The Strong MD | Season 2 Episode 6

Navigating Burnout and Boundaries: Insights from Dr. Sasha Shillcutt

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From Burnout to Boundaries: Dr. Sasha Shillcutt’s Journey in Medicine

Strong MD podcast features guest Doctor Sasha Shillcutt on gender equity

Dr. Jaime Seeman: Welcome to The Strong MD podcast. I’m your host, Doctor Jaime Seeman. On today’s episode, I’ll be sitting down with Doctor Sasha Shillcutt She’s a tenured and endowed professor and the vice chair of strategy in the department of Anesthesiology at the University of Nebraska Medical center in Omaha, Nebraska. Sasha is a CEO founder of Brave Enough. She’s a well published researcher in cardiac anesthesiology and gender equity. She’s an author and an international speaker. Sasha has taught thousands of women to achieve work life control through her courses and conferences. She speaks frequently to executives and leaders on the topics of professional resilience and gender equity. Her TEDx talk, titled the Art of Faith Forward, has been viewed by thousands of people. Her writing has been published in both the prestigious New England Journal of Medicine and JamA. She leads conferences and retreats for professional women through her organization called Brave Enough. I, know you’re going to enjoy today’s episode. Doctor Sasha Shilcut. Say your name five times. That is way too many. Like, s’s all in one. But welcome to The Strong MD podcast.

Dr. Sasha Shillcutt: Thank you so much for having me. I’ve been looking forward to this.

Dr. Jaime Seeman: I have been looking forward to this, too. We tried to record this weeks ago, and we’re both in Nebraska, and a snowstorm hits. And that’s just how our lives go sometimes as women in medicine. And we have so much to talk about today. I am so excited to dive into this.

About ten years ago, I went through a period of burnout

But for our listeners, just give people, you know, kind of the five minute elevator speech about your background and kind of who you are and what you do.

Dr. Sasha Shillcutt: So I am a cardiac anesthesiologist who practices at the University of Nebraska Medical center. I’m a tenured professor, and I’ve been a cardiac anesthesiologist now for almost two decades. and about ten years ago, I went through a period of burnout, professional burnout. I wanted to quit medicine. I have four young children at the time, and I realized that, whoa, this is serious. Like, I went to school for all these years, and I’m willing to just quit at all. And at this time, I was really beginning to develop a national presence in anesthesiology. So I was speaking all over the country, and I was publishing, and I had recently gotten an NIH grant. And then I had these four young kids at home, and if you looked at me on paper, you would probably be like, oh, she’s killing it. But inside, I was really unhealthy and physically unhealthy. My kids I felt like I was failing them. I was failing at work. So I kind of had this moment when a couple physicians I knew had also died by suicide. All of this kind of culminated in one year of my life where I went, something has to change. And I did what I call the year of no. So I said no to things for a year, which was really hard for me because I was a people pleaser and wanted to achieve, achieve, achieve. And I thought you said that by saying yes to everything. And then at the end of the year, of saying no, I had developed boundaries. I was much healthier. I started spending daily time with myself. I started exercising every day and eating healthier and going on vacations and doing all the things for myself I needed to do. But I was really lonely and isolated. And I realized, like, I don’t have any friends. Like, I used to have friends. Where did all my friends go? I’ve just been mom and doctor for, like, a long time. So, short story. I developed a text group, which became a Facebook group, which launched into my current business. I’m now an entrepreneur and founder of a company called Bravenae. And I teach, women, primarily women in healthcare, how to set boundaries. I have conferences, retreats, and courses for women in medicine. I’m a published author, of two books now. And I just have found my happy place in not leaving medicine altogether. I know we share this, but in really expanding my identity as a woman to be more than a physician, more than a moment, and really embracing being an entrepreneur, this is like Sasha 3.04.0. I don’t know. I’m losing track now. So that’s kind of where I am now.

Dr. Jaime Seeman: I love it. I think that when I went through medicine, too, I went through, from being a collegiate athlete and then into medicine, and I went through a very similar shift in my life, that actually happened through a tragedy as well, losing one of my best friends. And I think that so many times we get into that doctor mode and that becomes, like, our identity, and we feel like, especially after we become a mom and have children, that we start to just lose those pieces of ourselves, those other passions, and it’s like, I don’t have time to do those things, and we really can get into a rut. And I know that there’s going to be people listening that feel this exact same way.

Can you talk a little bit about on this podcast having children in medicine

00:05:00

We have brought lots of moms on here, and I think it’s such an important thing to talk about having children in medicine because I see women all also that delay life and having a family in place of their career and achieving things in their career. So can you talk a little bit about where did you have your kids in your training? Like, what did that look like? Maybe some advice for people listening, thinking about that?

Dr. Sasha Shillcutt: Yeah. And it’s a real issue. I know you are an expert in this, but infertility, specifically for women in healthcare and women physicians is a real thing. We have, like, two or three times the normal rate of infertility because we put it off until later stages and we’re stressed and all these things. I had one child, my first week of internship, I do not recommend. I had my first child that week, in July. And then I had my second, my third year, when I was a third year resident, and my, third, my first year of fellowship. And then my last baby was my second year, brand new attending. And honestly, everyone had its challenges at the time. Everyone was difficult. I actually got a real maternity leave with my last one, which made me feel almost guilty. Like, I remember being. Feeling like, oh, this is maternity leave. Because it was actually like ten weeks and I rested and I felt ready to go back to work. And, I had a four week maternity leave with my second child, when I was a third year resident and I had a two year old at home. That was horrific. And I actually, like, have had to grieve that part of my life where I lost that. Cause I didn’t even know any better, but I was wanting to graduate on time. Cause here I am again, overachiever. I was like, I can only take those four weeks off that they allow you a year. So it was rough, but honestly, I don’t think there’s a good time to have kids. I mean, I just don’t think. I think you gotta do it and the world will adjust and the world is adjusting slowly, but not completely. And you just gotta do it, because if it’s important to you and it’s a priority to you, then do it and let everyone else freaking flex accordingly.

Dr. Jaime Seeman: Yes. I mean, I’m sitting over here. I took four weeks with my first daughter, was born at the beginning of my fourth year med school. And that was actually the best experience because I had, I mean, fourth year med school, you know how it is. You have this. A lot of flexibility in the schedule. And I knew I wanted to be an Ob GYN, and it was very early in my fourth year, but my second and third child were born in residency. And, same thing by acGma rules. I took four weeks because you can only take at the rule at the time, I think, was eight weeks for the year. And I figured, I don’t want to take eight weeks and then not have a day off for like the entire rest of the year. So I took four, thinking then I’ll have these kind of breaks throughout the year that will kind of help me get through it. And I never would have survived without a very supportive partner who honestly worked an opposite schedule of me. So we passed in the night, but we somehow made early parenthood work and grandma’s close. Bye. You know, I couldn’t have fathomed him matching in another state and trying to attempt what we did. Looking back now, I honestly don’t know how we did it. We just did it.

Dr. Sasha Shillcutt: I know. I don’t know how we did it either. I don’t. There is definitely, though, my husband and I laugh about this. There’s like seven years of my life that I don’t have memory. I’m like, he’ll say, oh, remember when we took the kids to great wolf lodge and we did blah, blah, blah. And I’m like, no, I don’t. I don’t remember that. So I think I just didn’t sleep for so many years that it was like. I just was in this, like, check the box mode of just trying to survive.

You chose anesthesia as a specialty after going through medical school

Dr. Jaime Seeman: Yeah. Tell me about picking anesthesia as a specialty and then going on to fellowship. That kind of thought process.

Dr. Sasha Shillcutt: Yeah. So I was going to be a cardiologist. I actually did, like, my first year of internal medicine. And I. I was like, gung ho cardiology. I did cardiology research all through medical school. And then on my surgical rotation, I went to Haiti for a medical trip, in surgery. And there was all these residents and so there wasn’t really room around the table. And there was an anesthesiologist on the trip and he said, oh, come over here and help me, because I think he felt bad for me because I was just kind of standing there. And I started. He let me do spinals and I was intubating and I was like, oh, my gosh, this is super cool. And then I realized there’s all this physiology. And I loved the hands on notion of just not like, waiting for someone and writing a prescription, but physically doing it, giving the drugs and changing the physiology and all that. And then I switched to anesthesia and I just fell in love with it. And then I realized, oh, there’s this whole, like, cardiac anesthesia that I loved the cardiac physiology that’s why I really wanted to be a cardiologist. And yet I loved the hands on nature of anesthesia. And so, I’ve just found my niche there, and I loved it. I did, like, something like 150 hearts when I was a resident. Did 150

00:10:00

Dr. Sasha Shillcutt: tes as a resident. I mean, I was, like, basically did, like, a mini fellowship as a resident just because I fell so in love with it.

Dr. Jaime Seeman: That’s awesome. I have been in the operating room with you. You are amazing at your craft. Do you still love it to this day as much as you did when back then?

Dr. Sasha Shillcutt: I can honestly say I do. I honestly can say I love doing cardiac anesthesia 20 years later as I did then. There are aspects of medicine I don’t like, and there are things I don’t like. I don’t like doing 03:00 a.m. transplants. I wish they were all at 03:00 p.m. i’m getting older, but I love it. And when I feel myself getting really negative about medicine or my job, I just go back to that space, because that is why I went into medicine. And I have to remember that, when I get frustrated with administrative things or policies or bureaucracy or whatever it is, I actually feel better being in the OR. It reminds me of why I went into medicine, and that’s what kind of, like, brings me back to my why.

Dr. Jaime Seeman: Yeah, I love that. Yeah. 02:00 a.m. deliveries get a little bit old, but the same thing, you know, you’re in that moment with this patient or a family or whatever it is, and you need, like, those moments to continue to fill your cup, because otherwise, it is really like banging your head against a wall.

As you advance in medicine, you start experiencing gender bias and pay inequity

So let’s. I, hate to focus on the negative, but let’s talk about the things in medicine you don’t like, because I think there’s been things like that in your career that have probably been the stepping stones to brave enough and the things that you do now. So talk to me about what women in particular, face, you know, in medicine that is different than our male counterparts.

Dr. Sasha Shillcutt: You know, I thought that as I advanced in medicine and in my expertise, I would experience less bias, because, honestly, there are a lot of women. We are 83% of healthcare. Women make up 83% of healthcare. So healthcare would not exist in the United States or in the world, because we are 83% of the workforce, but we are 8% of the leadership, of top leadership. So, in my mind, I didn’t really experience gender bias when I was a very junior faculty or resident. Now, I did experience sexual harassment majorly, when I was a resident and fellow and junior faculty, because I’m in the operating room. And as you know, you know, the nascent reports that have come out, medicine, has the second highest sexual harassment than to the military of all workforces. So it’s rampant, and especially, I think, in our. In our areas of surgery. So I did experience a lot of that. I did not experience sexual or, gender bias or I would say, gender inequity. I wasn’t aware of it as much because I felt like, oh, there’s women all around. Like, we’re in the trenches, we’re working. And in my brain, I thought, I really won’t experience it when I start advancing. But the opposite happened to me, because what you find is as you start to advance and as you start to become a threat to power as a strong woman, then you start experiencing gender bias and gender discrimination, because our world of medicine is so misogynistic that we are not used to hearing even women’s voices lead or talk or give orders. And it’s not just men. It’s women, too. So I found that. Wait a minute. Why am I getting overlooked for this position? Oh, well, you’re too strong. You’re too abrasive. You’re too authoritative. You know, wait a minute. I just ran a code and saved a life, and now I’m getting written up because I asked for epinephrine forcefully or, like, with authority. I didn’t swear. I didn’t cuss or whatever. And my male colleague over here acts the same way, and he’s, like, applauded for his leadership skills. So that started emerging, really probably five to ten years in my career. I started seeing that, and then I really started seeing the pay inequity, and I had no experience with that before. You know, I remember very clearly a turning point for me and why I decided to take on this work is I had done a job for about three or four years that I had a title for, but there was no time and there was no money associated with it.

Dr. Jaime Seeman: Something administrative, like in addition to your work.

Dr. Sasha Shillcutt: Correct.

Dr. Jaime Seeman: Work as an anesthesiologist.

Dr. Sasha Shillcutt: Correct. And I did this job, and I was really proud of this job. And I went to, the leadership and said every year at my annual review for three years, I said, I really need money or time to do this job. Oh, you’re doing a great job. We just don’t have any money or time. So finally, I made a boundary for myself. I said, I’m not doing this job anymore. I told my husband, I’m going in there, and I’m saying no. I went in, I said no. And they were like, well, who’s going to do this job if you don’t do it? I’m like, I don’t know. Not my problem. And then three months later, one of my male colleagues who I trained to came up to me and said, hey, I’m gonna take over this job. Can I have all your files and folders and information?

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Dr. Sasha Shillcutt: We share the documents. And I’m like, sure. I’m really surprised that you took this job because there’s no money or time. And he said, oh, I’m getting money and I’m getting time. I went, wow. What? Like, I was so angry and hurt, and, you know, the world would probably say, well, maybe you didn’t negotiate better. Maybe you didn’t use these words or whatever. And I’m like, where’s the ethics in this? Like, that’s so unethical. And then I realized, like, that is normal. That’s what happens all the time. And if you don’t actually, like, if there’s no awareness and transparency, you don’t know, right? And so I just started doing this work in gender equity and started speaking up and started just saying, like, I can’t be the people. Like, people pleasing isn’t working right. Being the person who just waits and hopes that someone’s gonna notice me as a woman and pay me more, pay me what I deserve and all that, that doesn’t work.

Dr. Jaime Seeman: Sounds nice.

Dr. Sasha Shillcutt: So it sounds wonderful, but it doesn’t work. And so that’s when I really decided, like, okay, I’m going to start using my own platform and my own business. I’m going to start my own business, and I’m going to have my own social media, and I’m going to do whatever I want on those channels to promote these truths and promote women that are within my purview to speak on. And it, you know, that’s how I use my platform and that’s how I use my voice. I still, I mean, I just had a meeting this morning with our leadership team, and one of the things we went over was equity and pay equity, and we’re definitely getting better. And I think people are definitely more aware of this, but it is something we still have to speak up and we still have to say. And so those are the things I have faced as a woman. I don’t get sexually harassed anymore. Nobody’s going to come up to me and sexually harass me in the or because they’re smarter than that. They know, like, I’m like, not gonna mess with me. That happened to young Sasha. But I do experience gender bias, probably ten times more than I did then, because I think I’m a threat to power. And you just have to know that about yourself.

Dr. Jaime Seeman: When you say gender bias, you mean amongst your colleagues? I mean, I remember. And a thousand other women can tell the same story where you walk in and you say, I’m doctor so and so. And they’re like, oh, you’re the nurse, you know, like, when you say gender bias, is it, you know, systemic wide, is it just your colleagues? Is it.

Dr. Sasha Shillcutt: Oh, no, I think it’s systemic wide. I mean, just the other day, there was an email that went out that was doctor, let’s say doctor B, who’s the male, and Sasha in the line, like the email from administration, you know, and it’s like you’re at a meeting and they’re calling your colleague next to you, doctor B, and they’re calling you Jaime, you know, and at one point, do you say, excuse me, I’m a physician. Like I would. If you’re going to call him doctor, please call me doctor. It’s very tenuous and you have to kind of work through these. But those are the things that I’m constantly, like, deciding, is now a time to educate? Is now not a time to educate? Perfect.

About 40% of our residents are female

example residents. I train. I train male and female residents, and we have. About 40% of our residents are female. And I was just doing a central line the other day with a female resident, and it was a really difficult central line. And she kept apologizing. She was like, I’m so sorry, Doctor Schilcott. Oh, I’m so sorry. And I was saying, to the nurse, can you get us this, Orlando? Get us that. Or to the tech. And she kept apologizing. Like, I was like, we need this. And she’d say, I’m so sorry. And then I’d say, we need this. And she’d say, I’m so sorry. And I finally stopped her and I said, do you understand the male residents never do what you just did. And she’s like, what? I said, you have said you are sorry.

Dr. Jaime Seeman: She just learned it.

Dr. Sasha Shillcutt: For every single thing that you’ve asked for, it’s actually part of this procedure that you need. And this is not your fault. This person has really difficult anatomy and has had, like, ten central lines and has thrombus. Thrombus in their IJ. Like, that’s not your fault. Why are you apologizing? And I’m like, when you do that, you’re lowering your status. You’re lowering your position. You’re making everybody in the room think you’ve done something wrong. And she’s like, I don’t know. That’s just how I act. And I’m like, stop acting that way. Stop doing that. So it’s multifactorial. It’s everywhere. And once you’re aware of it, you can see it.

There’s something called the queen bee syndrome that affects women in leadership

Dr. Jaime Seeman: Yeah, I also see it. Women amongst women. And I’m interested in that dynamic that you’ve experienced, too. you would think that we just build each other up and that we support each other, but I’ve noticed in my path that that’s not always the case either. is it because we’ve lived in this environment where there is so much misogyny that it’s just that learned behavior and how we treat our female peers? Or. I mean, I would love to hear your perspective.

Dr. Sasha Shillcutt: Yeah. So there’s actually been studies on this, and a lot of times, the studies, people think it’s women being like, women on women in hate. And quite frankly, like, men love that. They love seeing that, and they love perpetuating that theory. There’s lots of reasons we could probably go into why, but the truth is that,

00:20:00

Dr. Sasha Shillcutt: number one, there’s definitely something called the queen bee syndrome. And that’s, you know, think about what I just said. Like, 83% of healthcare is women, but 8% of leaders, top leaders, are women. So we are, as women, have been brought up in this scarcity complex. It’s like when there’s been times of famine, you know, and people are, like, hoarding the power and hoarding anything good. And we as women kind of act that way, and we definitely see other women in power that way. the other thing that happens is that we don’t. We aren’t comfortable, as you said, with women who are authoritative or have agentic personality types where they take on some attributes that we see men doing. We’re like, why is she. Why is she ordering epinephrine? Why is Doctor Seeman, like, saying, I need this, I need this. I need this. Now, even though you’re doing it to save a life, we expect you to do it. Like, Carrie, can you pass the epinephrine? Would you get me the retractor? Like, that’s how we expect women to do it. And so when we don’t do that or other women in the room don’t do that, we get nervous. We get anxiety, actually. And we may try to temper that by being either, like, rolling our eyes or siding with the majority. Right. Because it makes us uncomfortable. I mean, I’ve been in meetings where a woman will start to speak up and she’s getting really passionate about something, and I’m like, oh, my gosh, oh, my gosh, oh, my gosh, what is she doing? And then I’m like, wait. I wouldn’t think that if she was a man. You know, I find myself even having this. So we all have it, and it can be really, I think, harmful and hurtful to us as women when other women do that to us. Like, it hurts more than if a man does it to us. I think.

Dr. Jaime Seeman: Yeah, I think we really have to kind of take off the lenses sometimes and just kind of step back from the situation.

Burnout looks different in different people, and it really depends on personality

so you experienced burnout at this point in your career. Tell us, like, what were the warning signs, like, for somebody listening? How do they know if they’re on the verge of burnout?

Dr. Sasha Shillcutt: Great question. Burnout looks different in different people, and it really depends on your personality, whether you’re introvert, extrovert male. Men and women, look differently when they’re burned out. Men tend to. So there’s kind of three main symptoms of burnout because it is a diagnosis. there’s depersonalization, and we all kind of do that. And we’ve learned how to do that in medicine even more. So, where we just kind of depersonalize and withdraw. there’s emotional, like, complete withdrawal, and there’s anger. Right. And men tend to go into angry mode, where women tend to emotionally disengage. So men look angry and women look lazy. and I think there’s red flags and how that is expressed to you. If you find yourself going to work and you’re like, I literally can’t even smile at someone today. I don’t even have the energy to speak to anyone. I don’t want to ask anyone how they’re doing. I don’t want anyone to ask me how they’re doing. I’m totally disengaged from this. When your patients or people start becoming just numbers or objects or cases to you or procedures to you, that’s a red flag. If you find yourself getting really angry about things that are maybe would make you a little frustrated. But if you’re a man and now you’re, like, just enraged and you’re angry, that’s a sign of burnout. and so a lot of it is emotional exhaustion to where when you go home, you can’t actually deal with the people that you love the most, and you’re actually probably worse to them, because you can be right. They’re your safe place. So you’re going home, and you’re, like, totally disengaged. You don’t want to eat with the family. You just. For me, it was like, I couldn’t wait till my kids went to bed, and I could just go to my room and turn on Netflix and be like, I don’t want to even talk to my husband. I had a lot of emotional emptiness where I couldn’t. Nothing made me even happy. And I, You know, I remember talking to my mom at one point, and she said, well, why don’t you get a hobby? And I remember thinking, a hobby?

Dr. Jaime Seeman: On top of all I have to do, you want me to.

Dr. Sasha Shillcutt: I don’t know what I would do. Like, I don’t even know what would bring me joy, you know? Or people are like, what brings you joy? And you’re like, what? Like, you’re so gone that you just. You can’t even think of that. and then, you know, taking on really negative behaviors, like, numbing behaviors. And those can be things that aren’t necessarily bad, but they become bad because they’re escaping. You’re escaping.

Dr. Jaime Seeman: Drinking a bottle of wine at night.

Dr. Sasha Shillcutt: Drinking a bottle of wine at night. just bingeing things that aren’t healthy or, you know, anything can be unhealthy, obviously, when we just are using it to numb us.

Dr. Jaime Seeman: Did your husband see that in you, or was this, like, self actualization?

Dr. Sasha Shillcutt: No, I think my husband definitely saw this in me, and he was like, you are just. You want to be alone all the time. Nothing makes you happy. You’re not laughing about things that are funny. You have. Don’t have a sense of humor.

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Dr. Sasha Shillcutt: We weren’t ever going out on date nights, or. I mean, I just was really withdrawing from everybody, even my kids. I just didn’t have joy.

Dr. Jaime Seeman: Yeah. Yeah.

This all started with a group text message amongst female doctors about burnout

So tell me about your pathway out of it. This all started with, like, a group text message amongst female doctors, and you’re like, hey, are you burned out, too?

Dr. Sasha Shillcutt: Yes.

Dr. Jaime Seeman: We’re just gonna commiserate together.

Dr. Sasha Shillcutt: Literally. I was like. I was like, I have to start. The first thing I did, actually, was giving myself 15 to 20 minutes a day to myself because I felt. I don’t think I labeled it as burnout, but I felt like I had lost myself. And I remember just feeling, like, I cry, like, all the time in secret. Like, I am crying all the time. And I don’t think I was clinically depressed. I think I had just lost. Literally, like, lost? Yes. So I started getting up really early in the morning and spending 15 to 30 minutes. Sometimes I’d walk on the treadmill. Sometimes I’d lift some weight. Sometimes I would just sit at my kitchen table and, like, cry for 30 minutes. I was. Started journaling, doing all this, and then I just started feeling, like, a little bit better because I had clarity. Like, that time brought me awareness. Like, oh, this thing that you have to do is making you really sad, and you don’t even want to do it. Just say you’re not going to do it. And a lot of it was having to break promises I had made professionally, which was hard. Like, I know I committed to give this talk in six months. I can no longer do that. M. I made a list of everything that made me feel stressed and anxiety, and I literally got rid of it. and if you feel that way and you’re like, I don’t want to do that, I’ll never be asked again. You will be asked again, because you will be. If you deliver on ten things instead of half assing 30, people will still ask you to do those ten things even more. That’s where I started. And then I was like, I had this clarity because I was spending so much time by myself, right? Realizing things. Like, I need female relationships. I need friendships I don’t have. I’m sure other women are feeling this way. If I’m feeling this way, there has to be other women. So I literally started a text group and was like, hey, do you want to be my friend?

Dr. Jaime Seeman: Like Miro’s friend group?

Dr. Sasha Shillcutt: Do you want to stay positive and have some accountability in a world where I feel like I don’t have a safe place to be?

Dr. Jaime Seeman: Like, who can say no to that?

Dr. Sasha Shillcutt: Yeah. And so that’s where it started. Just a little text group. And then it was like, if I didn’t text every day, they’d be like, why didn’t you text us our positive, encouraging thing today? And I was like, I don’t know, because I’m in the or working. And then my husband’s like, what is going with your phone? You have to get it out of a text group. You need to do something else. So I started a Facebook group, and it just kind of grew. Yeah.

Dr. Jaime Seeman: amazing.

You recently gave a TED talk about being a woman in the spotlight

So then you went on to author two books. The first one was grit and grace.

Dr. Sasha Shillcutt: Uh-huh between grit and grace.

Dr. Jaime Seeman: Yes. Tell us about that book.

Dr. Sasha Shillcutt: So I feel like a lot of times we, as women, have to choose, like, a or b. You gotta be, like, this badass, gritty person who doesn’t care about anything but your career, or you gotta be this, like, wallflower quiet. Everybody likes you and wants to ask you to coffee, but nobody thinks you’re competent, you know? And I felt constantly like that. Like, I was like, you, know, I am a very authoritative, blunt person. That’s my communication style. I’m very transparent. I’m very direct. But then if I would cry with a patient’s family before surgery, because I’m like, I don’t know if we’re coming back out of here. Like, I don’t know. And I’m starting to get, like, tearful because I’m empathetic. Then people are like, oh, she’s like a crier. And I’m like, wait a minute. I can be both of these things, right? And then I saw how my more introverted friends were criticized for being more introverted. My extroverted friends in medicine were criticized, for being more extroverted. Like, the bottom line is, you’re gonna get criticized as a woman no matter what you are or who you are, whether you wear lipstick, whether you wear dance goes or Louis Vuitton. Like, you’re gonna get criticized. So the book is really about leading as a woman and embracing what being a woman is to you. And if it means being. Taking, charge and being authoritative and putting people in their place one day and really operating at the top of your expertise, that’s it. And the next day, if it means crying with a family member because you’re showing empathy, that’s okay, too. Be whatever it is that you were made to be and what being a woman is for you.

Dr. Jaime Seeman: Yeah, I love that. I recently gave a TED talk, and the comment section of the Internet is always a very interesting place. But a vast majority of the comments were about my outfit that I wore. And it was like, this blazer dress, but it was actually shorts. It was actually a romper. So, I mean, most men, I don’t know if they know what a romper is. When the Internet’s like, why is your dress so short? Like, I mean, it was just wild

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Dr. Jaime Seeman: to read these comments. And, you know, I’m like, would they say this if this was a guy up here doing this? But I don’t think it mattered. I mean, I could have had pants on, and they would have been mad about something else, or I could have had.

Dr. Sasha Shillcutt: It would have been too frumpy if you would have dressed differently, it would have been not the right thing. Yeah.

Dr. Jaime Seeman: But, you know, that was the outfit that I felt amazing in, and that’s what was going to bring, like, my best presence to the TEDx stage. And I know you’ve given a TEDx, too, as well. yeah, it’s, you know, and that’s why I think it’s really. I really worry sometimes. I have, you know, three young girls, and the Internet can be such an amazing place. I mean, you’ve built social media. You’ve built brave enough. It definitely can serve for so much good. But, there’s always a flip side of the coin, and I think if you look for external validation from that, and that’s, like, your identity. Like, it’ll chew you up and spit you out every time.

Dr. Sasha Shillcutt: Yeah. Well, congratulations on your TEDx.

Dr. Jaime Seeman: Thank you.

Dr. Sasha Shillcutt: That’s amazing. And, yes, you’re absolutely right. It’s a great place. It is what you make it. Let it be. Right. You can definitely get consumed by people’s criticism of you or what they say. And it’s so easy. People will say things on the Internet that they would never say to your face.

Dr. Jaime Seeman: To your face.

Dr. Sasha Shillcutt: Yeah.

Dr. Jaime Seeman: Yeah.

okay, so then you wrote a second book.

Dr. Sasha Shillcutt: Yes.

Dr. Jaime Seeman: Brave enough. Brave boundaries.

Dr. Sasha Shillcutt: Brave boundaries.

Dr. Jaime Seeman: Brave boundaries.

Dr. Sasha Shillcutt: Yes.

Dr. Jaime Seeman: Tell us about that book.

Dr. Sasha Shillcutt: So this book was really, like, you know, I burned out the first time because I was doing things I didn’t want to do. I was doing things I thought I should do that other people expected me to do. And then in 2020, 2019, actually, before the pandemic, I burned out again. And this time, I burned out doing things I liked doing. And I was so ashamed that I would found myself in this place again where I was like, are you kidding me? I’m, like, supposed to be the burnout expert, and I’m burned out. But the difference was, in the first time, I was again doing too much of what I didn’t like, and then I was doing too much of what I liked. And that was like a big wake up call to me. I was like, oh, what is the common denominator here? Me. Okay. I can’t blame it on the, oh, this person making me do this because I’m a junior person or me. It was like I was. I really lacked boundaries. And so I went, actually, I thought I felt like. And, then the pandemic hit in 2020, and I felt like I was trying to help all these women and trying to help my family and trying to help my patients, and I just was burned out again. And so I was talking to a friend of mine who’s a psychiatrist, and she’s like, I think you might need to talk to a therapist, because I feel like you are trying to do everything for everybody. Every time I talk to you, you’re in, like, shero mode. You don’t know how to, you know? And I was like, I don’t need therapy. No, no, no. And the first time I went, I literally looked like Britney Spears. I had, like, sunglasses. Like, I was like, my husband’s like, where are you going? I’m like, I don’t want anyone to see me. I, like, waited in the car till right before my appointment, then, like, ran in because I was so ashamed I was going to a therapist, because here I’m supposed to be the person that’s helping others. And the first 30 minutes with this woman, she’s like, you have no boundaries. Like, I showed her what comes on, came on my phone every day from women all over the world texting me for this and this. And she’s like, you respond to this. And I’m like, well, yeah, they need my help. They need me. And then I told her about my family, and she’s like, you’re responding to all of these people, in your big, large family. And I thought boundaries, Jaime, were something that people going through a divorce need or, like, people going through toxic relationships. And she said to me, yes, you have a toxic relationship with yourself. M. And it was, like, mind blowing, right? So then I did what we do as doctors. I went and researched everything there is about boundaries. And I, like, was like, did this deep dive on, you know, and on pubmed. And I was like, wait, there’s no books for doctors or women professionals on boundaries or, like, what work life boundaries are.

Dr. Jaime Seeman: Right.

Dr. Sasha Shillcutt: So then I decided to write the second book, and that’s. It’s really about. It’s kind of a workbook about looking at the six areas of your life that maybe you need boundaries in.

Dr. Jaime Seeman: What are these six areas?

Dr. Sasha Shillcutt: electronics. Okay, so, like, access to your phone, email, tell us where you set those boundaries.

Dr. Jaime Seeman: Do you turn your phone off at a certain time? Do you have a limit of how many things you respond to?

Dr. Sasha Shillcutt: I do. So I have a couple boundaries. One is, I’m really good. This has taken me years to develop, but I do not answer work email unless I’m physically at work.

Dr. Jaime Seeman: Okay.

Dr. Sasha Shillcutt: Which is hard. but that. That’s my boundary. So if I’m physically, I may stay 30 minutes longer, not clocked in. But if I’m not clocked in. I’m not answering email because nobody dies over email. There are no email emergencies. I’m not intubating anybody over email, so it can wait. And that is hard, but that’s a very strong boundary.

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Dr. Sasha Shillcutt: the second one is, I have decreased my social media by about 90%. I am, I have very limit, limited social media access. I don’t answer private DM’s on.

Dr. Jaime Seeman: We’re gonna check our screen time. You guys get your phone out.

Dr. Sasha Shillcutt: So I have really strong boundaries around that. People say to me all the time, like, oh, my gosh, how are you on social media? And I’m like, I’m not on social. I go on for, like, 15 minutes twice a day. I go and I leave, and if I go and I start feeling icky, I just get out of there. And there’s some platforms I just don’t engage on at all. I may post my social media team posts, but I just don’t engage. so that’s one. The other thing is your health, like, your healthy boundaries, you know, what are your boundaries like? And you might think I need boundaries around my health, but we really do. I mean, we. Anything in excess is unhealthy, as you know, relationships, that’s really hard. A lot of us don’t realize that we have terrible boundaries with our kids, especially as working moms, if we are working professionals, because we. We have so much mom guilt that tells us when we’re not with our working mom.

Dr. Jaime Seeman: But you let them sit on the bathroom floor and talk to you while you’re trying to go to the bathroom. Cause you haven’t seen them all day. So this is, like, your five minutes?

Dr. Sasha Shillcutt: Yes. Okay. Yeah. So you really.

You can teach kids boundaries, and they’re good. Even a two year old can learn that.

Dr. Jaime Seeman: How did your kids respond to that? I mean, tell me how you kind of, like, approach this.

Dr. Sasha Shillcutt: Yeah, so I have. And I coach women all the time, and in, my coaching programs, I have every woman find a space in her house. And some of these women live in, like, New York apartments that are, like, a thousand square feet. So they’re like, we don’t have space. I’m like, but you have a chair. You have a. You have a stool, you have something. When you are there, nobody is to bother you because you’re having a moment. You might be like, I got to get myself together. I got to decompress from a bad interaction at work. I just need to figure something out. I need a moment to drink a hot tea for whatever it is. And kids love that. They’re actually are like, oh, mom’s in her and secret place. Nobody talked to her, you know, and we think that they can’t learn, but they can. Even a two year old can learn that. another boundary is, you know, we have, like, there are times where I’m sure it’s the same in your house. My kids play sports. They’re in a million activities. I could go to hundreds of kids activities a year, literally. and I used to think, like, if I’m not at work and my kid’s doing something, I’m going, like, I am there. A lot of its travel out of town, and just a few months ago, my son had a tournament out of town about 4 hours away. I’m flying home Friday night. I had probably a 60 hours work week. I was exhausted. I knew we were going to get home late Sunday and then go into another 60 hours work week. I was feeling so emotionally exhausted and frazzled for my week that I was, like, tearing up on the way home. I get home, they’re waiting for me in the car. Go grab your bag, mom. And I was like, everything in my body was like, don’t go.

Dr. Jaime Seeman: Don’t get in the car.

Dr. Sasha Shillcutt: Don’t get in the car. But I was like, I’m gonna be the. Then the mom reel starts, right? Like, you’re a bad mom. He’s gonna be psychologically scarred.

Dr. Jaime Seeman: He’s gonna hit his first grand slam, and you’re gonna miss it.

Dr. Sasha Shillcutt: Yes. And then I just said, guys, I can’t go. Like, I can’t do this. And my son was like, guys weekend, let’s go. Like, he was fine. All the guilt, it was all this narrative in the story that I made in my head, but I didn’t go. I would never have done that 510 years ago. Never. And now I know that about myself that I have to just. I can’t be at everything. Sometimes I actually stay at home and don’t go to things for my own well being. I know that sounds crazy, and women listening are gonna be like, there’s gonna be gasps. But that’s what is best for me.

Dr. Jaime Seeman: Yeah.

Dr. Sasha Shillcutt: And so that’s a boundary. Boundaries around maybe family members that are emotionally exhausting or difficult for you. It’s okay to set, boundaries around people you love. Right. and then work boundaries, obviously, is another whole, thing that I talk about in the book and how you have to put boundaries around that and then boundaries around your own expectations of yourself, because we have these grandiose expectations of ourself that every year of life. We’re just gonna rise, right?

Dr. Jaime Seeman: The next Mario brother level. Like, that’s what it feels like.

Dr. Sasha Shillcutt: You have to just have a, reality check. There’s gonna be grief. There’s gonna be years of loss. There’s gonna be years where you don’t have energy because you’re going. You’re. Maybe you’re going through menopause or you’re going through something physically, and you just have to really reel in the expectations you have of yourself and set boundaries around those.

Dr. Jaime Seeman: I love that. I love that.

You host a large CME conference every year in Arizona

another thing you do is host retreats, and these are for physicians, right? Tell, us about. Tell us about the brave enough retreats.

Dr. Sasha Shillcutt: Yeah. So I do.

Dr. Jaime Seeman: I haven’t been to one, you guys. I need to go to one.

Dr. Sasha Shillcutt: You’ve got to get to the conference this September.

Dr. Jaime Seeman: You got to do it.

Dr. Sasha Shillcutt: You need to be there. So I host a large CME conference every year, in scottsdale, Arizona, at the omni montelusha at the base of camelback. It’s this beautiful top resort and spa, and I do it there because I want women to relax and recharge every afternoon. I want you to be in a cabana. I want you to be waited on. I want you to

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Dr. Sasha Shillcutt: go to the spa and get a facial and a whole day and do all that. So it’s amazing in the morning, we have really great CME, and it’s focused on day one. We focus, really, about empowering you and taking your pulse. Like, where am I? What’s going on in my life? And then day two is really about your physical and emotional well being, and your stress triggers and how to process that. And then day three is about designing your work life. So I bring in women that you won’t hear at other conferences, and it’s so empowering, and it’s just a phenomenal, phenomenal, CME conference. And that’s in September. It’s the September 27 through 30th. And then I have retreats, which are just small, high touch kind of intimate settings where we normally have anywhere from five to 15 women physicians, and we pick a topic and we just dive deep. and those are really fun, too.

Dr. Jaime Seeman: Do you find those are more powerful, the small, intimate setting?

Dr. Sasha Shillcutt: Yes. The small, intimate setting is definitely. It’s more powerful for me, too. I always change. I always leave having awareness that I didn’t have going in. So definitely love those. Cause I get to know people more one on one, too.

Dr. Jaime Seeman: are people coming back for multiple times? Do they tend to come once and how many have you had?

Dr. Sasha Shillcutt: Yeah, I’ve had about eight retreats now and eight conferences. So, some women come back, some women may take a year off. Some women come back and bring friends every year. it’s always really interesting because I always, I’m a very spiritual person, so I always pray before every retreat and conference, and it’s always the people that need to be there. Sometimes I worry. I’m like, oh, my gosh. We have this transplant surgeon and this ob gyn in private practice, and we have this, you know, person who doesn’t practice medicine anymore, and how is this all going to work or whatever? And it always works. It’s always like, the people that need to be there show up and the relationships are really powerful. And some of these retreat women have gone on to, like, go on now they go on vacations without me. I mean, they’re just like, they’re brave enough groupies. Yeah, they’re brave enough group because I love it. They have found their people.

Dr. Jaime Seeman: Oh, my gosh. okay.

Sasha: Everyone asks me this question. It doesn’t matter what I’m talking about

So something that gets said to me a lot, and I’m sure it gets said to you, and I actually think I saw this in a quote on the University of Nebraska website. They did, like, a story on you, and somebody said, I don’t know how she does it. What do you say to people when they say that? How do you do it? How do you do it, Sasha?

Dr. Sasha Shillcutt: Oh, gosh, I love this. I love that you’re asking me this question, because I’m curious about your answer for several years when I. This is the question I get asked, by the way. It doesn’t matter what I’m talking about. If I’m talking about the mitral valve at an echo conference, people ask me this question. If I’m talking about gender equity, people ask me this question. Everyone asks me this question. And I used to lie. I used to be like, oh, I don’t do every da da da da ah. Cause I felt like it was bragging to say, well, but now I’m very honest. First of all, I don’t waste a lot of time. I’m not a time waster. And I don’t realize that there are people that do waste time until I, like, go on big vacations with families and stuff. And then I’m like, oh, what are you talking about? You’ve been just how many episodes? Like, I don’t watch television, okay? So I don’t waste a lot of time. I will say that about myself. I have very strict boundaries and good time management skills. But I don’t do everything. I don’t clean my house.

Dr. Sasha Shillcutt: I don’t drive my kids from place point a to point b a lot of times because I don’t love doing that. And I can pay my teenage neighbors to do it for me. So I don’t. If I pick up my kid from school, I get. Some women love that, and I’m not knocking that. That’s not something that makes me excited. If I pick up my child from school, they’re like, what are you doing here? They literally are like, something wrong? What is going on? Mom is in the school pickup.

Dr. Jaime Seeman: Is that okay?

Dr. Sasha Shillcutt: So I know I hire out a lot of things. We are not a 2.0 Fte family. We’re like a five point fte family. We have a lot of people helping us for little things. So I don’t do everything. And I don’t want anyone to think that I’m at home making pinterest cakes and, like, cooking seven course meals for my family. I don’t do that. But I also don’t waste time doing things that don’t bring me joy. And I don’t have a lot of time to waste. I’m very efficient. I’m the person that’s on a plane riding or working on a plane. I get up very early, and I work every Saturday and Sunday. That’s when I started writing my books. And now that’s just my work time. Some people think I’m crazy to do that, and I get it. But I don’t want to give this impression that I do everything, because I don’t. I have a lot of help, and I also don’t want to give the impression that, like, I. It’s easy because it’s not. So that’s just my honest answer.

Dr. Jaime Seeman: I mean, everything you said resonates with me pretty deeply. I mean, I think there is some, you know, a personality type that. That can work at a particular pace. And it’s. I tell people, you know, the way that I live my life is definitely not for everybody.

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Dr. Jaime Seeman: I have learned that I don’t sit still very well. So if you look at even from, you know, when I was a child to going to college, going to med school, you know, to where I am now, there really wasn’t idle times in my life. And the times that I did have that were idle. Like, I, had a gap year between undergrad and, medical school. I sold wedding dresses. but I was also getting married. And it was a good kind of like, forced break for me. or I had like a couple months off before I left residency and started private practice. But those months of my life, when I reflect back, were some of the. I don’t want to call them sad, but I don’t do well with like, extended breaks. like, to even flip the script a little bit on this four week maternity leave, I am not sure that I would have been better off taking twelve weeks. You know, I felt joy and fulfillment actually going back to work because then when I came home and I walked in the door, I was like, okay, now I get to be a mom. And so I enjoy kind of that flip switch back and forth. That’s just who I am, but that’s definitely not for everybody. And I am with you. I have a person that cleans my house. I, you know, my husband left his career, after 15 years to not be a stay at home dad. He works full time at a business that we own, but I delegate a lot more parental duties to him. And I say all the time, he changed way more diapers than I changed when my kids were babies. I breastfed the kid, and then he did the diaper and put the baby back in the crib. You know, we’ve just figured out how to be a team and how to make that work and, and, but it’s a two way street too, you know, I’m supporting his goals and aspirations, he’s supporting mine. And, like, that’s what a team is. And as long as we’re both having fun doing it, then we’re just gonna figure it out. And, I have family support. My mother actually just moved five doors down from me this June, which a lot of people were like, boundaries. Are you sure this is a good idea? Is your husband okay with this? His mother in law is going to live five doors down. But it is a symbiotic relationship. You know, my parents are at a place in their life where they need a little help. My husband mows their lawn and scoops their driveway, and my mom picks the girls up from school most days per week, but on Fridays is my day to pick them up. So I pick them up one day a week, and it’s, you know, my day that I get to go park and let them get in the car and ask how their day was and check their spelling test.

The reason I can work at this pace is because I love my life

yeah, so, you know, I don’t know. The real honest answer is I don’t know how I do it, I just do it. But every year has looked differently, and we just keep reinventing and figuring out what’s working and what’s not working and what has to give and where we can give more. And, it’s fun. I think that the reason I can work at this pace is because I wake up every day and I love my life, you know? And when I wake up and I’m like, I don’t like this, then I change something.

Dr. Sasha Shillcutt: Yes.

Dr. Jaime Seeman: But as long as I wake up and I’m loving my life, then we just keep running with it.

Dr. Sasha Shillcutt: Yes. And I love that we are so alike this way. And I also have to say, like, my husband is such a good reminder, to me because he will say, you are not the normal. And most people want to relax and watch an episode of their favorite show, and there’s nothing wrong with that. And he reminds me, like, I don’t watch tv.

Dr. Jaime Seeman: People ask me about a show, I’m like, never heard of that.

Dr. Sasha Shillcutt: I know. I, like, make it up. I’m like, oh, yeah, that’s funny. And, or just to get into conversations, I have no idea what people are talking about. But I’m like, I also, it’s good for me to have him because he regulates me and will say, because I burn people out, you know? And I did when I first started my business, I would hire people and I would have these expectations of these people to work. Like, I. And my husband would be like, honey, that’s not normal. Like, this is not. You have to let this person rest. You have to give them. So I have had to really learn that about myself, that, yes, it’s great to be a person that’s high energy and, like, I don’t even understand the word bored. I have never been bored in my life. When my kids would come to me and they’re like, I’m bored. I’m like, I don’t even know how to parent you through that because I’ve never experienced boredom. Like, I’ve just never been bored.

Dr. Jaime Seeman: This happened the other day with my daughter. I’m, like, in the kitchen doing 10,000 things. She’s like, mom, mom, I’m so bored. I mean, I could see it in her face like this, like, fear and panic and anxiety. I was like, what do you mean you’re bored?

Dr. Sasha Shillcutt: Like, so I’ve had to, I’ve had to learn that I’m abnormal and that to not have those expectations of other people. Because, I will say this. When I go on vacation, I vacation. Like, when I go on vacation, I don’t want to lift a finger. I don’t want to do anything and my husband’s like, the person that’s like, come on, let’s go do this and go do that with the kids. And I’m always like, you do that. I’m going to lay by the pool and drink my ties all day. I’m so tired. And so I do vacation, like a queen. But I’m telling you, I’ve had to learn that it can also be negative, and I can burn out if I don’t take that time to vacation routinely. So I go on routine vacations and really learn that it’s okay that my husband watches Game of Thrones. There’s nothing wrong with that. And not to judge him for doing that and not to be like, you should be working all the time, because I can definitely fall into

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Dr. Sasha Shillcutt: that trap. So it’s a balance.

Dr. Jaime Seeman: I love it.

You’re going to Europe with your kids this summer

Where are you vacationing this year? Do you have one planned?

Dr. Sasha Shillcutt: yes, we’re actually going to Europe this summer. We’re taking the kids to Europe. So that’s funny. My kids are big soccer people. So we’re going to go to London, and we’re going to do the whole soccer stuff because they’re all, I have a bunch of soccer players.

Dr. Jaime Seeman: It’s big over there.

Dr. Sasha Shillcutt: It’s big over there. So we’re going to do that, and that’s fun. And then, we have a house in Hilton head, and it’s our special place, and we vacation there at least four times a year and get away.

Dr. Jaime Seeman: I love that.

So for a woman listening, she wants to pursue these things outside of medicine

So for a woman listening, who kind of wants to be an entrepreneur, she wants to pursue these things, like outside of medicine. Any advice for this woman who’s interested in that?

Dr. Sasha Shillcutt: Yeah. Well, first I would say, do it. Just do it, because there’s no failures. It’s just data collection. And I think the path of medicine is so rigorous for so many decades of, like, literally 30 years of your life, if you take the traditional path, that you don’t give yourself time or space to think you can be anything else, or you can have an outside interest or something on the side or even a different career. And life is so short. It is so short. I lost a family member last year, who was 45, and his death has really changed my perspective. Now I tell people all the time, like, just go for it. Don’t let the fear hold you back. Where? Follow the joy. Whatever is fun about that side project or that interest, or you’re thinking about entrepreneur, do it. Because life is so short and you can reinvent yourself. There can be more to you than just doctor or mom.

Dr. Jaime Seeman: Absolutely. Absolutely. I, you know, my tragedy that happened, my best friend passed away at the age of 29, and it was this, The doctors couldn’t save her. They missed the diagnosis. So it was kind of this really weird thing as a physician, like, you know, questioning medicine, like, how couldn’t we save her? But then also just the perspective of life of, like, wow, she only got 29 years then saying, oh, my God, she got 29 years. And she had two beautiful children. And she taught me so many lessons that literally, I’m sitting at this table today, like, still, you know, spreading. And it is so true. I mean, you don’t know. You get 45, you get 29. I mean, what do you have? I don’t know. You don’t know. Somebody has that answer, and it’s not you and I.

Dr. Sasha Shillcutt: Right.

Dr. Jaime Seeman: And so you just have to make your life what you want it to be.

Dr. Sasha Shillcutt: That 100%.

Dr. Jaime Seeman: Yeah. I love that. So tell people how they can find brave enough. Maybe they want to enroll in your courses. They want to come to your retreats. They want to come to the brave enough conference.

Dr. Sasha Shillcutt: Yeah. You can find me online@becomebravenough.com. dot. I have a Friday newsletter called the scoop. It’s about a 32nd read. That’s probably the best way, is just sign up for that newsletter, and you’ll get all the information. The conference is this September. I would love to see women there. anyone can come. You don’t have to be anything. You can come in a hot mess and wear yoga pants and have physicians. No, we always have. About 90% of the women there are physicians, and about 10% are in healthcare or maybe law or education. A lot of healthcare executives, nurse practitioners, pas, anybody can come. It is for CME. So you will get continuing medical education, but anyone’s welcome.

Dr. Jaime Seeman: That’s awesome. That’s awesome.

Well, Sasha, this has been so incredible. Thank you for coming. And I cannot wait to watch whatever 4.0 version is coming because you just keep doing incredible things. And, you know, I really look up to you in that regard. So thank you so much.

Dr. Sasha Shillcutt: Thank you. I feel the same way about you. I think what you do and your messaging, and I love all the different avenues of you. You’re such a strong woman and such a good role model for women everywhere. So keep on doing what you’re doing, girl.

Dr. Jaime Seeman: That means thank you.

Strong MD podcast thanks you for listening! Subscribe, click comment

Thank you guys so much for listening to today’s episode. I know you loved the content. I had so much fun talking to Doctor Shillcutt. If you guys could do us a few favors just like this. Subscribe, click comment. All the things to help us spread these messages throughout the world. We’ll catch you on the next episode of The Strong MD podcast. Cast.

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