Transcription

• Dympna Weil

  Hi, and welcome to Prescribing Possibility, conversations that inspire us to grow, heal, and live with harmony. I'm your host, Dr. Dympna Weil. Thanks for joining me, friends. So today on Prescribing Possibilities, we are very fortunate to have a powerhouse woman physician, coach. And I consider her a very dear friend who has really helped me become more open to possibilities in my life. And that is Dr. Sunny Smith. She is a family physician who spent her academic career at UC San Diego School of Medicine where she wore all the hats. She then transitioned to entrepreneurship to focus on physician wellness. through coaching. And her coaching program is now the most effective physician wellness intervention that's been documented to date. And I am very proud to say I am a former client who really can speak and testify to that. Her company, Empowering Women Physicians, is among the Inc. 5,000 fastest growing companies in the U.S. And she has been in the top one to two percent of female entrepreneurs. in this country for the past six years. So I would love to invite magical Sunny Smith to join me. So I just want to welcome you to Prescribing Possibility, my friend, and have to thank you for inspiring me to dream. Sunny and I, for those listening, met four years ago when I was a client in her wildly successful and impactful Empowering Women Physicians coaching program. And yeah, it's been a long journey since. And I am just so really grateful to have you here. Thanks for taking your time to be with me.

• Sunny Smith

  Thank you. I mean, honestly, I would love to hear how you see your journey over the last four years. I know that's probably not your intention of interviewing me. But I think it would be lovely to hear like before you came. to us and then what has transpired since? Yeah, well,

• Dympna Weil

  you know, it's interesting. Before I started the coaching program, I had done some coaching myself, like self-coaching, which was kind of helpful. But then the pandemic happened and we were in New York and had no PPE and all the jazz. And then six months into it, I started having my dizziness and disequilibrium symptoms. And it was about, I guess, four months into that. Very wildly disorienting time that I was kind of going stir crazy and didn't know what to do with myself. And I had all these thoughts like, if I'm not in my white coat and I'm not seeing patients, I am not a doctor. And if I'm not a doctor, what am I? And what am I going to do? And what if this doesn't get better? And I was in that like spin cycle sort of thing. And so I found you online and I signed up. And then there was no turning back because I was able to, you know, learn the tools that I had, you know, picked up some of them right during listening to podcasts and that sort of thing in the past. But there was something very special about being in a group and doing that work together. I think particularly because of the time it was like it was exactly the right time during COVID when we all were really craving that connection with others. So that was before and during. And then since then, I have learned to be a lot kinder to myself and to, you know, allow what is going on with my body to go on and to realize, you know, my brain's not broken. I can do other things. I just have to do them a little differently than I used to. And that's a far cry from where I was when I started.

• Sunny Smith

  Right. And how did you go from that to where you are now? Because you're like, I thought I was broken, and then I realized I'm not broken, and skip ahead, here I am now having my own podcast and writing a book. So how did that evolve for you? Well,

• Dympna Weil

  interestingly, I think I just decided. Like, I decided that I was done in any way feeling less than or victimized or incapable. And when I made that decision, that was it. You know, it's like, well, how can I use my voice? How can I serve others? How can I care. So it was less about, you know, what I am, my limitations were, and it was much more about what are the possibilities and how can I, you know, shift and adjust and pivot. And I think that fluidity. really made all the difference, you know, rather than being so stuck in that one frame of mind. And that's really the whole beauty of coaching, isn't it?

• Sunny Smith

  Right. I was just going to say that actually kind of encompasses pretty much many, if not most people's journeys in coaching is like, there's this pain that brought me and I was stuck in the pain. And then you said, how can I, and looking at possibilities, that is literally the shift that we try to teach there. And like... you know, hope theory or the psychology of hope is having a goal, having agency, like believing that you inside of you have the agency and ability to make something happen, not waiting for something out there. Right. And then the third thing is pathways thinking, which is what you were just describing. It's like, how can I, what are the pathways? There's more than one pathway and doctors have been taught there is one pathway for through which you serve the world. And that is the way that you are valuable in society. And it is your identity. And if you don't have this, who are you? And so whenever there's a boss, that's a jerk or some kind of roadblock, midlife crisis or awareness or awakening of this is all the time that I have, what am I doing? I think that there's, again, that's like an identity crisis for many people and then it's that okay you come to this reckoning how can you Find this, whether it's the psychology of hope with those three steps or, you know, that's encompassed in part of coaching, just that part of possibilities, strengths, assets, you know, coaching that's strengths based. We're not looking at what's broken. We're looking at what's right with you and what's whole with you and how you can show up in the world with the magic that is uniquely you. And that's exactly what you're doing. Right. That's like exactly what you're doing.

• Dympna Weil

  Somehow. Somehow it happens, you know. It's so interesting because I think the part that I really benefited quite a lot from, well, there were many parts. I don't even know where to begin. But the one I can say that I was a little hesitant about was the group process. And it was just so validating to hear other people who have gone through the same kind of rigors of training, who have gone through all of these things. They kind of, they speak my language. They understand what I'm feeling. Even if they didn't have the exact same experience, it doesn't matter. Like the themes, I always say like the themes are the same. The individual storylines are different, but there's that connection when in that group.

• Sunny Smith

  Yes, I think that's really beautiful. Exactly the way you said it, because it's the part I was hesitant about. It's the reason people think this might not be for me because I just need my own personal one-on-one thing. I don't really want or need this group thing because we live in an individualistic society in general and then you put in the individualism in medicine like just strong work suck it up you can do it and then if you need help you just need a very personal help and you don't realize that you've been indoctrinated in a system that gives all of us a very similar mindset in addition to being human and so that one of the things you're most hesitant about is one of the most useful parts of a coaching that has an opportunity for one-on-one and for group because they're uniquely valuable and I think that is why you know we look at our data I think that is why we are so effective is because of the group yeah plus one-on-one one-on-one is effective 100% and we see data RCTs you know like it is effective and if you look at the effect size I think part of the reason that we are so, you know. effective with a large and very large effect size is it what you said is that part that makes people hesitant is the part that in the end is like whoa yeah I'm not alone whoa as you said it's you know the themes are the same the storylines are different but it's it's the human condition and the for us the female physician condition that we're examining very closely yeah I think that really

• Dympna Weil

  Sums it up quite lovely and the the interesting thing I found was you know the group coaching experience, right? A lot of it is done individually, but within the group setting. And I think people have a misunderstanding or misconception about that. And yes, it requires vulnerability. But I think immediately, because of that resonance among the people in the cohort, you just have this, it really is magic. And you I just remember feeling like I cried after the first couple of sessions when I was done. I remember sitting on the couch with Sean, my husband, and I'm like, they get me. And that was, that's when the idea that I didn't have to wear the white coat. For now, maybe I was going to wear it again. I didn't know how long this was going to last. I certainly didn't expect that in 2025, as I sit here, I would be doing this.

• Sunny Smith

  No you never that's the thing is you can never know how it's gonna work out you know we know that it all works out in the end if it hasn't worked out it's not the end but you just cannot know it's only in hindsight that it makes sense because there's so many possible paths forward we know there is a path but you just can't know and without that certainty as physicians we want control and certainty. We're like, okay, First year, second year, third year, fourth year, residency, associate professor, clinical professor.

• Dympna Weil

  I know how to jump through them.

• Sunny Smith

  I know. I know. We're like, where's the hoop? And it's like, it's a really beautiful kind of adult development stage to be like, and now you're on your own. Yeah. Go forth. Yeah. Little one. Like I just, my kid just graduated from sixth grade and I got him, oh, the places you'll go. And he's like, mom, you used to read this to me when I was a kid. I was a baby when I was in kindergarten. I'm like, I know, but at every stage, it's like once you come to this new place, okay, now let's watch and see what happens and what develops. And I think that we all have been sold this bill of goods that once you become an attending, you've arrived. And that's the terminal condition. And that version of you is the forever version of you. And it's like, wait a minute, adults have development stages too. And it's very normal, especially post-pandemic, as you've said, for physicians to look at their lives and their professional careers differently and to evolve over time. You know, we've had many of our clients featured for the way they evolved their careers. And some of them, many, most are still clinical, but they evolve in some way because it doesn't have to look like, for instance, the old white man from a hundred years ago that started residency and was on cocaine made things look like it doesn't have to look like that. Or even what it looked like 50 years ago, or even what it looked like pre-pandemic. So I think it's just opened up a lot of possibility for flexibility.

• Dympna Weil

  It's like my word for the last several years, you know. And you just mentioned evolving, right? So who were you before coaching found you? And then how did this version of you evolve?

• Sunny Smith

  So beautiful.

• Dympna Weil

  We're each telling our stories here. There's similarities.

• Sunny Smith

  Yes. And this is the condition of what we do inside, right? It's like everyone comes in and tells their story and we get to go alongside that person on their real life journey in real time as it happens. Because here, as we tell it, like, as you said, I never would have known I'd be on a podcast. And now it just all seems so clean and put together. And it's beautiful on the inside to see the messy middle as it evolves because it is messy. And so for me, I was a... Exactly. I was a professor at UC San Diego School of Medicine. I spent my whole career running a free clinic there, which was very, very meaningful and beautiful and like a custom created job just for me, where I was medical director there. And then I was a community director, which meant overseeing one sixth of the medical school and the students for their personal and professional development, which allowed me. Both of those roles together allowed me to be very intimately involved in their personal, professional well-being and development and relationship. And what does medicine look like? And what do we want it to look like? And idealism, because, you know, when you bring someone in who's just written their, you know, personal statement about why they want to be a doctor and you hand them their white coat in front of their family and everyone's crying and you say their name on stage and Then a couple of weeks later, of course,

• Dympna Weil

  they're depressed and scared and they're going to drop out.

• Sunny Smith

  And my job was like, it's going to be OK. It's going to be OK. I promise you it's going to be OK. And so helping guide them through the rest of that journey while caring for the most marginalized in society who can't even afford to go to the safety net. It's just, it's profoundly meaningful and yet it's heart wrenching to see, you know. Those who are the best and brightest and want to change the world and have all this compassion, we know objectively that we beat out the compassion in medicine. And so we know that we take people with... above average mental health for age match peers and make them much worse. And so what happened to me is that I got in a bicycle accident, as you know, and broke my arms and my face and wasn't able to continue with this very busy pace of nights and weekends. I worked every Monday and Wednesday evening until about 10 or 11 p.m. every single week for years, decades on end. And then some Saturdays. you know, always charting and writing letters of rec and being the course director, doing grades, just all the things that we all do and things pile up over the years. And I was a mommy of a preschooler at that time and everything came to a screeching halt unwillingly. And so it was a forced rest for me, just like yours. Interestingly, I have found it's often a true health crisis upon which we are no longer able to physically function. in the way medicine demands of us,

• Dympna Weil

  Which is inhumane and very sad state, like it takes us until the point where we can no longer function. Yeah,

• Sunny Smith

  We're broken. Yes, we have no choice. Yes, we have no choice. That is the point at which we will stop. Like both of my arms didn't work. And I could not even sit or stand. I couldn't care for myself. I couldn't go to the bathroom by myself, couldn't shower myself, couldn't feed myself. That's when we stop. And so at that point is the very first time I had discovered coaching or podcasts. Yeah, this is a podcast now. I didn't even know I had a podcast app on my phone until that point. Exactly. So someone told me and, you know, someone would put AirPods in my ears and press play and then I would be left alone for the day because I couldn't do anything. And I would just sit and listen. And I listened to coaching podcasts about when you can't change your circumstances. You can change the way you think about things. Because I was sure pretty pissed off I had been on that bike. And all I wanted to do was rewind time and change my circumstances. And that is not helpful. And that is not possible. And that is mentally taxing. And just like you were like, I am broken. What am I going to do? I was like, this is, I can't do anything. This is frustrating. And I switched from that to this might be the most useful perspective shift I could ever have. because I would see my friends come over and they were so busy. Women physicians, so busy. And they were rushing. They'd come visit, be real nice, and then be rushing to go do whatever. I'm like, what are you rushing to? Like, what's so important? Did you drive yourself here? You know, did you get yourself dressed today? You have such a blessing. Like, don't take this for granted. If ever I get back. to being able to do those things. I'm not going to do it the same. And so I had to give away, I was a director, I had seven different director titles, and I gave away most because everything I thought I had to do, obviously,

• Dympna Weil

  There was somebody there...

• Sunny Smith

  because the world. Yeah, the grades got done, the patients got seen, prescriptions got written, someone even dropped off my kid at school and picked him up and made him food, like everything. And I was like, I have to, I have to, I have to, I have to. And if you look at the lives of women physicians, That's what we do. Like we're playing, you know, one of my friends, colleagues, clients had said, it's like a 10 out of 10 score on gymnastics. You know how there's a level of difficulty. We all chose, okay, be a mom of young children and be a full-time physician and be in charge of this and that and the other. It's like, it's at least two full-time jobs.

• Dympna Weil

  No, it's the caregivers. Like it's the caregiver paradox is what I keep talking about. It's like, We don't take, we care for everybody else and everything else. And we do that wholeheartedly. And we love to do it. But we don't take care of ourselves. We're very good at it. But we don't take care of ourselves.

• Sunny Smith

  Yes.

• Dympna Weil

  Yes.

• Sunny Smith

  At what cost? At what cost? At first, it's fine. But it's the compound effect over years. That is like that fatigue that can't be made up in one night or one vacation, right? It's like. Yes, exactly. And so, so I learned about coaching. I learned about shifting my mindset. I learned about seeing things differently. I experienced it very deeply. And then when I went back, you know, I still had a lot of physical limitations. I had these big giant robot arm thing on.

• Dympna Weil

  And you went back with them. I just want to point that out to the listeners. Most people would have been like taking their papers to their doctor and saying, could you extend my leave? Which is very reasonable. Exactly.

• Sunny Smith

  I know. I know. I know. It would have been like I couldn't do pap smears. I couldn't do like so much. I had a robot arm on my arm. It was giant. And I was working as soon as possible because I didn't want to miss the next white coat day. So like I went to the graduation as an example and I was supposed to hood people. You know how when you become a doctor, you put this hood over someone and they choose a faculty member and it's a big honor to be chosen. And it's usually someone you've really bonded with. And I was in a wheelchair and I like couldn't sit and I kept leaning back and leaning back. And then I just had to leave and the dean had to do that for me, but I was trying to be there. So I took the summer off because I had to. And then I wanted to get back for that next white coat ceremony because I wanted to meet their families and have them, you know. be introduced to the person who's responsible for guiding them for the next four years. But again, giant robot arm, and then I'm off to the clinic with this giant robot arm. So, but I knew that I was limited physically. And so there was, you know, what can I do? What do I want to do most? And this would be something, because most people aren't going to have to go through this. And you hope that they don't have to go through this and that they can learn from. people like you or me or others who've gone through some kind of crisis and had to really reevaluate what is most important to you what do you want to do if you could re-choose your life from scratch which parts of what you do would you proactively put in as opposed to like what can I take out it's like no what means the most and what do I want to put in so I was like I want to advise students and I want to do clinical care and a lot of the other stuff that was administrative stuff and like I can let that go. Anyway, there's very long and very, very much shorter versions of this story, but

• Dympna Weil

  I've heard them all. Oh,

• Sunny Smith

  I know. I know.

• Dympna Weil

  Because I think it's really it speaks to like what we will put ourselves through, even unknowingly. We just do it.

• Sunny Smith

  Yeah, it's unknowingly. And that's the thing. It's the whole, you know, pot of water or temperature going up as the. frog is boiling and the frog doesn't jump out and doesn't notice. And so when I was asked to go back in, I'm like, oh,

• Dympna Weil

  that water's hot.

• Sunny Smith

  And I don't have my cooling mechanisms anymore. I'm like, I could dip my toe in. And so, and I did, and it was very meaningful. Yet, I had signed up for this coaching program. And then they offered, you know, that they were signing up people to train. And I knew there was one physician who had trained, Katrina Ubell, right? And because she was not crazy, it sounded like on a podcast sounded like she spoke normal doctor talk. I was like, so this means we're not crazy. So I did it. I went when I went there. It was a big secret. I didn't want anyone to know because I thought it was super weird what I was doing. I'd only told my best friends. But I ran into like four other physicians who were all there in secret. And I was like, we're not crazy. This matters. We're doing this. This is meaningful. I started doing it. I did it for free during training. And I had no idea if it would really work with strangers. And I'm sure you've had this experience too. Does this really work with strangers? Or is it just me? And so I worked with 10 people I was training, and it worked for every single one of them. And then I started my company. And it's been really one of the most meaningful experiences I've had in my life, I've been able to have on an ongoing basis. It's helping women physicians look at the lives they live, look at the indoctrination we've all received and re-evaluate from a place of, I don't know, awareness, compassion, insight, empowerment. Like you are one of the most educated and empowered women to ever have walked the face of the earth. And so what are you going to do with that? Because we are not taught that. We're taught you must comply. You're in debt. You have to do all this stuff. Pay off your debt and then pay off your mortgage. And then once you're maybe 55, 65, you can sort of lighten up. And it's like, that's not really the way it has to be. And we certainly don't have to work like you and your specialty, right? You don't have to work 30, 36 hours in a row. You don't have to take call one weekend every single month. You don't. I find especially as people get to midlife. say your perimenopause menopause you're like this is so staying up all night every fourth night is not easy and it's not good on my family and it's not good for me and so it's like what we were able to endure in our 20s and 30s gets harder in our 40s and sometimes gets feeling near impossible or at a breaking point in our 50s and certainly by 60s but you don't have to keep doing it all that time it's like how can we modify so i want to i want to just go back a minute and say

• Dympna Weil

  You know, you had to, you mentioned like becoming a different version of yourself, like thinking what was possible. So like, what did you have to unlearn in order to get to the place where you could lead again? Right? After your healing? I'm just, I'm curious.

• Sunny Smith

  Yeah, that's a really good point. I mean, what I had to do, I think, because I was convinced, like, I just felt like I had a weekend. You know, like once you realize that this is all, everything is made up and everything in medicine or whatever profession people are in, whatever standards, like Monday through Friday is made up. Eight hour days are made up. 12 hour days are made up. 36 hour days are made up. It's all made up. And then we just all agree on this mental construct. And once you start seeing it's all just a mental construct. And I remember my department chair had said to me, That 40, because I was like, I work 40 hours a week and our funding, it was during the last Trump administration. And so our administration, our funding for our free clinic had been cut. As you can imagine, the grants that we used to receive to care for undocumented people were no longer available at all. You couldn't even apply for them. So my salary was cut. Our clinic was cut. We went from five days a week to three days a week. And I was still working because again, our days were long and I was still working 40 hours a week. I said, do you think 40 hours, I don't work 40 hours a week. and he goes 40 hours a week is not full time. He said, everyone here works 60 hours a week. That's full time. And I just looked at him like dumbfounded after I had returned with this big robot arm on. And I'm like, I was just said very specifically, I do not agree with your mental construct.

• Dympna Weil

  That's such a powerful statement.

• Sunny Smith

  And I just sat there, right, that 40 hours a week is part time. I do not agree with that mental construct. And in my mind, because I had been becoming more aware. of just bias and patriarchy and just all and the way things were and how medicine really was largely made by old white men. And I would look around at the leaders and this was an old white man with a stay at home life. And I was like, I have to because once, you know, like picking the kid up at preschool, it's a real issue. I have to be there by six or they'll call child protective services. Like this is not a joke.

• Dympna Weil

  And they don't understand that.

• Sunny Smith

  And if you No. And if like, if I have to be at clinic at eight and school starts at eight, you're really telling me and I'm like, can I please be there at 815? And they're like, no, I'm like, okay, so you're telling me I have to look for a nanny and tell her I need her for half an hour in the morning. Because I mean, I know it sounds ridiculous, but like when, when the responsibilities that my work shifted from what it had been to what it was going to have to be because of these funding shifts, I was like, I just know I do not comply. I will not comply with this huge shift, which is a huge salary cut and is a huge shift in the number of hours and where, and none of this works with my ability to care for this body of mine and this home of mine and this child of mine. And I just will no longer be complicit in your system that makes no sense.

• Dympna Weil

  Amen.

• Sunny Smith

  So because it's like,

• Dympna Weil

  it's the system, right? It's like they have this, there's this way of doing it. And then when you raise the point, like, well, couldn't we try doing it this way? And it's like, no. And you're like, are you listening to yourself?

• Sunny Smith

  No. Yeah. That is just when you start to, because I had been removed from it. And when I was coming back, the changes were happening. And I was like, what is, why is everyone going along as if this is okay? So anyway, that's the original transition. And then I, I started surrounding myself. I was surrounded with not only those small number of doctors, but a community of people who were coaches. And it draws together a like-minded group of anything is possible, what you see and believe. Well, you see what you believe, first of all, which again, came to fruition very clearly in the COVID era and all of that, is you will find evidence for what you believe. It's the way the brain works is confirmation bias. And so. When I would learn about psychology, along with neuroanatomy, along with function, it's like, this is science, that we find what we believe. And so look at what you believe, and see if you want to create different results, then you have to start to believe other things as possible. And so just like you said that your word was possibilities, my word at that time was possibilities. I was like, okay, if they're forcing me to go part time, I'm going to force. whatever, if I chose to stay at a job, because notice how I get myself the agency back. If I choose to stay at a job where they're saying this is part time, then fine, I'm going to take the rest of my time. And I'm going to work on this business that is very meaningful and show people how I'm not choosing to comply with anything I don't want to comply with anymore. And you don't have to either, whether it's your marriage or your work or your mother in law or your whatever the circumstances and even if there's circumstances you can't change. you know, like some people that I coached had prophylactic mastectomy or like, it's not saying you can just not comply with something. Cause I mean, obviously there are circumstances in our life, just like my arms or whatever that you have to deal with, but how do you see those? And how do you find your agency instead of my boss is a jerk. They're telling me this. Okay. I can choose to stay or I can choose to go. And so I really found that I believed here's the thing is I believed what my coach taught me. And because a lot of people were skeptical, right? And you know this too, and you did too. It's like, I believe that I create my results and that I'm responsible for my results and that I'm not a victim of anybody else's system because they told me this or they told me that. And I never want to gaslight anybody by being like, this is your fault. You're the victim. Don't play the victim. That's not what we're saying. We're saying we start and validate right where they are. It makes sense. You're in this. that you're in. It makes sense that you're in the situation you're in. It makes sense that all of them are trying to extract as much work from you as possible and that they value RVUs more than they value the patient outcomes. It all makes sense. The system makes sense. You make sense. And so given with radical acceptance of what is, what do you choose? And so I think that's a very empowering, it is what it is. Right. Don't argue with reality. That's a waste of time. And now what do you choose? Where is your agency? And that's my cope theory, right? What's your goal? What's your agency? And then there's many pathways to get there.

• Dympna Weil

  And I think you hit right on it there. It's like you just need to, for me at least, it was knowing that I could choose something differently. Because, you know, a lot of times like our lives are, at least during like medical training, it's so prescribed. Like this is what we do.

• Sunny Smith

  yes this is how we do it this is the path yeah and then entrepreneurship as you know is the exact opposite which is like you make it all up all of it you make up the business you make up the prices you make up the offers you make up who you work with you make up how it works and what time and all of it is made up and so when you see you go from like everything is prescribed and you have absolutely no choice like residency is one option where you're like here's what it is you don't get choice. And We can find spaces where there's choice. If we ever look, we can always find spaces where there's choice. For anybody who wants to reference the book, The Choice by Edith Egger is amazing. Holocaust survivor, if she can find choice in Auschwitz, it always inspires me and reminds me everyone can find some place where you have choice, even when you feel trapped and there is no choice. And so, you know, we brought her into EWP a couple of times and I've done a couple of things with her recently as well in her own programs. and It's just remarkable to remind ourselves we're always choosing something in this life and be mindful.

• Dympna Weil

  And sometimes when we don't decide to do something, that too is a choice, right? And that's, I think, we forget that part of it is that, you know, we may not want to make a decision about something because there's a lot to think about or there's a lot involved in it. But at the end of the day, you can still make that choice too. Leave the job. Leave the toxic relationship. And figure it out afterwards. Like you don't have to have all of the answers. That too is a really important thing because we're so used to having all of the answers. Like people come to us for the answers or to find out the answers. And then all of a sudden we're just saying, I don't have to know all the answers.

• Sunny Smith

  And in fact, there aren't like real answers. Like I recently, more recently in my evolution of myself. So then I created this very successful, amazing, impactful, meaningful. group of women physicians. And then, and that has gone on for the past, you know, several years. And then about six months ago, I had a life-threatening illness and where I almost died on the, I was laying on a hospital floor begging for my life, truly believing that might be my last moment. Impending doom, you know, those listeners who know about medicine and impending doom, like it's this sense of this is my last moment. This is, I had sepsis. And my lactate was 5.6, which is, you know, a critical life-threatening illness. And I was laying on the floor. They thought I was faking. And the whole point of bringing that up is that, you know, I thought that I had this idea of it's your choice. It's your life. Before, when I went through that, oh, my arms were broken. And if I ever get healthy again, this is how I'm going to choose things differently. But I never thought I was going to die at that time. Like, I never thought my life would be over. I just thought I might be disabled and if I could get my ability back. back then I would live differently. This time six months ago was like that on steroids because I really did have moments because I did think I was going to die then I got better because you know I got the right treatment I started getting much better and then I went home and started getting worse again and I just thought and I had to lay there thinking am I calling 911 am I not calling what am I going to do. I grabbed a notebook and wrote to myself may I get to live. if I get to live and I wrote for real, cause I'm such a coach slash journal or slash processor slash mental health person. I'm just like, if I really do get to live and like crying, writing it, like praying to the universe, if I get to live, this is what I want. You know, this is what I want to remember. And none of it was about things like work and being a director and that type. It's like, I just want, No, I just said, I just want more days on this planet. That was the first line. It always makes me tearful if I think about it. But like, I just want more days on this planet. Just more days, please. Please give me more days. Please let me wake up tomorrow. Please. And then more healthy days. Could I please have more healthy days? I want to be able to sit up and walk because I couldn't walk from the bathroom to my sofa. And I was like crawling. I was like, please, please let me be okay. And then I wanted, after that, I wanted to see my little boy smile and laugh. I just, please let me let him see him smile and laugh. And then like see my fuzzy doggy and feel a fuzzy blankie and watch the sunsets into the ocean. And it's like, when you realize that's what matters, you know, you don't have to end up on hospice or with some terminal diagnosis to realize this is what matters. If you are quote-unquote wasting or at least not spending this very very precious gift of life on this planet the way that's in alignment with you then what are you what are you doing who is owning you if not you it's just I know there's the practicality because some people must say like must be nice to be able to just make decisions the way you want like I have bills to pay Every one of the 8 billion of us have bills to pay. Some have more privilege and some have less privilege. And all of us get this day. Like this is what we get. And so I think that that has been that acute awareness of life and the preciousness of what a gift it is to exist. It can't be ever present. Because how could you go about your day, right? How could you do the things? Except to be present for every moment, like every healing encounter that we have as physicians. And yet to say, and my own, you know, life and ability to be present and live and feel joy and be with my family and be with myself and be with my friends and be in awe of the universe is equally as important.

• Dympna Weil

  And let me let me ask you this. I don't mean to interrupt you. But I wonder, like, how do we not just how do we believe that? Right. I know how we can cognitively go through all the steps. But how do we? Like, go from, I want to do all of these wonderful things that bring me joy. And how do you hold that with the realities of medicine? And that's a lot of the trickiness, right?

• Sunny Smith

  Yes, it is. I think a lot of people that I find who are women physicians actively practicing right now, really start with the, this is what I have. And it's like 80% of their life is stuff they don't want. And I'm going to try to do yoga if they come into some kind of wellness space. They're like, well, I will try to do yoga by I'll do the 5 a.m. club. Right.

• Dympna Weil

  I'll punish myself and add something else.

• Sunny Smith

  I'll wake up extra early. And that's the way to get better. But I think, I mean, I understand that. And yet I challenge us to think if we start with the blank space, a blank slate. Which sometimes some of my clients go on leave because they come in distress. They do go on leave. Most don't, but this is an example, right? Where it's like, what if you had three months? Because you actually can take three months off. I know everybody says, must be nice. Oh, I'd like a sabbatical. That's for the, I've seen so many people say like, that's for the rich people. I'm like, I don't know. People do it when they get any kind of diagnosis and it seems to work out. So why do you need the diagnosis? But if you just look at, okay, if you did have a blank slate and you filled your cup first and put life in first, this seems very out of reach, I know, to most people. But as a thought exercise, even if you're not going to act on it, what would your life look like if you put life first and you worked so that you could have fulfillment and also obviously pay your bills? But it wasn't that... they gave you this job option and you had to take it as is. It's like, no, if you were in charge of your life and you designed it, what would you want it to look like? And so many of my clients, as an example, will leave some job they really find is not flexible for them and they might start doing locums.

• Dympna Weil

  That's an option? Oh,

• Sunny Smith

  I make way more money in way less time. This is fascinating. or they do... per diem, or they sign up for a second job. As an example, you know, that would be a job with no call or a job that was three days a week or whatever that is. That's just some do telehealth. And then the thing is, of course, you think you want flexibility, but inside of our minds is actually still, we're still our old selves. And so I find a lot of people say, for instance, who go into telehealth, they will work so many hours because you get reimbursed. you know but for the number of hours and so we're like wow look how much I can make it then we work ourselves into the cycle again and so it's like be careful yes the overworking cycle it's yes what we know it's comfortable we're so used to it yes you know what's uncomfortable is having downtime at first it's amazing and then you're like so you experience this right like what do I do with this downtime I'm supposed to be seeing people and working really fast to be traveled in that time

• Dympna Weil

  Thinking, I'm supposed to be working, what, like, what am I doing? And it was, for me, I found it particularly tricky, because it was the middle of the pandemic. And I felt guilt about not being able to be there to care for patients and to help my team out, you know. And it's interesting when you brought up the changing of, you know, positions, something I inherently did for myself over time, right? I left. an academic position when it was no longer tenable and went into private practice because I figured, well, then I'm going to have more say and autonomy. And then the business of healthcare evolved. And that was no longer true because even in the private... you know, practice before it was bought out. It was how about we do this? How about if we're on call, we don't work that Monday and see patients? Or when we're on call, maybe we shouldn't have patients in the office because there's so many of us. And these were like, to the end of my life,

• Sunny Smith

  right? No work post call. What is this? No clinic? Like, again, all the rules are made up and it's autonomy people want. And so I believe that, and the Surgeon General of California, which is where I live, talks about workplace flexibility. Because these like cookie cutter things don't work for everyone. Everyone is human. Everyone. Everyone. And so that means we're all going to take our turn. Like your mom is going to get sick and die. Your grandma is going to have something. Your child is going to get sick if you have a child. Your body is going to have a health need. And so we will have different seasons of life and we will have different needs. And can our workplaces become flexible? And I think that's the way of the future is that we don't have to keep doing it this same cookie cutter way that, you know, Linda Street is someone, you know, from she talks about negotiation for coaches, women physicians on that. And she says something like, you know, we're all trying. I can't, I'm going to mess it up. but like we're all trying to walk in the same shoes and the shoes are were like made for white men and they they're too big and they give us blisters and we keep trying to walk and it's just like it doesn't this one size fits all shoe doesn't it rubs a lot of us the wrong way and is super uncomfortable for different reasons and it fits some people just fine but some of us just need something a little bit different and so I think instead of looking at the people who choose something different as broken What we do in our program, in our communities, is we see them as strong. Like, we think that is strong work, is look at you making your own way. Look at you creating this life that you love. And even my job, for instance, running a free clinic in the basement of a church, like I sat in toddler chairs. They were for two-year-olds for 20-some years. Like, that was just made up. And so I have came to learn that. Creating a free clinic out of nothing is kind of was similar in some ways to creating a business out of nothing and creating a whole new company and something that never existed. Although one of them was quote unquote free, but there is no free lunch. You need grants. You need donors.

• Dympna Weil

  Someone's paying for it.

• Sunny Smith

  Someone pays for everything. But looking at there was not because I tried working at a community health center, many community health centers. and I did you know, per diems and worked in the ED and worked in like with senior citizens and home visits and all the things my first year, because there wasn't really a job that was fit me perfectly. Because when I'd work in the community health center, which I did a lot of hours, I was very dedicated to underserved care. But at the end of the day, I'd have like, you know, 30 charts piled up and it just this pace and it was. Not a good fit for who I am fully. It met a big part of what I wanted to do, yet I couldn't do that as a career for the next 40 years. And so being able to find this space where I could create something that aligned my meaning and purpose. with my sort of skills and capacity. You know that I'm long-winded, obviously, on this podcast, but for having known me, like a 10-minute visit is not really easy for me.

• Dympna Weil

  That's why we love you,

• Sunny Smith

  though. For most people. Yes, yes. So I had to create a space where I was allowed to take my time and allowed to teach the way I wanted and allowed to heal. And we looked at our outcomes and we published our Free clinic from the basement of the church, outcomes in JAMA and in leading medical journals that we were as good or better as other healthcare systems. Because if you allow people to shine in the way that speaks to their strengths, which is what coaching does, what are your strengths? Let's lean into those and allow you to be more you. And there's some people who are super efficient and they're like the epic super users.

• Dympna Weil

  No, that is not me. I don't want it to be me either. Like, no.

• Sunny Smith

  It just wasn't me. It would never be me. I could try, but it wasn't. And so my strength is my heart and my compassion. And so how can I find a job that highlights those and allows me to be me and contributes that part, for instance, of medical education or patient care. And so now it contributes that part in physician well-being. I always did well-being at the med school, but it would take, interestingly, you know, eight years or so for someone to become an attending and get out the other side. And then now what I do. It takes eight weeks. That's our program. Eight weeks, not eight years. And to remind people, they have agency because they don't see it. But if you surround them just like, you know, you with a whole bunch of people who are going through this very real struggle in very real time, I'm struggling with this. I'm trying to find this. What can I do? And they have to go out and experiment in the world. Okay. I went and told my boss this, or I went and cut back here, or I went and again, whether it's personal or professional. they go do the thing and then they come back and like oh god this is awful this is horrible this is very uncomfortable yes and you live you did it and you are getting yeah what you want you did it and we feel proud when we do things that are hard like that's when we look back on our life the things we're most proud of the things that were hard not well and you know easy it's interesting because one of the things that i have come to see in my clients and i'm i i know they're

• Dympna Weil

  there and yours because I've listened to the stories, right? I think we also have been sold that kind of shiny object of when you're done, you'll be this and you will you'll be able to balance it like successful people balance it all. And what I have learned is that that is hogwash, because balance does not exist at all, except for that tiny little... moment, right? Otherwise, it's the struggle to try and get back into balance. So when we frame it that way, and that's the image that we have, like clearly that mental construct does not help us. So I've started looking at it as harmony, right? We have all the pieces and they can all be moved together at the same time and you just shift from one to the other, but it doesn't mean that something's more important. And something is less important, like on the scale. And for me, like when I started thinking about things that way, I started at least taking some of the pressure off myself as I was in these other environments that were not helpful, you know. So it's interesting because what we're talking about is such a it's such a complex multifactorial issue, which is the the system. which needs to be fixed. But in order to have that, we have to be well.

• Sunny Smith

  Yeah. And you know what I think is I believe the way the system is going to have to change is when we refuse to participate in it as is. Because when we all participate in it, we are complicit. We are complicit in a system that is harming. And killing physicians and patients. And so I remember when I first heard that, I was at an American Academy of Family Physicians meeting, and it was sessions about underserved patients, and they were talking about those of us who were working in underserved medicine were complicit in the disparities. For instance, by me working at a church late at night that goes to 11 p.m., my patients at times had been hit by a bus. crossing to go to the street to the bus station from our clinic because it's so dark out and head to the ICU and I'm like I'm complicit in that what do you mean and so it's really hard to think like I'm fighting against the system I'm doing the good work I'm and yet if we can all as physicians just see every day that we go and we work faster and faster for more RVUs and they say jump and we say how high and we don't stop and say I don't want to work more than 12 hours at a time anymore. And if we can't do it for ourselves, if we can do it for the people underneath us, sometimes that helps. It's like, would you want the new hire to get only six weeks of maternity leave? Would you want her to pay overhead and come back $50,000 in debt because she was out of her league because of her baby?

• Dympna Weil

  Would you want her to not take care of herself and not treat her postpartum anxiety or depression because she was afraid of not having her job? Yes.

• Sunny Smith

  Of what the other partners would say or think. And especially for younger trainees, too, if we have a young medical student, do we really want our daughters, for those people who do have daughters, some are going into medicine, would you want your daughter to have to take seven days call? Would you? Is that the life you really want for someone? And if not, why do we not say, this is not right, we can do better. And I know the system has limitations. And I know there's not a deep enough bench. I know. But as long as we keep, it's an unfillable need, right? It's at every community that we're in, every one of us, like I'm a family doctor, there are not enough family doctors. We're the number one recruited specialty across the country for years and years on end, decades on end. There's not enough of us. So does my child have to pay that price? Do I have to pay that price? It's an unsolvable problem. And so how can we live our own life in a way that is meaningful to us and fills some of the need and is willing to leave some of it unmet such that, like, for instance, last week, I was just at ACGME, the residency accrediting body. I'm like, You know what we need? We talked about the deep bench. I'm like, what we need is more GME dollars and more residents and more attendings. That's what we need. Not for us to work twice as many hours as every other shift, right? I mean, airline pilots and all kinds of industries have these truckers limitations and we operate on people's brains at like 30 hours deep.

• Dympna Weil

  That's dangerous.

• Sunny Smith

  It's not, yeah, delivering babies. It's terrible. It's not safe. And we do it and we do it and we do it and we do it because we're afraid we're going to lose our jobs. And really what I talked to a lot of people about, it seems so superficial for people to look at it this way. But the excuse, if you really boil it down, comes down to but, but, but money. They don't want to lose their job. And there's a saying that's something like, The only thing more addictive than like chocolate and heroin is a monthly paycheck because we think it gives us security and does it? I mean we learned in the pandemic,

• Dympna Weil

  no. That's true and I can imagine if I go back to what you were talking about before when you were lying on the floor in the emergency room septic, was that anything, was that even on the list? No.

• Sunny Smith

  I didn't, I'll tell you my little boy was standing there watching me. begging for my life, holding his fuzzy little doggy. And I never once, make me so tearful every time I talk about it, but I never once thought, good thing I have enough money for him. Like, I never thought of that. Good thing that I have a trust. Good thing. I was just like, I just want to live. I just want to live. I just want to live. The amount of dollars. And plus, if you look at, of course, at our median. income in the country versus physicians, because I coach physicians who make, say, $100,000 because they're part-time, all the way up to a million dollars a year and everywhere in between. And there is no point at which, like $300,000, $400,000, $500,000, that someone's like, okay, well, now I totally have enough and I'm golden and I'm going to start working on my own terms. And that goes the same for net worth. You think, oh, well, once I get to a certain net worth or once I pay off my student loans or once my house is paid off. The scarcity is indoctrinated in us, right? And we all think we have to, it's not just the money, but we all think we have to do it because we'll lose our jobs if we don't. And it's like, well, what if you did lose that job? Let's just play the worst case scenario. That's sort of a coaching concept we can do. What if you lost your job?

• Dympna Weil

  What if? There's another one.

• Sunny Smith

  Then you'd go get another work. Yeah. And maybe more aligned with the way you want to live your life. You're an incredibly valuable member of society. You really are your skill set, your education. It's unmatched.

• Dympna Weil

  And I would argue one of the biggest things, not to interrupt, is compassion. We are dealing with some of the most compassionate people on the planet, doctors, nurses. teachers, right? People who are in these service industries, who it's their compassion that really drives everything. And that we kind of just, you know, poo poo a little bit.

• Sunny Smith

  So I think that people come with that knowing they're unhappy, not knowing what the other side is going to be like. And there I believe very much there is no yellow brick road to the other side. It's like you find the path by walking it. And just believing in possibilities, as you said, and being willing to fail and be like, that didn't work. Okay, let me try this. That didn't work because they think I'll have to have it all figured out. And so that's 100% because I'm going to stay on this track for the rest of my life as soon as I pivot. And it's like, what if you're willing to do like a few things in this phase of life until you figure out what really fits best. And then it's not this all or none thinking that I have this one job where my boss is horrible or I'm homeless on the street. That's just not the way it goes.

• Dympna Weil

  There's a lot in between there. And I think that's really the beauty of coaching is that it actually opens us up and cracks us open to the fact that from the best case scenario that we might be pining for, and the worst case scenario that we keep catastrophizing about, that coaching helps us to recognize there's so much potential and possibility and opportunity. in between that we would never that we don't think about right because our brains are here and here right. And i think it's that willingness i think to uh to experiment and trust yourself to course correct because if you trust yourself to course correct then you can try anything you can experiment with you could go be a barista the problem is go go back and be a teacher you can People fantasize about that all the time. Like the escape fantasy. People fantasize about going and getting admitted to the hospital just so they can take a break. Like just a mild gastroenteritis, like whatever, some kind of, you know, some kind of illness that I know. Or they want to go to like a hotel for a weekend. Or they just want to escape. And then the barista becomes one of these escape fantasies too. And it's like it doesn't have to be so extreme, people. You don't have to go from I'm a full-time physician at this one job to... I'm in the hospital or I'm at a hotel for the weekend or I'm working at Starbucks. But that's your brain trying to serve you by saying, this pain is so big. Listen, I'm trying to get you out of this pain. And so instead of going to that extreme or noticing when we have that extreme, and the most extreme of that is suicide, which is suicidal thoughts, which is trying to get you out of the pain you're in, is to say, maybe there are some other options. Maybe, just maybe. And you know, when I coach, I really find that maybe, just maybe is super powerful because it's hard to deny that maybe, just maybe, like maybe, just maybe we'll have a man on Mars soon. We'll have a woman.

• Sunny Smith

  Maybe, just maybe there might be someone on Mars. Or a woman president.

• Dympna Weil

  Like maybe, just maybe.

• Sunny Smith

  Maybe, just maybe one day.

• Dympna Weil

  It could happen, you know. But it's getting to that point of saying it could happen, right? So I want to be very mindful and respectful of your time. I have one final question for you, and I'm going to try and keep you to like maybe a sentence. I don't know. What are you like of all of these amazing things that you've done thus far in your career, in your life? What are you most proud of personally, not just not just professionally, but personally?

• Sunny Smith

  That's a beautiful question. I think. Coming to the place where I live my life and every day in alignment with what matters most to me.

• Dympna Weil

  I can't thank you enough for bringing all of your light and your honesty and your vulnerability. And I know everyone listening will be very moved by everything you had to say. And hopefully they'll be more open to possibilities in their own life from hearing your story and the wonderful transformations that you. help make happen each and every day. And I'm so grateful to still be a part of that circle.

• Sunny Smith

  Thank you so, so much. I hope so, so very much. Possibilities, people, so many more possibilities than anyone has ever imagined. Infinite possibilities and being open to the magic of that. So it is so full circle and beautiful to come back and be with you on this phase of your journey. And I can't wait to see more.

• Dympna Weil

  Yes. And where can people find you?

• Sunny Smith

  Google everywhere. No. Empoweringwomenphysicians.com. The people here are listening to your podcast, so they can hop over. I have a podcast, like free guides on our websites. If you are really a woman physician, you can come to our Facebook group. I'm there all the time. I love the people in there so very much. And we have a lot of people who are not women physicians trying to get in now. So do not go over there if you're not a woman physician. We'll filter you out.

• Dympna Weil

  We're very careful. Very. So thank you so much.

• Sunny Smith

  I'm so proud of how you're showing up in the world and all that you're doing. It makes me so happy.

• Dympna Weil

  I appreciate that. And I just continue to be inspired by all the things that you're doing. Truly. It's awesome. You've been listening to the Prescribing Possibility podcast. I want to thank Dr. Sunny Smith. for joining me today. And I hope you all heard something that cracked you open in just the right way. If you're feeling called to explore what healing or possibility might look like in your own life, let this episode be your permission slip to start. You can learn more about Dr. Smith's work in the show notes. And if this conversation moved you, please share it with someone else who is quietly carrying too much. Until next time, keep going gently. You don't have to do it alone. Just come back to yourself, and I'll meet you here again. Bye.