pregnancies pretty early on because I [01:03:00] didn't, I didn't ever want to like go through that on my own, but I actually.

Like had just been getting ready to tell family and friends. 'cause you like the first couple weeks of pregnancy, you're not pregnant, you're just Like the first two weeks of pregnancy, you're just like, the time from your last period. And so we'd actually like, just found out we were pregnant, just getting ready to tell people.

'cause like I said, it was about six weeks. And so at that point, you know, like then we're telling our parents and it's like telling them like, I'm not pregnant, which is a really, a really challenging thing to share with people. The wild thing is that now it feels really meant to be. So my daughter, was born on my grandmother's 100th birthday, or what would have been her 100th birthday, which is like.

So amazing to me. My, my grandmother was very close to me. She lived until 95 years old. [01:04:00] Wow. And we lost her about a week before I found out I was pregnant with Jack, our oldest. And so I'm pregnant with Jack and, you know, we're doing the testing and I'm like, I just know this is gonna be a girl. Like, I'm gonna name this little girl after my grandmother.

And then of course it was a boy. And then we had another boy and I'm like, Ugh. Like I just, you know, my grandma was so special to me. I want that to be part of the story. And so, finding out I was pregnant with Eddie, finding out that her due date was my grandmother's birthday, having her on that day, what would've been her 100th birthday?

We've named my daughter. So my daughter is Edna Mabel, named after my grandmother. We call her Eddie. And like that piece of it now, in hindsight. It's sometimes really hard to reconcile the heartbreak of a miscarriage within. Also, I did move forward, you know, within the time I would've otherwise been pregnant and [01:05:00] having another child and like Eddie could not have existed.

If that pregnancy had worked out. And so reconciling the, sadness and the grief of having lost a child with the, you know, the wonderfulness of the child who's like here in front of me can sometimes be really challenging. and so like in hindsight I get to, I get to see that and I get to, to feel that.

but it was, it was really hard in the moment. 'cause it, you know, my husband knew. but like I said, we're sharing it with other people in like as the miscarriage is happening and not necessarily wanting to talk about it super broadly, but then also. Like also wanting to, and like share that and get like comfort from people who were really close to me.

So it was, it was tough. And I was honestly, I, was ready fairly quickly to try again. I just had a [01:06:00] couple of irregular cycles. My body was like, I don't know what happened. And then we had a regular cycle and just, and kind of dove right in. Maybe even in just that response of like, if I'm focused on the next pregnancy, then this one won't hurt so bad.

I, don't know, like there's pieces of it that

I also feel like I, you know, blacked out or just don't totally remember from that time.

Dr. Toya: It's tough. And how did your husband handle it?

Dr. Sara: Actually, he, he had a really tough time with it. I think the. Like it being in my body, even though it was out of my control, still felt, still felt somewhat in my control.

Not in like a blamey way, like I've done something to cause this, but like I, you know, I saw the miscarriage happen, like I knew that it had happened. It was very clear to me what was happening. And so there was a very concreteness around that. Where I feel like for men, even just in a pregnancy that goes to term and ends [01:07:00] with a baby, there's, there's a connection there that's just different.

You know, the experience of it from outside versus it happening within your own body, I think is really challenging and feeling like there is no control over that. And he, he had, he had a really hard time with it. We still haven't shared it with any of our kids.

It didn't feel. Right to do that. But we had like, had a little ceremony and, we rented a condo when we first moved here, so I still, or like a town home and I still laugh. Like there's a, you know, dead baby in the backyard of that, of a town home that we've never told our landlord about, or, like, planted a little flower bush over it and it's part of the earth, you know?

Yeah, No, exactly. And it's like planted, like it was right. We backed it up to this like beautiful wooded area and so we, it buried it and like had a little ceremony and like I [01:08:00] said, planted it, planted flowers on top of it. And, so it kind of, you know, makes me smile to, to think about that and kinda chuckle, but it was, it was tough.

Dr. Toya: Thank you for sharing.

Yeah, thanks for asking. All right, so is there anything else that you wanted to share about all of the very unique situations that you've been through with each of each of your kids? Or after you've had all three, what was something that stood out to you, something you wish you knew?

Anything else?

Dr. Sara: I think. boundaries have been important to me for a long time. And my old job, if it taught me anything, it was boundaries. And that realization coming into my own practice, being my own boss, seeing where sometimes it wasn't the employer, it was me at times, that was the problem. You know, we have these ideas [01:09:00] about how hard we should work or working when we're sick and some of these different things, and getting very clear on that and seeing what ownership that I needed to take because there were places where I was indeed the problem in places where I was happy to overwork.

I, had a patient, I ended up having norovirus actually, and I was seeing a patient by telemedicine luckily, and, very quickly got the urge to get sick. And, uh. Ended, like, I shouldn't say, ended the visit. I wish I had ended the visit. If I had wise, if I was wise, I would've ended the visit, but muted and turned off my camera.

And like, as I was getting up, like, projectile vomited onto the wall. And the worst part of it was that I cleaned myself up, brushed my teeth, came back and finished the visit. And it was such an eye-opening moment of dude, like, you are self-employed. If [01:10:00] this is not a situation in which, like, if you can't handle this situation, like if you're boss is such a jerk and you're the boss, like you've gotta figure it out.

It's not okay. And so learning some of those boundaries, seeing where they are, my own responsibility, and then applying those ruthlessly, I think has been one of the biggest, one of the biggest lessons for me. and then in opening this practice in which. I get to employ that, which I get to share that with my patients, treating patients in the way that I want it to.

And even just to share my son, my 7-year-old now, broke his arm about a month ago, and I keep my phone on do not disturb, and I missed the phone call from the school. Our nanny came downstairs because I was at home doing telemedicine visits to tell me like, Hey, the school's calling me now, and I left in the middle of a patient visit to go pick up my son from school.

We canceled patients for the rest of the day and [01:11:00] my patients were texting me. Oh my gosh, Dr. Stombaugh, is your son okay? I'm saying a prayer for him. We were able to reschedule everyone really quickly and it was just such a powerful moment because it was. A really good sign for me that I, I am clear what my priorities are.

This is an example of how I've chosen them and I've built a practice that really supports that and I support patients in this way, but then they also learn and care about me. And seeing that humanity goes both ways was really, really powerful.

Dr. Toya: Okay. This was great. Thank you so much, Dr. Sara. Yes. I will include all of your information about you and your practice in the show notes. Doc, this is, I just have to say this at the end of your beautiful story, Dr. Sara is the reason that I am here right now on this podcast and celebrating two years of Dr. Toya coaching. She [01:12:00] is the person, if you've listened to, I dunno, multiple of these episodes where I've talked about why I started coaching. She's the one who was like, why are you trying to open a medical practice? This sounds like coaching. And even as I gave my excuses, she was like, Hmm, nope. That's not right.

It sounds like coaching. And she pushed, and here I am. So I always give a huge shout out to Dr. Sara for pushing me beyond my comfort and allowing me to. Step into something that I was unfamiliar with and scared about, which is usually, you know, when we stand behind professionalism and things that we do as physicians, a lot of it is fear.

And that's all it was. And that the people that I have been able to reach and help this, this podcast that you're listening to right now, none of it would've happened if it wasn't for Dr. Sara.

Dr. Sara: So I'm forever grateful. I love that. [01:13:00] I'm so honored to be a part of your story, so thank you for sharing that.

Yes. And thanks for taking my feedback. I don't know why we had just met one another. Exactly. I just dug

in and so I'm so proud of you.

Dr. Toya: Thank you. Thank you. I, yes, I didn't mention that she did not know me. At all.

And you know the, it's being in a community where. People are like-minded and also bold enough to speak their mind. And I didn't feel offended. I didn't feel defensive. It was just like, ha, that's interesting. Tell me more. And, well, I didn't even need to say, tell me more, because she took it upon herself to tell me exactly what was on her mind.

Dr. Sara: But yes, she came from love and care and, curiosity, just exploring those things.

Dr. Toya: Yes. So I am, I'm really grateful and I'm very happy that I got to hear some of your [01:14:00] stories, some things that I didn't even know about. And I'm very grateful for you sharing all of it with me and with the doctors listening, I know a lot of people will, hear themselves in your story and get a few tips on boundaries and all the things.

So I'm very, very happy that we are able to do this. So thank you. Thanks for having me today. Yes. All right, doc. Don't forget to share this episode with another physician mom. And leave us a five star review. Dr. Sara was amazing. You need to go on Apple Podcasts and say, Dr. Sara's episode was amazing.

And then if you are not on Apple Podcast, leave a five star rating everywhere else. It helps other physician moms find the podcast and just help her feel a little more seen and a lot less alone. So I will see you on the next episode of Stethoscopes and Strollers. Bye.