Paging Dr. Mom
I was a medical student with two kids, trying to keep it all together. I constantly felt like I had to defend my decision to chase a meaningful career and raise a family at the same time. But professional women with children shouldn’t have to choose between ambition and motherhood.
Paging Dr. Mom is a podcast for the women doing it all and wondering if it’s ever enough. If you’ve ever felt the pressure to be everything to everyone, this space is for you. I’m Dr. Angelle Downey, a family physician, single mom, and host who believes we can thrive, not just survive, through the chaos.
With real talk, expert insights, honest stories, and a few good laughs, we’ll navigate the mental load, burnout, identity shifts, guilt, and joy that come with being a high-achieving woman in a messy, beautiful life. Together, we’ll cry, connect, and grow into the strong, wise women our kids are watching us become.
Let’s build a life we don’t need to apologize for and actually love living.
Paging Dr. Mom
Bonus 1: Motherhood, Medicine, and Mental Load: Dr. Karen Leitner on Redefining Success Without Guilt
If you’ve ever felt like you had to push through pain, guilt, or exhaustion just to prove you’re a “good doctor” or a “good mom,” this episode is for you. Dr. Karen Leitner joins me for a raw, relatable conversation about perfectionism, burnout, and the emotional toll of always holding it together. We talk about why women physicians often carry double the guilt, how self-compassion actually leads to better care, and what it looks like to stop pretending everything’s fine. Karen shares her own journey with burnout and undiagnosed ADHD, and I open up about the time I kept working through a serious illness because I felt like I couldn’t let anyone down. If you’re running on empty, this is your reminder: you deserve rest, and you’re not alone.
💻 Links from Karen:
🎁 Free mini-course for women physicians: Life Support for women doctors — use code FREEMINI at checkout
📆 New 8 week CME Course starts Oct 15: How to Feel Better — For Women Physicians Done Pretending Everything Is Fine
This episode includes a paid partnership with BetterHelp. Click the link, betterhelp.com/drdowney, to get 10% off your first month.
Click below to purchase the 365 day journal I created called Enough As I Grow. I am a proud affiliate partner with Amazon and will receive a commission from purchases at no extra cost to you.
🖋️ Enough as I Grow 365 day Guided Journal on Amazon
Email: drangeladowney@gmail.com
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🎵 Music: Upbeat Strings by Evan MacDonald
Today's conversation is one that so many of us need to hear, especially if you've ever felt like you have to earn your rest, prove your worth by overworking or carry the entire household mental load without complaint. I'm sitting down with Karen Leitner and we're diving into the guilt so many moms feel around self-care, what real self-compassion looks like and how we can stop internalizing the outrageous expectations society and medicine put on us. If you've ever felt like you're failing while you're doing it all, this is your reminder that you are not alone and you don't have to keep pushing through. Hey, hey, I'm Dr Angela Downey and this is Paging Dr Mom, the podcast for women who are juggling careers, kids, chaos and cold cups of coffee. We're talking about the real life behind the resumes, the messy moments, big feelings and how to stay human when you're doing all the things. If you've ever felt like the only one trying to keep it together, you're not. We're going to laugh, cry, vent and thrive together. So here we go. Hello to all my busy mamas. I'm Dr Angela Downey and I'm so glad that you're hanging out with me on Paging Dr Mom.
Speaker 1:This podcast is for all of us who are just trying to keep it all together while juggling kids, careers and whatever else life throws our way. We will explore all of those moments that we definitely wouldn't be putting on our resumes. I am very excited to introduce you to today's guest. Dr Karen Leitner is a physician and certified coach who helps women enhance well-being, reduce burnout and grow as leaders. She's the founder of Karen Leitner MD Coaching and an ambassador for the Laura Breen Foundation, which advocates for clinician mental health. After training at Brown, the University of Rochester and Mount Sinai, she held roles in primary care, academic medicine and digital health before launching her coaching business. She lives outside Boston with her husband, three daughters and her beloved mini golden doodle, oscar. Hi, karen, it's so great to have you on Paging Dr Mom today. How are you doing?
Speaker 2:I'm great Thanks for having me.
Speaker 1:I am so thrilled to have you on the show, not just because of the incredible work that you do with women physicians, but I must admit I'm just a little bit starstruck because I remember messaging you several years ago, thanking you for all the wonderful work that you do, and I was really grateful to have you there when I was going through a period of burnout. So thank you for all the media that you put out there and you bring this really grounded, compassionate perspective that makes me feel like I don't need to hustle my way into worthiness. So thank you for being here today.
Speaker 2:So nice. Thank you so much. I mean, the reason I do it is because I wish I had had someone to do any of that for me when I was going through it, you know. So I've lived it all too, but that means a lot, thank you.
Speaker 1:Yeah, I think when we're struggling, we feel kind of alone and like everyone else has it all together and we like why can't I keep it together? And so it's really nice when someone's willing to put themselves out there and just say that they've struggled as well and to offer support. So maybe let's start by having you introduce yourself and tell us about your journey to becoming a life coach for female physicians.
Speaker 2:All right. Yeah, I was putting my makeup on getting ready for this and I was thinking about this. You know, I've thought about it so many times. People have asked me that so many times. I never woke up one day and was like I think I want to be a life coach. Like that wasn't part of how this came about. I wouldn't have expected it if you asked me. But what happened was I had a hard time in training, I think, mental health wise. I had a lot of anxiety, I had ADHD and I didn't know it. I was super unhappy.
Speaker 2:I remember I used to message my mom and be like I think I've made a huge mistake in medicine and she was always like just keep going. And it was that difference between, like the internal struggle and the external struggle which you kind of alluded to. It's like how many of us are struggling and you wouldn't even know because we're trying so hard to pull ourselves together. And then I got a job after a great job, and I loved it in the beginning. And then I had my kids and I just I sort of like blew up because I was trying to do everything like 150 percent, as we all do, and I wanted an A in being a mom and being a doctor and I really felt like I was getting an F and so I didn't know I was having burnout. I thought I was just couldn't handle it and I left my practice which was really hard my patients. So I felt a ton of shame and guilt and inadequacy and all those negative feelings.
Speaker 2:And the interesting part is like I recovered from that, I looked for 100 different jobs to try to find the job that was going to feel right for me. I just thought it was the job and I did a lot of things but none of them really fixed the idea that I was just like this doesn't feel right or I'm not that happy of them, really fixed the idea that I was just like this doesn't feel right or I'm not that happy. Until I got a job working doing medical patient advocacy, which I really loved actually. But along the way I started listening to some coaching podcasts and found that they you know, I remember listening to the first one where it just said your thoughts create your feelings and I was like what?
Speaker 2:Like my thoughts are the reason I feel anxious and overwhelmed and embarrassed and ashamed, because my thoughts and I can maybe have some control over those and I don't have to believe all the thoughts that come up in my brain. So I really started to apply those tools to myself for a long time and they helped so much. So I don't know if you have this commercial in Canada I was thinking about this too this morning but there used to be this old TV commercial, or like on the radio, talking about the hair club for men. Do you know that? Okay, I know the club.
Speaker 1:I just don't know if I know the commercial.
Speaker 2:This guy would come on and he would I forget what he would say, but it was the hair club for men. And at the end he'd say and I'm not just the founder, I'm also a client. You not just the founder, I'm also a client, you know. Because he also, like, had hair loss. And I was thinking like I was my first client.
Speaker 2:I did all this work on myself. I changed my mindset, I changed how I saw myself, I worked on having more self-compassion. I had to let go of perfectionism and just sort of go through all these and do things that felt really uncomfortable and outside my comfort zone, stopped fixating on pleasing people all the time, and it made a huge difference in my life. And then this is the long version, but you told me we have lots of time, so I'm just giving it all to you.
Speaker 2:My company I was working for got acquired and I found myself going from feeling like amazing at work and loving it and feeling so impactful and having seniority and like just living large and also it's very rewarding to feeling now like resentful, stuck, bitter, undervalued. As you can imagine is similar to how a lot of us feel when we're going through burnout. So I hired a coach. I joined a coaching program actually because I was like, yes, some of these help me, but now I need like professional help, and that was so powerful and helped me so much more. So that's when I decided to train to become a coach, because I wanted more for myself. And then during the pandemic I realized, because I wasn't seeing patients and I wasn't at risk for getting COVID, I wanted to get back to the doctor community where I live and I offered volunteer coaching for people and then it was just from there. I started my business and it took off. That's how I found it.
Speaker 1:Yeah, yeah, that's quite the journey that that you've gone through and a lot of us going through medical school. We don't have those types of courses to teach us how to take care of ourselves and teach us, like what, what we need to do to be mentally well. So why can I say something about that?
Speaker 2:Not only do we not have the courses, but the medical system itself traumatizes us, Like it is traumatic to see people sick and dying and to be under-resourced. So it's like it creates some of the need for the supports and then it doesn't provide them for us. So it's a double whammy.
Speaker 1:Yeah, I remember thinking that, like the medical system, just I never really felt supported by it. So I would see, you know, I'd be on the ward, somebody would call in sick and you'd almost be shamed for calling in sick, like oh, I went in when I was sick. Like why can't you do the same? And we write all these notes for other people to be off work, but yet insist on going into work, like I've had a colleague call and say you know, I've got strep throat, I'm dying, but I feel guilty for calling in sick and all these patients are going to have to get rescheduled. And so we just, I don't know, it's like we don't have this feeling that we can take time to take care of ourselves and have patients get cancelled. So why do you think a lot of us feel guilty just for taking care of ourselves and have patients get canceled? So why do you think a lot of us feel guilty just for taking care of ourselves?
Speaker 2:Well, it's like you said. I mean, in training, if you call out, it's like you are giving someone else, like you're making someone else go in for you, and that is not encouraged. It's not like we all help each other out, it's like very individualistic, it's very under-resourced, so like why isn't there an abundance of people to meet the need? Right that we're like skeleton crew and so you take one key person out of the rotation and now everyone else is struggling. So you know, I think that's part of why we feel that way in training, and then it just carries through. But the culture tells us to be self-sacrificial and stoic and not show vulnerability and not be weak, not be perceived as weak, you know. So a lot of systems rely on people to just not question, and I would argue it's sort of like the system would collapse if we all realized we have agency and we can take better care of ourselves.
Speaker 2:So it sort of it preys on our generosity and our caring and our compassion and our dedication and how hardworking we are, and so it's. You know you have to start to separate, like well, at what point can we keep blaming the system for what sometimes we're perpetuating on ourselves right, Like we still get to say I'm going to go in, I'm not going to go in, I'm going to take the consequences, but the guilt, guilt is like I'm doing something wrong and we don't believe it's wrong to take care of ourselves. So a lot of it is. You know, we have to be uncomfortable and we are sort of evolutionarily designed to want to fit in and belong and not be rejected. Sure, Because you would die out on the planes if you were a gay person?
Speaker 2:Right and it's the same thing with everyone in medicine is showing up even when they're sick and coming back after a week of maternity leave and doing all this crazy stuff Although you guys, at least from what I hear it's not that bad. But even in the States I can't tell you how many women have said two weeks and I went back and even paid maternity leave isn't guaranteed in every state, so it's like you have to go against the grain when you show care for yourself and that's uncomfortable and it's not modeled for us. So there's a lot of confounding variables.
Speaker 1:Yeah, yeah. Calling in sick is definitely uncomfortable and feeling like you're putting pressure on your colleagues to take over the slack. So you mentioned Matt Leaf. So how did motherhood shape your own career path?
Speaker 2:Oh, that's such a great question. I really think when I was choosing medicine it didn't occur to me to think about how would I fit in kids and what if I have these other needs I have to meet. I also think when I look back, you know I did internal medicine and pediatrics and so I wanted to know how to take care of the sickest of the sick. Like I wanted that knowledge. And once I had my own kids, emotionally it became challenging for me Like I didn't. You know, it was a lot harder for me to imagine kids being very sick and then me taking care of them. I haven't heard that from a ton of people in pediatrics, but that was part of it for me.
Speaker 2:But the biggest thing was I suddenly felt like pulled in two directions and I had like double the guilt, because I used to just have guilt like if I wasn't working hard enough, but now if you work harder, then you have guilt because you're not there caring for your kids.
Speaker 2:So women have this extra pressure, like the double bind, where we're expected to like do everything and be everything but we're not given the supports to succeed in either arena. You know and that's a huge generalization but most people. There's still a gender disparity in the way the household works and childcare and who's the you know, the default parent. And so for me, I felt this responsibility because I wanted to be there for my kids so much and I would just try to fit like shrink my job so I could fit it all. But I never really. I never found a way to do that very successfully because I was still trying to perfect and people please, which is what you're talking about we don't want to let anyone else down. We don't want to ask for something for ourselves that might make someone else uncomfortable. So it was a perfect storm for burnout for me.
Speaker 1:Yeah, for sure, I always tried to give my kids like 100% of whatever energy I had left, but there just wasn't that much energy left. So like 100% of 10% is like not a lot, and it was really hard for me to juggle how much to give in one place and how much to give in another place, and when you're trying to give 110% in both places you will burn out Like it does. It catches up with you and you do everything to take care of everybody else your patients and your kids but not yourself.
Speaker 2:Yeah, and that's challenging it is and I think you know, just going back to some of the things that come up a lot in coaching we tend to be very black and white, like all or nothing thinkers in medicine a lot of the time. You know it's like do they have a PE or do they not? You can't be like, well, they might, but they might, you know. You kind of just like are looking for that answer. I think it makes a lot of us fixate on the areas where we're falling short and we like hyper focus on that. We call that the gap.
Speaker 2:Most of us that I have experienced are very hard on ourselves for the way we mother, even when we're already doing a good job. I wasn't doing a bad job, I was just telling myself I wasn't doing a good job all the time because I was so fixated on like, and their hair isn't brushed and I didn't realize the diapers needed to be a bigger size, you know. So it's that inner monologue where we're just never happy with how we've done. It's never enough. A lot of it has to do with just scarcity sinking, which is like I'm not enough, I'm not a good enough doctor, I'm not a good enough mom, I don't have enough money. I haven't done enough charts, like it. Just the thinking follows us around Like what is, what is a good enough mom? Like tell me, you know. And when someone does answer that, it often is like would you ever tell a patient you know? Oh, you work 40, 60 hours a week. You're not a good mom. But like we think about ourselves, you know.
Speaker 1:We also see social media. Right yeah, showing us you know, all these pictures of these families doing these like amazing things together and you're like, wow, I'm just really happy that I got my kid to brush their teeth today and that their clothes aren't wrinkled. But it's hard when we get these messages all the time on media. What motherhood should look like?
Speaker 2:Oh yeah, that's a whole other category. I mean it's pity and people lying on social media, but then it's also the patriarchy. It's like the system was designed for men and all the leadership was men, and even like the advertisements that created the idea that we're supposed to like wear high heels and vacuum and give our husband a martini when they come home. That was marketing from advertising agencies, but it sinks into our collective subconscious. So then we have these expectations of what we're supposed to be able to do that are totally not realistic. And then we are judged. You know, we are discriminated against by, like the misogyny that's also really prevalent in a lot of Western culture. So it is very multifactorial. It is not just something that we put on ourselves, but the part that we have control over is the narrative we want to believe. Forget about what we're being told. It's like OK, but I want to know in my heart that I'm a good mom and I get to decide.
Speaker 1:But worrying about what other people are going to think about you just perpetuates this idea that you need to be perfect and just makes you feel bad about the job you're doing.
Speaker 2:Yes, and the meanest person is always going to be you. It's listening to the mean version of you telling yourself and again, maybe some people don't identify with that, but by and large, like we had to be kind of drill sergeanty to achieve and to to get into medical school and to get through training and to survive 30 hours on call, we have this like come on, suck it up, be tough, don't mess up. What's your problem? And that we just continue that constantly. And that for me, was, I think, the biggest like epiphany I had, or the thing that made me the happiest was realizing I don't have to talk to myself like that anymore, like I, I'm at, like what do I? I'm, I'm doing the best job I can, I'm going to be flawed, I'm a human being, it turns out. And that messaging rate when I go on social media and I'm like I'm flawed and you're flawed and it's OK, how about we all stop pretending? It resonates so much like we're all pretending in medicine, you notice.
Speaker 1:I think For sure. It's interesting that you bring up like the 30 hour shifts, because I would never stay up for 30 hours ever. I feel like it's super unhealthy. I love my sleep. I think sleep is so important. But yet the medical system, when you're in training, you're expected to stay up for 30 hours and they're like you know what Studies have shown that this doesn't cause you to not perform properly. So do it right. And so it's almost like our training has taught us to ignore our bodies and ignore our feelings because they need us to work.
Speaker 2:Yeah, so we've trained ourselves that we're the last priority and you know, whatever our bodies are telling us that we need to do, it's not real and to ignore it. You know, if you were going to set up a system, the ideal system for medical trainees would it be 30 hours on, underslept and underfed and underpaid, Like there's very high rates of untreated, there's very high suicidality, suicidal ideation in training. So obviously the way it's set up is not working. But instead of us all like rallying together to change it, we take that and we use it against ourselves.
Speaker 2:Oh, I'm the only one who's so tired, who can't make it for 30 hours, Like, what's wrong with me? I'm the problem, you know. So we have, we've sort of been a little bit brainwashed, Like I. I think of it like Stockholm syndrome, you know, like someone kidnaps you but then you want to protect the kidnapper. It's like we would never tell our patients go to work when you're sick. But we do it because of that, what we've internalized from the toxic culture of the workplace, and I think it's just important to call it out.
Speaker 1:Yeah, I had a couple of rough years in medicine. You talked about you going through burnout and I did the same. I think I was actually burning out before COVID hit and then COVID came and then I was like, okay, like I need to rally, I need to get this, I need to get myself together because COVID's coming and we need to do all this stuff. So you know, a couple of years into COVID, I just felt myself burning out more and more and more and I could feel myself getting tired. I could feel myself getting really short with patients. My patients was like razor thin and I think my body kept telling me to slow down, but I was like, no, I need to keep doing going.
Speaker 1:And my stomach was upset all the time and I started to feel, you know, like a lot of back pain and I didn't know what was wrong with me.
Speaker 1:And it turns out I had like osteomyelitis and septic arthritis of the sternoclavicular joint. I have no idea how I got that, but even with that, I kept pushing myself to go into work. So I would do had like five hours of IV treatment every day. I would do like two and a half hours before a clinic and two and a half hours after, I kept going in because I felt like I couldn't say no to my patients. I didn't want anybody else to pick up the slack. So I kept pushing and pushing and this went on for like six months and I just I wasn't getting better and at that point I started having heart palpitations. So my body would just start like falling apart and, like I don't know why, I felt like I needed to keep going. It's like I always felt this need to just keep pushing through and I could, you know, grab energy from wherever I could find it and just keep going.
Speaker 2:But I became like a horrible person find it and just keep going, but I became like a horrible person. Wait, I'm sorry. No, no, let's back up for a second. You're like I don't know why I kept pushing and pushing. I'm like, yes, you do, because that's what we are told to do. Yeah, so I just I have to reject in any way that you were a horrible person, but perhaps there were some ways you were showing up that you didn't like and didn't align with how you see yourself. What do you mean by that?
Speaker 1:So I mean like the stuff that I would say to patients.
Speaker 2:I just became so resentful of everybody who wanted any of my time.
Speaker 1:So if anybody wanted any of my time. I was like so upset. I'm like thinking to myself like who are you to be complaining about your everyday problems when I have this going on and nobody cares about me?
Speaker 2:Yes.
Speaker 1:And it took a long time like way past, when I actually healed from my infection to realize that I was actually giving people permission to take my time and I was like allowing that to happen.
Speaker 2:How did you?
Speaker 1:realize that Lots of therapy Okay, yeah, lots of therapy, but at the time I don't think I could see it. So I was just going into work every day and I would get so angry and people would be, you know, talking to me about their problems and in my head I'm thinking you think you've got problems, I've got this going on. My IV line is hidden under my sweater here, you can't even see it. So that's what's going through my mind. I could only think about myself and what was going on with me and it was just making me so angry all the time. And that was just like a culmination of years of just not taking care of myself. And so, yeah, I ended up, you know, telling somebody that they were like my worst patient on my roster and that when I saw their name in my schedule I wanted to call in sick that day.
Speaker 1:And I think we all get some those kind of like gut sinking feelings with certain patients sometimes who are emotionally really heavy. But we have a filter and we know not to say these things and we know how to regulate our emotions. But at my peak of burnout I just I was not able to do that and it just became so overwhelming that I just one day just walked away. I shut down my family practice and I walked away. It was really hard for me to see the role that I had actually played in that I'm the only one who can protect myself. I'm the one who has to say you know what I'm not feeling? Well, I need to take care of myself because no one else is going to do that for me, and it took me a long time to realize that. Why do you think we do that to ourselves? And you talked about like the system has taught us to be like that. This is probably messaging that we get when we're children too, right?
Speaker 2:Well, I just first I just wanted to say like I'm so sorry that you went through all of that and thank you so much for just sharing it so openly. It's still painful to hear and to imagine you going through something like that, like you are hurting that's how it shows up. When you're hurting inside, your body is hurting and your mind and your mental health is hurting. And so I wanted to just sort of briefly just define what burnout is, because it's used so much sort of colloquial, you know, in the oh, I'm so burned out. But like what do we actually mean? And everything you're describing is like classic. First thing is emotional exhaustion, not just being tired, not just being so sleepy. You want to sleep, but it's like I don't have anything to give anymore, like there's just nothing in here, like tired beyond tired. And then the second big red flag for people is when you lose your empathy. That is part of burnout. So you went into this because you care about people and you find yourself not caring, and that is part of the disease. I'm not going to, I don't mean disease, but, like you know, sometimes it would be like if you were like I have diabetes and I I'm peeing all the time, you know, and you're like I don't know why I was doing that. It's like no, but this is defined, this isn't specific to you. So you lose empathy. Emotional exhaustion. And then the third part is sort of lack of personal efficacy, like what's the point thing I do matters anymore? Like why am I even doing this?
Speaker 2:So the other thing that I think is just interesting to point out is that resentment, all that resentment that you're feeling, that you're sort of judging. Like we're really good at judging ourselves. We judge ourselves all day long negatively. That's also part of being women physicians. But like we talk about resentment as being like drinking poison and expecting your enemy to die. The patients don't feel it. Until you say something, until you act on it, they don't feel your resentment. You feel it. So you're sitting here trying to do this really hard job and then feeling extra miserable because your brain I sort of think of it as like the canary in the coal mine Like when you start to notice yourself being very resentful of others, you have to stop for a second and be like okay, wait, what do I need that I'm not getting? And that was just so. In a way, we're like thank God for the resentment and thank God that you, like lost control of your behavior, because that's what saved you and got you out of there. Otherwise, who knows how much longer you would have kept doing it right.
Speaker 2:But the third thing I wanted to just normalize for you because you know I've spoken to hundreds and hundreds and hundreds of women physicians is this we have a hard time differentiating between blame and responsibility. Like for sure, you had some responsibility for what happened during the time, because you were the one choosing to go into work and see the patients and you know, whatever you made those decisions, there's no one else like puppeting you. So, yeah, you're responsible. That doesn't mean you have to accept blame or feel bad about it, because obviously you were always doing the very best you could in the moment and had a lot of extenuating circumstances and all these factors, like we talked about how we're socialized and how the system pressures us and how we're you know it all contributed to that. So I can't tell you how often people I'm trying to think of other examples where I see women physicians blaming themselves instead of like we want you to take responsibility and we want to feel like radical responsibility is what I'm always talking to my clients about, because if you don't have any role in it, if you're just zero responsible, then you don't have any control to change it. So if it's just my hospital's fault, if it's just the system's fault and medicine is terrible everywhere and it's all. You know the way it's reimbursed and blah, blah, blah there's nothing for me to do. So I have to find the 1% that maybe I play a role in, because that's the only thing I have control over and when we are focusing our energy on where we have control, we feel so much more in control. And that's part of why I think for me the mindset coaching was so helpful, because I couldn't change.
Speaker 2:If I you know, especially with ADHD like I can't change that, I'm going to forget stuff and like double book stuff and you know, make mistakes. I just made such a bad mistake. What was it? The other day I was so bummed about it and I, just, I, just I was like I cannot even believe I, oh, I know what it was. My daughter asked me please go on this website at this time and book these tickets. We can only go on this day. We traveled to Acadia National Park. She wanted to watch the sunrise on this mountain. She's like Mom, I'm trusting you. I was like I got it. I got it and I set an alarm, I set a timer, I had the password, I had the website.
Speaker 2:I was sitting there and then my other daughter distracted me. I don't even know what happened. And then I'm like, well, I still have 10 minutes. Let me go look at this thing. And I don't know if you're, if you know, with ADHD, you have time blindness. I completely lost all track of time and suddenly it was like 10 minutes past when I was supposed to do it.
Speaker 2:Like I blew it and I was like like I can't believe I did that and let her down so badly. I couldn't believe it, right. So old me would have just like hated on myself, like beat myself up. What's wrong with me? I suck. But I am able now to be like, oh my gosh, that's so hard when you wanted to do that for her. It's not like a free pass. So I just really encourage you to think about, like, what does self-compassion look like when we retell those stories of times when we didn't show up the way we wish we had, like I actually apparently I don't know, but one of my patients wrote this review of me in like health grades or something. They said I yelled at them. Maybe I did, I don't know. It was someone who I had had on like chronic opiates for a long time and then they like revealed to me that they had had someone else prescribe or something like that. I don't know. Like we're human beings, so we're still going to be human.
Speaker 2:Sometimes it's like how do we treat ourselves after the fact? How do I treat myself after I yell at my kid? How do I treat myself after I maybe make a mistake? That was another huge one for me is, I know I'm like, I'm like airing all my dirty laundry about the kind of doctor I was and I was a really good doctor. I can say that now. But the things no one talks about is you're going to make a mistake. It's just human nature. How are you going to show up for yourself when that happens? And for you know it's like shame, stigma, blame, like beat yourself up, hide, avoid and, you know, fall off the planet. Like that's how we're taught to handle it.
Speaker 2:It's another way.
Speaker 1:It's like this is part of being a human and a doctor like society plays a little bit of a role, because they tend to put doctors up on these pedestals and you know they forget that we are human and that we do things that sometimes we're not proud of. We make mistakes.
Speaker 1:So I think that I always had this idea that you know and I'm a perfectionist I had to do things in a certain way and be a great doctor all the time. So when I, you know, didn't show up the way I wanted to show up, it was really hard for me to accept that I wasn't fulfilling this role that I felt like I was supposed to be doing.
Speaker 2:Well, it turns out and most people don't know this that doctors are human beings also, and all the things that apply to other humans apply to us too. We get sick, wouldn't you know? Like that's part of the toxic piece of it. Of course you want to be the best doctor you can be and you don't want to make mistakes, of course, but it is not. We're going to fail. So, instead of telling us not to tell us how to manage it when we do, that's just life, you know. You got to change that messaging.
Speaker 1:Do you think that imposter syndrome plays a role in that? You know I already. You know, sometimes don't feel like you know it's only a matter of time before they figure out that I don't belong here. Or, you know, all the other doctors are smarter than me. So I have this thing that I need to prove. So when something does go wrong, it just reconfirms for me everything that I already believed.
Speaker 2:Yeah, so I don't. It's, it's not an actual syndrome. So I say imposter phenomenon because there's no. If you look at there's, it's not like a medically agreed upon thing. So it's like it's the the main thought distortions that I have identified through my own stuff and I'm we're talking through them all right now that basically, like women in medicine, subscribe to some or all of these things the perfectionism, people pleasing, like over self-sacrifice, imposter thinking, learned helplessness, scarcity, mindset. So imposter thinking for sure contributes to that, but it's overly prevalent, like how can 80% of us be imposters? So it's even just recognizing that, instead of believing I wasn't good enough, I'm like, oh, I was just thinking I'm not good enough and I think that all day, every day, wherever I go, and then I show up worse. Right, so it's sort of.
Speaker 2:Yes, I definitely believe that for so many of us, we have these thoughts and we're also messaged from the external world that we are less than like, we're called nurse all the time and we're paid less than our male counterparts and we are, you know, first named and all the things that society does, the patriarchy when we are women or when we have marginalized identities.
Speaker 2:Part of imposter thinking comes from that too, you know, but it's a thought pattern. So what I encourage people to do is just notice it. Oh, there it is. Oh, I'm thinking I don't know enough and like you have to remind your brain sometimes that you actually do. Like, what are the facts? Well, I'm board certified and I went to med school and I passed my step exams and then I, you know, practice for five years and I have a degree. Like okay, I just have to sit with the dissonance that my brain thinks I don't know anything, but I have so much evidence that shows I do, and then just like, move on. I talk a lot on imposter thinking and I feel like another huge piece of it is that self-compassion piece.
Speaker 1:It's like oh, I feel like I know less than everybody else. Yeah, that's part of the human experience that did at this retreat was we had to write down on a piece of paper like thoughts that we had about ourselves in medicine, and you know so many people wrote down things like my colleagues know more than me, Everyone in my office is a better doctor than I am, and so afterwards we had to go post these sticky notes on this board and it was written down so many times. I'm like how can all of us be terrible doctors? Right, these are some of the smartest women I know, and it was shocking to me that they all felt the same way that I did. But yet we are all very smart and great doctors in our own right, but yet we all feel like we're not good enough if we're trying to compare ourselves to other people, other doctors.
Speaker 2:It's not just women for sure, like men, have imposter thinking too, and part of it is, you know, when we're in the gap. All the time it's the compare and despair. We're always going to compare ourselves to the people that we think are better and never look at all the people who, like, maybe are different or not as good as we are. So I think what I love for you is that until you start having the conversations that's the thing is it's so isolating when you just are stuck in your own head, afraid to admit to anyone that you feel somebody's feelings. It can be so healing when you start talking about it and you know, for you, your retreat, for me and my coaching programs, there's, you know, 50 women all badass, amazing, smart, accomplished doctors saying I feel like a bad mom, I feel like a bad doctor.
Speaker 2:We are actually amazing doctors, right? So I think that can be helpful. When you externalize it to someone else which is what you're saying You're like that person is amazing. I see how hard she works, I see how smart she is, I see how much she loves her patients and takes good care of them and shows up so much for her family, but she seems to think she's not adequate. So then I'm like oh, wait a minute, maybe I who do all those things also, maybe I am enough. You have to learn how to remind yourself that those thoughts are lies. You have to learn how to remind yourself that those thoughts are lies. Yeah, that's what, like being able to notice your thoughts can be so powerful, because you just realize, like, but that would be the old tape that my brain would listen to. And now I'm like come on, karen. No, she's a human being.
Speaker 1:She messes up too. So one of the core messages that you've brought up a couple of times today is that self-compassion is, like such, a key part of healing. So for someone who's deeply entrenched in perfectionism or self-criticism, where do they begin?
Speaker 2:Well, you know, the simplest way to think about it is what would you say to your best friend? Listen to what you're saying to yourself. What would you say to your best friend? Would you say you're a terrible mom because you were late to pick up? Would you say your house is a disaster and you, you know. Or you're an awful doctor, you know? You just would never say those things. They're really unkind.
Speaker 2:First step is just noticing how you talk to yourself and for most of us, when we start to listen to, part of self-compassion according to Kristen Neff, who's done a lot of research on this is self-kindness. So what I was saying like talk to yourself the way you talk to someone you love, mindfulness, so like being in the present moment. What's happening right now is I forgot my laptop charger and my laptop almost died and I felt embarrassed, and that's all that's happening right now, and it's okay. If you're worried about the future or if you're regretting something you've already done in the past, then you're not being mindful, you're not in the present moment, noticing what's actually happening. And then the third part, which has come up a couple of times already for us in this call, is the common humanity, which means we're never alone. Like we, for whatever reason, the human brain is designed to think that when something, you do, something bad or horrible or embarrassing or that doesn't meet what you think is the standard, we think we're the only ones. And realizing like everyone has a bad day, everyone fails a test. Sometimes Everyone's clothes don't look good, everyone, you know, gets whatever it is Like.
Speaker 2:Life, we say in coaching, is the 50-50. It means half the time I'm going to show up and I'm going to love how I answer the question and half the time, you know, I'm going to not enjoy my job. Half the time I'll like it, half the time I don't, half the time I'm the kind of mom I want, half the time I'm not. So it's just realizing like there is a balance and our expectations are so skewed and they're so high for ourselves and then they become so high for everyone else and then we get disappointed and then we don't know how to deal with any of these emotions that come up, you know, shame or embarrassment. We basically turn our feelings off as doctors because we kind of are trained to do that.
Speaker 2:I think it starts with noticing how you talk to yourself and trying to be kinder, and I think the part that feels really hard.
Speaker 2:Like I'm always teaching self-compassion to my coaching clients and a lot of times people think I'm saying, well, just give yourself a free pass to be mediocre, that if you have self-compassion, if you're nice to yourself, you'll just like slack off and be lame and not achieve. But the opposite is true. Like the studies show that you perform better when you are not mean to yourself. And if you think about a little kid who's struggling with something because we tend to have self-compassion when things are going okay but, like God forbid we make a mistake or we hurt someone else then we are doubly mean to ourselves. Like a kid is not going to get better at math if they fail a test and we like scream and yell at them and make them feel like crap. But that's what we do. It's like when you encourage someone, they're going to be more likely to do better and the data supports that. But that's, I think, sometimes hard for physicians because we just we're used to just blame and shame.
Speaker 1:That's what we do, yeah, and it's hard when you feel alone in it, so it's nice when you can actually talk openly about these things and normalizing that we do make mistakes and that we do not need to be perfect. We are not perfect.
Speaker 2:There's no such thing we will make mistakes.
Speaker 1:We're trying to be perfect all the time. We're just setting ourselves up for failure, because that's just not something that most people can maintain and we move the bar, we move the bar.
Speaker 2:Not something that most people can maintain. And we move the bar, we move the bar. We're like, oh well, this, then we reach that, just the narrative that it'll be better when you know it'll be better when I finish training. It'll be better when this happens. When that happens, no, it won't, it's still going to be half good, half bad, so human.
Speaker 1:What would you say to the mom who feels like she's just dropping the ball home at work in relationships and who secretly wonders is it just me Like? What would you tell her?
Speaker 2:I would tell her it's not just you and like, welcome to motherhood. And you know, some of the hardest things you'll ever do is be a parent. But you can either help yourself through that by like, sharing and being honest and recognizing that this is part of it, but I think that's the biggest. This is the thing that I wish people understood. It's like we care so much about being parents, we are so hard on ourselves because it matters so much, but when you are beating yourself up, you show up worse as a parent.
Speaker 2:My kiddo, like, fell off the bed when she was 10 months old and bumped her head and I was just like, oh, she's fine, by the way. But just in case this happens to anyone else because it kind of happens to all of us, right, I'm like I'm the worst mom. I can't believe I did that. I feel so horrible, like I also make it all about me. My kid just got hurt. Like, yes, I care about her, but. But when you're in that guilt and feeling terrible about yourself, you're very self-focused, which makes you disconnected from the people you love and like want to be present with. It's not about me in that moment, it's actually about her. But when I'm. So if I'm just like, yeah, this happens, it's okay and let's take care of baby now, that's better momming than the shit. I'm awful, I'm in shame and I'm so flooded I'm not even maybe going to be like do I go to the doctor? Do I call an ambulance? That's not the best example.
Speaker 2:But another one I love to think about is like it's so easy for us to judge ourselves based on how our kids do and to catastrophize into the future.
Speaker 2:So my kid's room is messy and I'm just like she's going to be a failure and she's going to live under a bridge and it'll be all my fault and I'm a terrible parent, you know. And then I get dysregulated and I'm in that space of feeling again like shame and failure that I'm not curious about or I'm not creative in how we think about problem solving the messy room, or I'm not even asking if it bothers her, or I'm not figuring out, I'm not using the smartest part of my brain to communicate and to talk it out with her, because I'm already just in this. I suck place, so I'm going to show worse. So it's not even that thinking like being kinder to yourself just makes you feel better. You will show up better for the other people you care about when you're not feeling so bad about yourself. It's really hard to be loving and present when you're like I suck, I suck, I suck, I suck.
Speaker 1:And I'm also thinking of like, if you're sick and you're going into work and you're not feeling very good, you're not going to be your best self and you're not necessarily going to be helping your patients all that much. If, like with me going to work every day when I was just so burnt out, slamming doors, yelling at people, telling people they were the worst patients, that wasn't good for them, and all that was because I wasn't taking care of myself and I wasn't able to be fully present with them.
Speaker 2:Really important to take care of yourself, because you're not going to be able to show up very well for other people if you're not cared for it is so true and our judgment is so bad at that, which is why sometimes I think we need to outsource it to someone else. Like I can't tell you how many people want to go into work sick and whatever I try to talk them out of it, or I'm just like this is crazy, or you know. And then and then, after when they've been out, if they, if they listen to me, they're like I went back to work and I was such a better doctor, I had more energy, I cared more, I was smarter, you know. So it's this idea, it's another thought error. It's like I need to stay up super late, working harder, you know, but if I went to sleep and had a good night's sleep, then the next day I would get more of my work done.
Speaker 2:It's undoing a lot of these false beliefs we have. Or, like with perfectionism, like I talk so much to my clients about our notes, we think I'll write a better note later. It's like, no, you won't. Two weeks from now is not a better note. Do it now, do it crappy now Still be better than the two weeks from now when you don't remember anything and you will have more time for you. So it's like we have to start unlearning some of these beliefs we have that actually create the opposite of what we want.
Speaker 1:Yeah, actually create the opposite of what we want. Yeah, yeah, you can't pour from an empty cup. You can't One thing, yeah.
Speaker 2:Yeah, but we know that Right, you knew that, like you did, and multiple people told me I should be off work. It's knowing versus like feeling. You knew that, but you felt like, if I don't go to work, what does it mean about me? You know, I feel ashamed or I feel weak or like you know. So unless you work through some of that stuff, it doesn't matter that you know it. It's kind of like knowing we should eat healthy and exercise. Well, what good is it to just know that? How do we actually do it? And that's where we have to shift the way we're thinking. We want to act differently, which you did amazingly and like.
Speaker 2:I'm so happy you shared that you were open to going to therapy because there's so much stigma in the professions and like, yeah, like I always talk about, I take medicine for anxiety and I take medication for ADHD and I think therapy is wonderful and I've invested in coaching and I'm like do all the things to make yourself feel better. There's no shame in that. I think it's wonderful that you got yourself to such a better place. Let's give you credit for that too. I love therapy.
Speaker 1:It was something I was always afraid to do. For a long time I started going to therapy and I was like, wow, this way of thinking, and sometimes I just I need somebody to tell me that.
Speaker 2:So, even though I am well now.
Speaker 1:I am loving being back in medicine. Although I'm not full time anymore, I still go to therapy because I think it's just so helpful and, yeah, I think it's good for my mental health to go.
Speaker 2:I think sometimes people think like I have to be. It's the same thinking I need to be so sick to go to the doctor. I need to be mental health to go. I think sometimes people think like I have to be. It's the same thinking I need to be so sick to go to the doctor, I need to be so unhappy to go to therapy, I need to be so struggling to hire a coach and I'm like that is so backwards. I'm like I will never go without a coach and I'm the happiest I've ever been in my whole life. But I want to keep learning and growing and expanding what is possible for me and I see that in you also. So it's just a very different paradigm. We're not like fixing anything, we're just meeting us where we are and helping us like keep being the best us. I think it's amazing, yeah.
Speaker 1:Yeah, when I was sick I ended up having to go for surgery, and so I did take three weeks off after my surgery, even though I was supposed to take six. But during the three weeks I was like relieved.
Speaker 2:I was like I know, I know.
Speaker 1:I know, but I was like relieved. I'm like, wow, this is great, I've got this time off, but really like we need to learn to take that time off before and to take care of ourselves. We don't get to that point and having surgery is not a vacation. Really important that we take care of ourselves all the time. You're an ambassador for the Lorna Breen Foundation that focuses on clinician well-being.
Speaker 2:What do you wish that all physician moms understood about protecting their own mental health before they hit the wall? Yeah, I mean, I think it just comes down to being OK if you need help, you know, and we are messaged from medicine not to need help and we are messaged from society to be the help. It is so hard for us as women to ask people for help, which is crazy town, but it's just part of it. So I want people to know you matter and you can't help other people if you're not okay. So take care of yourself and get help, even if it feels uncomfortable to have to admit to some of these things, because you're way too precious. Way too precious. Yeah, even when you think you're not doing a good job at anything, you are doing such a better job than you realize and sometimes you need someone else to remind you of that. I definitely did, and you probably did too. Yeah.
Speaker 1:Yeah, for sure yeah. And just realizing that you're worth the time to sit back and take care of yourself.
Speaker 2:Well, remember I was saying one of the things, one of the thought patterns is the scarcity mindset, and it's like, yes, we don't want to invest the time in having more time, we don't want to invest the money in having more money You're worth investing in, and you can't keep putting everybody else's needs ahead of your own. You have to take care of some of your own too. Or look what happens to you you know, for sure For sure.
Speaker 1:Your body will eventually stop you. You do hit a wall after a while. You just can't continue. Karen, where can listeners?
Speaker 2:find you. You can head over to my website, it's wwwkarenleitnermdcom.
Speaker 1:And I'm going to be putting all of your links in the show notes and tell me about this free mini course that you have, yeah, so.
Speaker 2:I have this mini course that's called Life Support for Women Doctors Although if there are non-physicians who listen to your podcast also, who are in health care, I think it could still be really beneficial and you need to use a little code. The code is going to be FREEMINI, all one word. It's nominal, it's $27, but I would love your listeners not to have to pay and I basically put in there my best tips on, you know, charting in your inbox and setting boundaries and overcoming some imposter thinking and how to negotiate. That doesn't just apply to money, but, you know, with your spouse or with your toddler, like these tools are very valuable. I'm trying to help women physicians' lives be easier, both from an emotional standpoint but with the sheer amount of work that we carry. So people have watched it and said I don't bring home charts anymore, or I got this great raise, and so it's a nice little way to sort of, without investing a ton of time, still make some big changes in how you're showing up in your life.
Speaker 1:You also have an eight-week course coming up in October.
Speaker 2:I do, so this is like the 15th or 16th time I run this program. It's eight weeks long, it's called how to Feel Better for Female Physicians and it's in the US and Canada. I offer CME and it basically helps us take this work and really apply it. So it's a lovely community of women, just like we talked about, who aren't afraid to discuss and share openly some of the challenges we face. And then I just teach a lot of in-depth tools and strategies to help manage better in life, and over 500 people have done it and it's really fun.
Speaker 1:And anyone's welcome to reach out to find out more, and they can find out about that on your website, correct? Yeah, awesome, karen. Thank you so much for joining me today and for sharing your wisdom with such honesty and warmth. I love this conversation. I know that a lot of my listeners are going to walk away feeling seen and supported and maybe a little bit more inspired to be a little kinder to themselves. It was a gift to have you here today.
Speaker 1:Oh, thank you, Nice to talk to you and thanks to all of you who are hanging out with us on Paging Dr Mom. If you enjoyed today's episode, go ahead and hit follow or subscribe so you don't miss what's coming up next. And if you want to keep the conversation going, you can find me over on Instagram at drangeladowney. I would love to hear from you. Take care, for now you are doing better than you think. That is it for today's episode of Paging Dr Mom. If it made you smile, nod along or feel just a little more seen, then go ahead and hit that follow button and share it with a friend who needs to hear it. Take care, for now you are doing better than you think.