Modern Marriage & Medicine: Redefining Success as a High-Achieving Woman with Sydney Ashland
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🎙 Episode 10 & 10.2 | Endocrine Matters Podcast
What does success look like when you're a high-achieving woman navigating medicine, motherhood, and marriage—all at once?
In this powerful conversation, Dr. Arti Thangudu is joined by intuitive consultant and coach Sydney Ashland to unpack the emotional and cultural dynamics that impact women physicians today. They explore the hidden toll of compartmentalization, gender role tension, financial stress, and burnout—and how to redefine success on your own terms.
Sydney shares mindset tools and practical strategies for creating authentic connection at home and at work, reclaiming agency over your time and values, and building a life that reflects who you truly are—not just who the world expects you to be.
💬 “Each woman gets to decide for herself what freedom means.”
This episode is a must-listen for any woman feeling overwhelmed by career demands, societal expectations, and the mental load of modern life.
Listen to the Full Episodes
🎧 Press play below to listen:
Key Topics & Timestamps
Skip to specific parts of the episode:
PART ONE:
00:00 – Why cultural beliefs about success need redefining
02:00 – How Arti discovered Sydney and why this conversation matters to women physicians
04:00 – The emotional toll of being a high-achieving woman in medicine
07:00 – Patterns of self-criticism, compartmentalization, and emotional shutdown
10:00 – The mental load of motherhood and responsibility in medicine
12:00 – Masking at work vs. authenticity in patient relationships
16:00 – How direct care models can help physicians show up more fully
18:00 – Mindset blocks for women balancing caregiving and leadership
21:00 – Comparison culture and the pressure to appear like you’re thriving
24:00 – Internalized expectations and defining success on your own terms
27:00 – Relationship dynamics when women out-earn or lead at home
30:00 – Unintentional emasculation: hidden power dynamics in partnerships
33:00 – The disconnect between structured work and chaotic home life
36:00 – How planning and shared calendars reduce resentment
39:00 – Why structure = freedom (and how calendars save your sanity)
PART TWO:
41:18 – The invisible costs of leadership: confidence erosion, fatigue, and disconnection
43:00 – Why rest isn’t enough: understanding emotional, mental, and physical exhaustion
46:30 – Reframing self-care as energy input, not just downtime
49:00 – Unique stressors in medicine: managing care vs. seeing transformation
51:00 – The financial side of burnout: debt, outdated salary expectations, and lifestyle creep
55:30 – How financial literacy and strategy create true freedom
59:00 – Challenging cultural narratives around what women "deserve"
1:02:00 – Taking back control: the power of mindset to change your life
1:06:00 – Think → Feel → Imagine → Create: the path to redefining success
1:12:00 – Final message: pause, reflect, and remember—you’re not alone in this journey
Episode Highlights
Key Takeaways:
Success doesn’t have to mean sacrifice—define it on your own terms.
Compartmentalization at work often leads to disconnection at home.
Default parenting and financial imbalance can strain marriages—but open conversations can heal.
Structure (like calendars and planning) = freedom, not restriction.
Mindset is everything: reframe comparison, self-doubt, and guilt to reclaim your power.
Emotional fatigue is real—and refilling your cup takes more than just rest.
Financial literacy is self-care. Understanding debt, taxes, and contracts gives you options.
Leadership comes with invisible costs—like erosion of confidence and authenticity.
You’re not alone. Real connection and community can transform your life.
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Sydney Ashland: [00:00:00] The other side of the challenges are you get to now decide what you want your life to look like. Often the values and beliefs that we have are assumed values and beliefs. You know, what was your mother's values and belief? What do you see, you know, reflected in your religious communities or in your cities?
And then ask yourself, are those values and beliefs that are reflected in me? And if the answer is yes, but I wanna change that, or No, not at all, then LA let's start defining, you know, making new definitions about what it means to be successful, to be an empowered woman, to what freedom I. Definition is for you, and each woman gets to decide for herself.
There's so much potential for unlimited freedom, [00:01:00] unlimited resources. If you are, you know, really clear about what it is you value, what you believe and what you want, and then creating. A system to make that achievable.
Arti Thangudu: Hello friends. Thank you guys so much for being here today. I am so excited for the conversation that we are going to have today. Today I have Sydney Ashland on, and I met her in such a serendipitous way. She was on a podcast, which I love Amy Porterfield's podcast on digital marketing, and she talked about a topic that is so near and dear to my heart as a [00:02:00] physician, and the conversation was not really about digital marketing at all.
It was more about relationships, specifically a marriage in a. Situation where the woman is in a high earning position or a high powered position. And how we navigate that because even though it's commonplace now, it's still not necessarily what culture has expected from us from when we were children or even now a bit.
And the responsibilities of what it means to be a wife and a mother and a husband and a father are different than they were 50 years ago. However, those cultural norms have. Have not met where we are today as far as women in careers and for professional women. And so I thought it was a fascinating conversation.
So I, being [00:03:00] the overzealous person that I am, I reached out to Sydney and I also learned that she worked specifically with physicians. And I was like, we need to talk. 'cause this is a conversation that me and my friends need to hear and we need to learn about. Because marriage is challenging. I think if, if you're in a marriage and it's not challenging, um, pm me please, because I need to know what you're doing.
But there are challenges, but it is also such a beautiful thing and such an adventure and journey that we can, if we lean into it and we lean into it correctly with the correct tools, we can make the most of our marriage and, and our lives. So. I was so thrilled that Sydnee said yes, that she would come on our show to discuss this in more detail with all of you.
So from there, I'm gonna let Sydney introduce herself. Sydnee, would you tell us a little bit about you and what you do?
Sydney Ashland: Well, thank you so much. Um, I am a business consultant and coach that work with high [00:04:00] profile, um, high earning individuals. I started out many, many years ago working with physicians primarily because I had been contacted by a physician who loved the work that I was doing.
Had referred several for patients to me and then started referring colleagues. And we started working a lot with physicians who were dissatisfied in their, um, current roles, who wanted, um, to have better work-life balance, um, who were depressed, who felt, um. Burned out. So having worked in the corporate setting, having worked in, um, the field of medicine for some time be prior to becoming a consultant and coach, I had some real, um, tangible ideas of what physicians the double binds physicians find themselves in [00:05:00] and, um, help develop a couple of hospitalist programs.
And so really had an up close and personal sense of what was going on. So I love my work. I work with, um, physicians who sometimes leave medicine to become entrepreneurs or sometimes become entrepreneurs within medicine and those who just have small practices or concierge practices. So it's a great variety.
I love it. And I'm happy to be here today.
Arti Thangudu: Well, thank you so much. And I think Sydney introduced a really important piece of, of this, is that. She really understands what healthcare has done to physicians, um, and, and the system with which we're working in and how that can, can contribute to the personal and professional and spousal challenges that we can face.
And, and, um, I'm really gonna lean into [00:06:00] that today because I think that's a really, really important piece of this because the, one of the purposes of this podcast is to help women and women physicians specifically recognize that they can have that life that is happy, right? Mm-hmm. It is not like churn and burn at work, churn and burn at home, and then you.
Are just kind of like dead and you don't, and empty by the end of the day. And sadly, like as rewarding and wonderful as a career in medicine can be. Not all of us are getting to experience that. And hopefully we can use this conversation to either get out of bad situations at work or reframe to make that situation better for us than it is currently.
So Sydnee first, um, let's start at the beginning. What patterns have you seen in high achieving women, especially physicians, when it comes to like the emotional toll of success? [00:07:00]
Sydney Ashland: Well. I've witnessed firsthand what this, like you said, churn and burn environment does to women. And one of the first things that seems to be, um, very common is hypercritical of self.
That's the very first place that women often go, um, because they've become used to pushing themselves so hard and expecting so much of themselves that when they experience a level of, um, intensity that's taking an emotional toll, rather than becoming soft and understanding or curious about it, they become hypercritical.
Um, after that. Initial response. Often they start compartmentalizing, you know, really not being their true, authentic self in every area of their life, but compartmentalize who they are at work. [00:08:00] What's the face that they show to the insurance companies versus the hospital administrators, versus the clinic administrators versus patients.
And so there's all of these compartments in their life that they manage with this hypercritical perception of what they should be. Um, secondly or thirdly, they start to shut down their feelings. Once they've realized that no matter how much they do, they never really feel like they're doing enough, then they start to shut down their feelings a bit.
And from there they can often become depressed. So that's sort of the, the cycle for women, the hypercritical, I. Sense of things, compartmentalizing, beginning to shut down feelings and then full-blown depression.
Arti Thangudu: Yeah, I, I can see that. And also I think with women, especially once we become mothers, we get this like immense sense of responsibility.
And I don't know [00:09:00] how better to explain it, but I think a lot of us feel, and I know I feel this way, is that if I don't do this, and it, some of it's true with our children, right? E especially when, you know, we have grown them with our bodies and we have nourished them, um, with breast milk for their first year of life, like, and nobody else can do those things for them.
Um, we feel this. Insane intrinsic sense of responsibility that bleeds over not just to our children, but sometimes in, into other parts of our life, like our, our career. And, um, and, and as a physician too, as kind of the, uh, the leader of a team. You can also feel that way, like this immense responsibility.
And there's a lot of joy that can come with that responsibility, but there's a lot of. Stress and, and load that can come with that. Do you think that's a part of it? [00:10:00]
Sydney Ashland: Absolutely. That's a part of it. Too many hats, too many roles that we're playing. And how can you be, you know, your authentic self in every role.
And there, there also has to be certain level of masking, right? Um, that if you've been up all night with a baby, you can't be, you know, complaining to your patients about it. Um, because they're there, because they're in distress. So the, the pressure becomes quite intense pretty quickly.
Arti Thangudu: I think that's so true.
And I think, of course there's some, there's some component of compartmentalizing and masking that we have to live in. Having a professional career or just a life in general, right? Like you could have had a bad morning with your child, but you're still gonna smile at drop off. You know, like it's just, we have, we have to function in the world at the same time.
There's a balance between that and showing up as your true, authentic self. And I believe that [00:11:00] sometimes we feel that our true, authentic self is not enough and therefore we have to be something different. And especially in patient care. Like, I have a funny, a funny way of putting it, but I'm extremely introverted and so when I go into a patient room, especially when I first started practice, I would almost like, I would be me, but like.
An extra version of me, you know, like a different version of me. And I liken it to Beyonce because Beyonce supposedly is, uh, an introvert. And then her like, stage persona is Sasha Fierce. So I would always call it like my Sasha Fierce, um, that's here today, you know? And so, um, and I don't think it, it necessarily is a bad thing, but I have learned that I, I now have a direct care practice and I have a much smaller patient volume, a lot more control over my schedule and the care that I [00:12:00] provide.
And I feel that I am able to, yes, of course I have like a professional persona that I bring to, to my office visits, but I also feel that I'm able to show up for my patients. As my authentic self. We don't just talk about, these are your labs, this is your result. And I think they appreciate some of the perspective on life because a lot of my patients are going through some of the same things that I do or you know, that's how you connect with a person.
And I think that's also something that particularly women love. Like I, that's one of my favorite things about my career. It's like yesterday, like I was navigating, I had a patient who had a knee surgery and was in, in the hospital and I was helping her navigate getting the nurse to get her the food that she wanted and like the coordinating her medications 'cause they were trying to give her insulin in the hospital.
But she really did well on non-insulin medications. Things that were. [00:13:00] Like, like kind of mother Henning, her care and, and being her advocate. And I feel like now that I'm in a practice model that enables that and allows for that, I'm able to be that mother hen that I, that I truly am and, and take care of my patients in a way that's very meaningful.
And of course the patient was extremely grateful and was like, gosh, I totally like 150% understand why you practice the way you do more than I ever have before. She's like, I understood it before, but now I really, really get it. Because the care that is standard is just, it's not supportive or good. And like building those strong relationships really, um, can light us up.
And so I think you are right that, that being able to show up as our authentic self can be really, really helpful. Next question for you as a coach. Are there like mindset blocks that [00:14:00] come up for women, especially women who may be breadwinners for their families, but also are trying to balance being a caregiver, a leader, a healer?
Do you feel like there are things that we, stories we tell ourselves, or things that we think that might be inhibiting us from, from getting that life that truly serves us
Sydney Ashland: Well, I think one of the first, most common things that women do is compare and contrast with other women. You know, we're we, we may be introverted or extroverted.
Or extroverted or, um, somewhere in between. But you know, we are social creatures, you know, from going back, you know, eons, uh, women. Would join together and try and support each other in child rearing and in what they were were doing in, you know, decades and centuries past. [00:15:00] And so we're used to looking to our right or to our left and seeing what other women are doing.
And unfortunately, the field of medicine really tends to isolate. Individuals in medicine. Um, there's a little bit of the divide and conquer perspective in training. And so I think what women start to do is look around themselves to see what other women are doing. But unfortunately, they start making assumptions and projecting, because I hear from women all the time, everybody else around me is doing just fine.
They aren't struggling with, you know, work life balance. They aren't struggling with really feeling disillusioned or having lost parts of themselves even. It's only me. So that's, I think, where we have to start being really real with each other. As, you know, colleagues, friends and coworkers. You know, we really [00:16:00] need to start being real so that we are not living by some idealized, imaginary standard that doesn't even really exist.
So that's one mindset block I think. Another is to, having not had a ton of role models, um, women are sort of blazing the trails themselves. It's not unusual for a woman to have a career that's now standard and, and yet how do we do that? Um, and so I think we don't have, um, mindset solutions that are innate to us because we didn't have a lot of role models.
So, so we feel very alone in it. So I think it's the isolation, the looking to others around us and making huge assumptions and projections and um, feeling like we're never enough. That's also a huge mindset block. You know, I [00:17:00] can do more. I'm capable of more. I know I can do more. And although that's inspiring and even, um.
You know, something that I admire, it's also very self-sabotaging because we, you can't be all things to all people. And, um, that adage that you can have it all, I don't think is true. And when we try and live by that mindset, we feel like we miss the mark in our disappointed.
Arti Thangudu: Yeah. I think that, um, comparison is, is really challenging.
I think also we have a tendency, and it, it may be worse in some cultures than others to pretend things are really good or not, not share. And I do think that obviously there are some things that are personal and private, but that you. Might not wanna, you know, you have to share with your spouse only or something [00:18:00] like that.
But at the same time, when we can share our struggles, we can learn from each other. And we do learn from each other. And I'll give you an example. I had lunch with my girlfriends last Friday. They just came over and we, we had lunch 'cause we got some new furniture that they wanted to see. And we were talking about our kids.
And one of my friends was talking about her daughter and, and some concerns that she had, but she wasn't sure if she should be concerned about them. And in this little, like afternoon three women, we came up with solutions. We gave each other resources, we provided each other with like legitimate like resources from like Mayo Clinic and, and Harvard.
And like really legitimate things that. We can implement. And in so learning, um, later, later that same weekend, [00:19:00] my son basically threw a temper tantrum. Um, and my husband was like, wow, he really had a pretty bad temper tantrum. What, what are we going, like, how should we address this? And I was like, well actually we were, I was just talking with my friends about this and I have all of these resources that I've reviewed and actually one is sitting in the printer.
So we can both read, read the resources that I've printed, and we can together come up with a plan on how to. To help my son's frontal lobe function better. He's seven. Right? And I think that it was just this beautiful alignment of women coming together, sharing our struggles and not being judgmental of each other's struggles, but trying to find ways to solve problems.
And not only did it serve the person who brought up the struggle, it also served all of the rest of us. You know, not just in [00:20:00] feeling understood, but also in a problem that arose later for me. And so I think that we are smart as individuals, but when we come together, we are so much better. Collaboration for anything good is always going to be better than, than one mind working alone.
And I think that is so important that we be real with each other. And the other very specific place I see this, that physicians are terrible at is talking about compensation because. Physicians are not open about their compensation. I don't know why. Maybe it's because they don't wanna tell somebody else that they're earning more or they feel insecure that they might be earning less.
But we know that there's a gender pay gap in medicine still. And so if we can be real with [00:21:00] each other about what we're actually earning, that will help us all rise. You know, that will help us come together and say, Hey, why am I working the same amount as this other male doctor and, and earning less? And why are all the women earning less than, than the men, um, for the same work product or perhaps better work product, you know?
And so. I think there's so much power and honesty. Um, so I love, I love that you bring that up. Many of our listeners are women who may be like the breadwinner or out earn their spouse or earn equal to their spouse while still bearing a lot of the, the child related responsibilities. I think the statistic is that women who work in the home and women who work outside of the home both, both do about [00:22:00] 80 or 80 plus percent of child related responsibilities.
I know that's true in my household, and I think partially my husband's hours are very challenging, but also I want to be the default parent. You know, that's, that's something that's important to me. And so to me, it doesn't feel. Sometimes it feels unfair. But now that I've sort of understood the story that I want to tell, which is something that you an an idea that you sort of planted in my, my head, now that I understand the story that I want to tell, it's easy for me to say, okay, well I'm choosing that I wanna be the default parent.
And I, I feel comfortable and confident in the decision that I've made to like take, pick the kids up from school and all the things that, that I do in the home. [00:23:00] But I also can understand that this can be very challenging because of that cultural narrative that, that we've been told for so long. I would love to hear you touch on that and how.
How culture makes this dynamic where women are earning more and perhaps even outearning their spouses. How culture plays a part in that and how that experience can go for both sides of a, a marriage.
Sydney Ashland: Well, I think that what I've, I've noticed is that, you know, we're, we don't always acknowledge what we've internalized, you know, so we've internalized, um, beliefs and values from our family culture, but also from our, you know, community cultures from the collective more, um, societal culture.
So there are many influences on us that we have internalized, and I [00:24:00] think the most important thing is to acknowledge that because that's where our sense of. Conflict arises from is because we're sort of at odds with what we have internalized and what we want for ourselves. So I think to have conversations with your spouse about where they came from, what were the expectations for them, and what do they want for themselves, and then to share in kind what we feel about that.
I've had many experience where. Couples sit down and have that conversation and discover they're further apart than they knew they were, or they're much closer together. And if you are further apart in terms of influence and values, then you can just really look to compliment each other versus, um, feel like you're pulling in two opposite directions and it needs to start with you and your spouse first, because that's the only way you can be a [00:25:00] united front in the world at large and have a sense of, this works for us.
And this is why I think the other thing is you don't know what you don't know when you first start out. So the woman surgeon, the female surgeon who ends up saying, I love the fact that my husband is going to be a stay at home dad. And that, um, we're reversing roles. Well, we have to remember that when roles were reversed a couple decades ago, there was lots of oppression and lack of autonomy, and women felt very, very limited.
And sometimes women can even bring that into the relationship at home and wonder why then their husband feels emasculated or why, you know, they're in so much conflict when it felt like such a great vision. So I think you just really have to stay on top of, you know, how it evolves over time and be willing to change and pivot [00:26:00] with, you know, changing circumstances.
So, you know, I, I think that's where it begins.
Arti Thangudu: I loved the, when you talk to Amy about how some of the things that we as women do, I. Can unintentionally be emasculating to our male spouse. Can you talk a little bit about the that and what things that we might be subconsciously doing or accidentally doing that?
Can actually make our spouse feel worse or resentful?
Sydney Ashland: Well, I think one of the things that we do and is quite common is to have expectations un. Unspoken expectations that we aren't owning about, you know, what we expect a supportive partner to look like. And so if that person is doing things like [00:27:00] taking time off to golf or belongs to a gym and is, you know, staying in good shape, we can start to perhaps feel resentful.
Like, I'm out there working my tail off and you're golfing with buddies, or you're out at the gym and you know, I feel disrespected in that, or underappreciated. And, you know, our partners can begin to feel like they have to ask permission in order for it to be okay. And that's very emasculating like.
Honey, please can I go play golf with the guys? And then it's hard for women to feel really respectful of somebody who's groveling or asking for permission, so that doesn't feel good at all. The other thing is feeling guilty about the fact that you're away from the home so much and then wanting for your spouse, like, I want you to have more friends.
I want you to [00:28:00] go out and do things. You know, I want, you know, and, and maybe even confidentially, um, share with me that they feel a little bored with their spouse. It's like, you know, when I met him, he was doing this and he had all of these dreams and now, you know, it's so mundane and boring. And I think that's another way to unconsciously emasculate because we're, um, putting them in a double bind.
I think double binds are really. Contributing factors to feeling disempowered. Emasculated not really a part of the team. And then sometimes men have a lot of guilt around the fact that they aren't the primary wage earner and maybe they're getting pressure from their families, or they are getting teased by some of their friends about having a sugar MoMA, you know, that's taking care of them and then they feel underappreciated for the role they're playing that makes it possible for, you know, their [00:29:00] partners to be high achieving, really driven players in medicine.
So that's what I, I witness.
Arti Thangudu: Those are all things that resonate so much and I'm sure they resonate with, with our listeners. I think obviously the first thing to do is identifying those behaviors or that language that we're using, but do you have any. Like tips or tricks or scripts or language that we might be able to use that could kind of untangle those conversations.
Sydney Ashland: Mm-hmm. Well, one of the things that I strongly encourage is that we really watch absolutist language. You always, you never, I'm always, I think that's a way of speaking that, um, really is disempowering to both individuals actually. Um, [00:30:00] because that extreme language starts to paint a narrative that is distorted.
And then the other person feels like they have to defend, they feel criticized, they feel like they have to defend. And so then they're looking for all kinds of evidence to prove that that isn't true. And, and so that's, that's one tip. Look for the distorted, um, languaging. Um, start talking about we and shared responsibility versus the I because.
It's that collaborative language, that's what do we wanna do this rather do with this rather than, well, I, you know, it's the, well i that can really start to be experienced as a declarative statement rather than a collaborative statement. So really looking for collaborative language versus declarative independent language.
Uh, we want to [00:31:00] be interdependent, which means that we rely on each other in healthy ways, not ruggedly independent or codependent and enmeshed because that's where, uh, we can also run in, into difficulty where we're almost afraid to be our full selves for fear of, you know, harming the other individual or being too egotistical.
Um, you know, so really watching your language. Can you define codependence for us? Codependence is usually where we take turns being dominant or submissive. So, you know, the, the woman who's, um, I'll use a surgeon again, although I'm not trying to beat up on surgeons, but it's just a really good contrasting example.
So a woman who works in the OR all day has to be very organized, has a [00:32:00] whole team supporting her in that organization. If you have somebody at home who's with children all day and who's trying to run a household, she's very likely to come home to, um, chaos, to less than a organized, functioning environment.
And so you know, that dominating energy of she's been calling the shots all day in the OR and it's like, what's been happening here? Why is this and this and this and this? And starting to take over. And then perhaps whoever's left at home starts scrambling around, oh, I'm so sorry. Well we had this and this, and starts to try to justify or explain and then that doesn't feel good.
So there's codependence in the sort of organized, disorganized, the overly helpful person who then requires that the other person be helpless. You know, the [00:33:00] person who over functions and then the other one under functions, the aggressive or passive or passive aggressive versus assertive. So there they're sort of, and we, we change hats.
We move back and forth. It's not like male energy is always dominating and female energy is always submissive. Not at all. We, we play the role back and forth. Um, so having difficulty managing that, dominating more submissive energy and finding that assertive place in the middle and also in measurement where we can't quite tell where we begin and end and where the other person begins and ends.
Arti Thangudu: That's so fascinating. And I think that, um, you know, when we're at work, we are getting stuff done like we are. Maybe the healthcare system now makes this challenging, but like we know what we are doing. We are [00:34:00] trained to do what it is that we do and very well trained and we have a lot of experience. And so while of course each patient is an individual, we're trained to handle that situation, parenting and running a household is like you're making it up as you go.
You know? And I think that honestly like for a lot of us, work is easier than home life. And I think it's because it has like structure and the stakes are high, but like your child, there's no stake higher than your child. And so we're all like trying to figure it out the best we can. And so I think when you are in this structured environment, and then I.
It's juxtaposed with this very unstructured, there's no plan for this. It can be very jarring, especially if you're not recognizing that about yourself and you have [00:35:00] expectations for someone else to be executing the home life in a similar fashion to how you're executing your work life. They're just not comparable in that way.
And we as women, I think we're naturally, or a lot of us, not all of us, but a lot of us are naturally, like we see all the things, right? We, we see the things that are out of place. We see the. Undone laundry. We see all of those things the second we step in the door. I mean, I mean, I walk from our kitchen to my bedroom and pick up 10 things and replace them in the place where they're going to, where my husband can like, walk from the kitchen to the bedroom without noticing anything, you know?
And so I think when we're hypervigilant and hyper aware of the things in our homes, and we're dealing with a spouse who has just different priorities, honestly, like they have their brains work differently, [00:36:00] um, every, all of our brains work differently. It can be challenging. And I think it's, it's very important for us to sometimes step back and let it be and let them be, um, whether it's our kids or our spouses, and sit with that and be okay with that.
And instead of. Resenting someone for not rising to your occasion. Trying to be mindful and understanding of of their priorities, and if it is really a problem addressing it instead of withholding it until you explode. You know, I think. Right.
Sydney Ashland: And I, I think one of the things that you just mentioned about the structure and then the control within the structure, but there's also power dynamics in medicine.
You know, there's the power of the corporate structure that sort of contains it. There's the structure of the medical [00:37:00] board and how it interacts and controls physicians, insurance companies, you know, even patient reviews that, um, physicians are so anxious about. So there are power dynamics in medicine that are just almost accepted as normal.
And so to transition to coming into the home where the, the optim is, where the power dynamics are collaborative and where it isn't, that top down structure can be really challenging. The other piece I hear a lot is the person who's been home all day, I. Often want somebody else to come home and start making decisions.
I've said, no, all day long, I've made all the decisions about who's gonna do what, where we're going to eat, what's happening. So turning to the, to the spouse that comes home and say, okay, so what do you want to eat? Where do you wanna go? What should we do? And the person who's been making [00:38:00] decisions all day at work doesn't wanna make decisions either.
And so there's this, you know, resentment that builds between the two, um, and decision making and, um, the power dynamic becomes really, really important.
Arti Thangudu: Yeah. When you're like, but I've been answering to this 7-year-old tyrant for the whole day. Yes, yes. Um, can you help me out here? I think one tip that I have to add in here, even though I'm not the expert, is planning.
Like, take some of those decisions off of the table. Like figure out what you're gonna to eat on Sunday night. So like, you're not back and forth trying to make that decision. Figure out what your bedtime is. Figure out, like, have those things set so that Yeah. When we're all exhausted and our willpower is expended at the end of the day, we're not in a place of setting ourselves up for failure or fight or resentment or any of those things.
It's just like kind of getting, [00:39:00] getting the stuff Agreed.
Sydney Ashland: Yes. Done. And yes. And a, um, in that planning, having a shared calendar that both people are contributing to is huge.
Arti Thangudu: Some people are better at calendars than others, what I've learned in my household. But, but no, I think, I think I, I couldn't function without my calendar.
I don't like, I review it every Sunday evening, remove things that are not vital, and then I review it every evening to make sure I know what's going on the following day. Because otherwise, you know, between work and podcasts and, um, kids and all of those things, and after hours board meeting and things like that, it's just impossible.
So I think probably a lot of people have a calendar system here, but if you don't, gosh, I, I don't, I don't know how you're functioning, but once you have one, I bet you'll be like, uh, uh, I don't know. Able to take over the world or something like that. 'cause it's, [00:40:00] it's so much so. Actually, it's vital. It's vital.
Freeing.
Sydney Ashland: Freeing, right?
Arti Thangudu: Freeing. Yeah. Sometimes people, like, I've had friends look at my calendar and they're like, your calendar is making me insane. I'm like, no, my calendar is my freedom because now I know what's happening. And yeah, it's busy, but at least I can, that's how I can manage it, you know? And I get to do all the things, like I get to do so many cool things in my life, but it's because my time is organized and structured.
So, um, yeah, the calendar planning organization, like sometimes people feel like that's too much work or that's too much structure. I want to be like, you know, a little bit more laissez-faire, like a little bit more free spirited. I'm like, no. The organization enables you to be, to be free. It, it is, is your freedom.
So. Um, yeah, super important. So I think we've [00:41:00] touched on this a bit, but can we talk about kind of the invisible costs or opportunity costs of being a woman in leadership? Um, particularly for those of us trying to hold space for patients and our entire team at work, our kids, our spouses, and while also trying to show up as our best self, like take care of our own health.
We talk a lot about self-care as not selfish, and I think that's kind of a catchy line, but I do think it is really important for us to, to do that and to understand that self-care isn't like always massages and manicures, right? Like that. If that's part of your self-care, that's great, but that's not necessarily what the, the true depth of, of what that means is, and it's more about.
Doing the things that enable you to do the things right, like we just talked about the, the planning and [00:42:00] organization so that you are able to do that so you are able to build a business. Your time is free, not tied, you're not tied up to someone else, things like that. So I would love to kind of hear your thoughts on that.
Sydney Ashland: Well, I think one, invisible cost is, uh, eroding of self-confidence because when there are so many expectations external. Expectations as well as internalized expectations. It's really easy to start feeling like you're not measuring up, like you're dropping the ball. And confidence starts to be eroded. And when confidence is eroded, um, it's hard to advocate for yourself in medicine.
And then you're much more likely to be, uh, invisible, be taken advantage of, um, feel like you don't really have a voice. And it all goes back to the confidence. So it's really important to. Keep track of [00:43:00] your expectations. You know, what are my expectations for myself and what are the external expectations or what I presume or assume the external expectations are, and how can I modify those so that it doesn't take such a toll?
I think there's also a physical toll. So many women end up with migraines, metabolic disorders as a result of pushing too hard, depleting themselves. Going back to your, um, comments on self-care, I think. Often there are these, um, terms that we become sort of sensitized to, like burnout, self-care, and people just start to roll their eyes.
So I think thinking of it as energy in versus energy out, you know, energy out happens all day long, so what can you do to bring energy in? That's the whole idea of self-care. [00:44:00] People will say to me all the time, but I rest all the time, or I just crash on the weekend. But that it's not enough just to crash.
You actually have to fill the tank often. Use the analogy of the car, you, you know, you can say this car should be just fine. It's brand new. It has a great engine. Yes. Well, if it doesn't have gas or it doesn't have speed. Spark plugs or battery, it's not gonna run. And all of those elements are energy into the car.
So really looking at that. I think another invisible cost is the cost to our relationship and our family systems. Because when we have to be there for everybody else at work and we're pulled in a million different directions, it's easy to show up at home in a way where we're not engaged, where we're. On our devices, scrolling where we're on our computers, um, doing charting late at night so that [00:45:00] we meet a standard and don't get penalized for having charts out.
So, you know, our family relationships start to suffer as a result, and that's often invisible. We aren't able to focus on what our values are and instead assume other people's values for us and later feel like we're a shell of ourselves and that we've lost parts of ourselves along the way.
Arti Thangudu: Yeah, so I love this concept of, and it's something that I was recently introduced to, and I think it's such an important thing for us to understand.
It's the idea of not just resting but refilling your cup. And so it, what that kind of means to me is that. Instead of on Sunday when you have some time, maybe if you get some time to yourself, if, if your spouse is home, there's like [00:46:00] taking a nap or doing something that makes you feel alive. Like whether that's, for me, a lot of times it's like exercise that, that's something that fills my cup.
But for other people it might be like an art class or going to a museum or doing something that, you know, makes, makes you feel going to a new restaurant. Whatever it is, it's your thing like doing that. So you're not, you're not a well slept, well rested empty tank, but you are, uh, you know, a well rested full tank.
And I think, oh, we can understand that in that when we're doing jobs and careers that we love where we feel like. We're doing something for the world or we're doing something that really lights us up, or that's creative and we get to do things like, for me, I love doing this podcast. It fills me up to have these conversations.
That we can understand [00:47:00] that, that makes us, that brings a joy into work. And it brings a joy into like crunching the numbers and accounting, right? Like, it's like, okay, well I'm doing that. I have to do that, but I also get to do this. And we can see, we can understand it in that way, but also translating that in into our lives of like refilling, giving ourselves the fuel to do the hard things.
Um, by also balancing that with, with things that really energize us. I, I love that concept. I
Sydney Ashland: might mention one thing here that, you know, when we're talking about filling our tank and the invisible cost, there's emotional fatigue, there's physical fatigue, there's mental fatigue, and sometimes people's resistance is, I'm just too tired, I'm exhausted, so I'll make suggestions about activities or engage ways they can engage in life.
And it's like, I are you kidding? I'm so exhausted. So what I will ask people is to try and [00:48:00] define whether it's physical, mental, you know, um, emotional exhaustion, and, and then to even give percentages to each can be really helpful. And, and then forcing yourself to do whatever it is that deep down inside you wanna do, and ask yourself afterwards, do I feel better or worse for having done it?
I
Arti Thangudu: think that's a great way to look at it, because if it's something that you thought you were too exhausted to do, but then you do it and you feel better, then maybe in fact you weren't, you know, maybe you were exhausted because you weren't doing the thing. So my, my question is, now that you've worked with so many people in the medical space, do you think that there are specific things about being a physician, specifically in the healthcare system of today in America, that is perpetuating or exacerbating this feeling of overwhelm, [00:49:00] burnout, exhaustion in women physicians?
Sydney Ashland: Well, I think that's, you know, a very valid question and a very, you know, probably has a very complex answer. I think there are so many contributing factors. One of the, the things about medicine is we're managing care, you know, and when you're managing care, sometimes it feels like it's this never ending loop of frustration where you're just trying to manage rather than really heal or, um, embrace deep seated changes.
Um, and, and seeing transformation happen. So it becomes very discouraging when you're just managing care versus really being able to meet goals, feel like you're producing results. It's sort of [00:50:00] an, a never ending, uh, cycle of frustration often. So I think that's just. You know, part of medicine in general and, and, you know, people being sick or not feeling well is also a part of the system, right?
And it fuels the system. And so physicians who are attracted to regenerative medicine or functional medicine get really, really excited sometimes, or at least initially because it starts to feel like, oh, it's a totally different focus where we're really seeing results and that gets ex exciting versus just being on that treadmill.
So that's a part of it. I think that sometimes the financial focus, uh, but it needs to be there because most people that come into medicine have huge educational debt that they're [00:51:00] bringing into the practice. And so I think the relationship to finances and money is a huge piece of. Is part of the problem.
It's what's needed in order to fuel this big machine called healthcare. But it also keeps us from really sometimes feeling successful. The old image of a physician being the highest wage earner in a community is antiquated. That's just not the way it is. And often they're trying to live beyond their means in order to keep that, you know, status symbol sort of going when it no longer really applies.
And so that can really fuel disenchantment feeling frustrated and just like you're being negatively impacted by the whole financial system that is medicine as well as the, the healthcare.
Arti Thangudu: Yeah, I think that the financial [00:52:00] part, it's not one that we love to talk about, but it's, it's so important and I think that.
A lot of physicians do have a lot of medical debt, and also we are not, we're not trained in finances or how to manage our finances. And also, at least in my generation, when we were growing up, physicians were much higher earners than they are now. Like the salaries were higher than 20 years ago than they are now despite inflation.
And I think that the expectations that some of us went into medicine with of what our lives would look like at the end of it, are not being met by, by traditional practicing of medicine now. And I think that that is a challenge. Uh, I do think that physicians need to, young physicians, I. Or [00:53:00] maybe it's us.
Maybe we need to be doing a better job of educating young physicians what debt means and what taking out loans means. Because I, I think that of course, banks are trying to sell loans like they, they will do better the more money you borrow and the longer it takes you to pay it back. Like that's how they make money.
And so I, I know a lot of people who graduated around the time that I did fell into these traps of income-based repayment and, um, are sold these shiny loan opportunities that help them lead a more. Normal lifestyle as a medical student than most students have. You know? And it's not like when our parents were in medical school and those loans were at 1% interest.
Now they're accumulating at 8% interest while you're not paying them off. And that's a huge [00:54:00] number. And I think that financial strategy and understanding finances and budgeting is so, so important. And your finances are a huge ticket to your freedom. I mean, my husband was in that boat and when we graduated from Fellowship, he had more than a house mortgage in, in medical school debt.
And like you said earlier in this conversation of doing things as a we, I really, I. Took ownership of that. And I was like, this is our debt because this is our family and these are our kids. And if something happens to you and you can't work anymore, guess who gets to pay it off me by myself. And so I really, you know, we buckled down and we came up with a strategy to pay that loan off very quickly and aggressively.
And I understand that that might not be [00:55:00] the op the best option for everybody. I'm not pretending to know everything about everybody's life. But there are people who are told that, okay, well you can, you'll have loan forgiveness in 20 years or 10 years if you work in this, this type of hospital setting, or this or that.
In my opinion, you cannot trust anyone more than you trust yourself. And if you can buy yourself financial freedom by being mindful of. You're loan early, like don't take out more than you need. Or if your parents can help you but you don't want them to because of a reason, really assess that. Because if your parents can help you and they're willing to, and it's not gonna be bad in any way, then that might be a good option given how expensive medical school is right now.
If there are other alternatives to, to anything you can do to shrink your loan, your debt [00:56:00] from medical school, very seriously. Look into that and very seriously look into how you can aggressively pay it off early, because as you grow in medicine, your lifestyle grows, your children, you have children, they have needs, their lifestyle grows.
So if you can get it, I think that was like. Financially the best thing that we, and we did it when we had nothing, right? Nobody helped us pay off our loan. Our parents didn't help us pay off our loan. We did it while I was starting my business. Like it's possible to do this. It's just you have to be extremely strategic to buy your own freedom later from this without it hovering as like a dark cloud over your head with fear.
Like my biggest fear was what happens and we can't afford this loan payment anymore. Or what happens if. You're only young for a short window of time after your fellowship is done, right? And so life starts getting real pretty fast. And [00:57:00] so I think they say that there's like this death forgiveness, but when you look in the fine print, there's no death forgiveness, okay?
Like this is, somebody took out this loan, they let you borrow it. It's your responsibility at the end of the day. And so I think that's a very, very important point that we don't talk enough about in medicine and certainly not enough with medical students.
Sydney Ashland: 100%. And I think, so to advocate your, for yourself with the, the banks and the companies that you've taken it out with as well.
Sometimes they will negotiate with you because I've had people in their sixties still owing on their medical debt from going to school. And I've also had people who've retired that, that with a huge medical debt, um, because, um, it just kept compounding. So this is why it's very important for you to advocate for yourself and your work environments.
Really understand what the [00:58:00] wages you're being offered are, what the overhead is, what the RVs are, and what that means. Because sometimes people will say, oh, it looks like it's $360,000, but there's all of this fine print. It's not really $360,000. You have much less to live on, plus pay back your debt. So your point, and especially for women who often are not paid at the same level, just as you previously said.
Yes, yes, yes, yes.
Arti Thangudu: Yeah. And I think that, um, understand what taxes means. Mm-hmm. And how much that's gonna get taken out of your income because Yeah, it's a lot. It's a substantial amount. And if you have several thousands of loan dollars of loans to pay off, then you know it eats in. The other thing is like, don't.
Get yourself in a position where you're house poor. Like don't buy the big house, the big cars, right out of training. That is the, I think that the period when you graduate from training is [00:59:00] most crucial because you're used to living small, at least I hope you are as a resident, right. Not getting yourself into more debt.
Mm-hmm. And you're not exposed to a lifestyle. So if you can really buckle down and get rid of your debt when you're young, before you're exposed to a lifestyle, then you'll know. The means with which you can live. And so you're not saddled by like, okay, I have to make $500,000 to have my lifestyle.
Because for the three to five years out of your training, you were still living like a resident. And you know, and I think that if you know, and you have the confidence that you can do that, then you're like, oh, hey, I could start my own practice. Hey, I could do this other thing that is more important to me, or maybe I can work fewer hours because I do have these responsibilities at home.
It gives you so much more flexibility if you're lean and you are then debt free. [01:00:00] You know, if then you all of a sudden have that extra $5,000 in your bank account every month that you aren't paying to the debt. And it's just a different way of looking at things, which I think many doctors are. Have this idea of I deserve this material thing because I worked so hard and I worked so hard at work.
The fact of the matter is nobody deserves a material thing. Either they can afford it or they cannot afford it. It's pretty simple. Either you have enough money for it or you don't. You don't deserve a thing. And so you deserve to be respected. You deserve your human right. You know, there's some things that you do deserve, but having a material thing that's like a specific house or car or handbag or pair of shoes, like, no, no, no.
And so I think that, but a lot of doctors do think that way. Especially a lot of women doctors, you know, [01:01:00] there's like these Facebook groups called Dr. Purse Club and things like that, and I just laugh 'cause it's, you know, they're fun to follow along. But you know, I think there is this. Mentality among women physicians of, I deserve this because I work hard.
And, uh, I think we really, it, it can be very damaging. So before I let you go, I worry that this episode might be a little bit like of a downer in some ways. You know, and that's not the goal at all. Our goal is to say your potential is infinite. To have a life that you love and where you, you can do all the things that are important and valuable to you.
And your best asset is, is your mindset. And so I would love for you to kind of talk to that, like how can we inspire women to go get [01:02:00] after it, go get after the things that they really value, how they can come out of this space where misery loves company. 'cause a lot of. Women, doctors and a lot of doctors in general are in these like Facebook forums and, and groups where we just complain.
But maybe we can change that narrative and say, you know, we have a power as physicians, as these professionals, and a very rewarding career. How can we make the most of our lives and live, live our our best for ourselves? Or what we see as best, I guess, is a better way of putting it.
Sydney Ashland: Right. Well, I agree with you 100% about those groups that are really focused on negativity and so not at all did not want that to be the focus here at all today.
Instead, um, starting at that place where we're getting real with ourselves and like we talked early on about how we assume, compare and contrast and, [01:03:00] and then say, make up a story about that for ourselves. Hopefully today we've dispelled some of those myths that, you know, everybody struggles with balance.
Everybody struggles with how to be, uh, an empowered, highly driven, successful female physician. And, um, be real with yourself about what the challenges are. The other side of the challenges are you get to now decide what you want your life to look like. Often the values and beliefs that we have are assumed values and beliefs.
You know, what was your mother's values and belief? What do you see, you know, reflected in your religious communities or in your cities? And then ask yourself, are those values and beliefs that are reflected in me? And if the answer is yes, but I wanna change that or know not at all, [01:04:00] then LA let's start defining, you know, making new definitions about what it means to be successful, to be an empowered woman, to what freedom.
Definition is for you, and each woman gets to decide for herself. There's so much potential for unlimited freedom, unlimited resources. If you are, you know, really clear about what it is you value, what you believe and what you want, and then creating. A system to make that achievable. So part of that system needs to be really paying attention to how you think, you know, how we think influences, how our lived experience is.
And so, you know, are your thoughts. Majorly negative. Are they sort of a constant [01:05:00] compilation of things you have to do in order to be okay? And do you want to continue to think that way or do you wanna take charge of your thoughts, not have your thoughts be in charge of you? Once you're in charge of your thoughts, you will notice that the emotions follow.
That you know, all of those places where you felt insecure, overwhelmed, dissatisfied, begin to lighten and brighten because you're thinking about life differently. And when your feelings then follow and, and start to shift, then you start to connect with hope. You start to connect with the what, the how, and the why.
What am I here to do? How am I gonna accomplish that and why? And I think often we start with the why first, and then we get confused or overwhelmed. It's like, I don't know. I don't know. So start with the what first, then go to the how then. Then the why will be, you know, [01:06:00] obvious to you. So yes, we want to inspire everyone listening that this is a time where you have power to really change your life, to live by a totally different.
Standard than what you know, somebody else in your field might have. Because there's a lot of autonomy inside specialization, even in medicine. So allow yourself that. Allow yourself to dream. Because once you're in charge of your thinking and your feeling, then you will often find that you have energy to begin imagining.
And once you can imagine and dream, then you can start to create. So it's the thinking, the feeling, the imagining and designing, and then the creative process that then is what transforms lives.
Arti Thangudu: Absolutely. I love that. And it all starts between our ears, right? Like I think that [01:07:00] changing the way we perceive things is absolutely possible.
And. Getting very clear about the life that we want to live, the relationships that we wanna have, the people that we wanna serve. Like who is it that I want to be to other people, to myself. Like what kind of person do I want to be? Uh, is so important. And I'll give a sort of funny example of this, not funny, but someone, one that maybe people can relate to.
So in our household, my husband is the best human I know, but we do have somewhat traditional roles. And I, there was a time after pandemic where he started working part-time because he's an ICU doc and he was working 24. Probably 18 hour shifts a month, [01:08:00] um, if not more, for, for a very, in that very challenging time and everybody was dying and he was burnt out really.
And so we made a conscious decision to let him work fewer shifts a month, recalibrate. And um, we were in a fortunate situation where I was earning enough that we could, we could afford to do that. And in that time period it started to annoy me. Okay. Like he was home a lot and still a lot of the things weren't getting done.
And I was getting a little frustrated because I was like what we talked about, right? I was the primary breadwinner and like it was challenging. And then we are not the type of couple that explosively fights, but you can sense, like we can feel each other's tension and then. One day, he's like, I [01:09:00] don't feel like you resent me anymore.
And I was like, that's because I decided I wasn't going to anymore. And he is like, what do you mean? How do you, how does one just decide? I was like, well, I have a very powerful mind, and I know unequivocally that I'm a woman who is loved and that is enough for me. And he was like, I don't understand. I don't understand how you can just flip a switch like that.
I was like, well, I have a very powerful mind, and I decided that this wasn't worth me being mad about anymore. Like, there's literally no re like we're, we're fine. Everything is fine. Everything is good. And even if it wasn't like. I get to choose, like, I get to choose what my mind tells me to feel. And sometimes I'm not saying that I'm always a hundred percent in control of my emotions or that I'm a robot or something.
Like sometimes I get mad sometimes, like, you know, we have disagreements. [01:10:00] I'm not saying it's perfect, but in that moment I recognize that I had the power to change how this was going. And I did it. Like literally one day I decided that I wasn't going to resent him anymore. And I honestly haven't resented him since because that's not the type of person who I want to be.
Also, he's a great husband. It's not like, you know, he's like some jerk and that I'm powering through this. Like he's, he's great. But, um, but it's just to say our minds are incredibly powerful and when we can see it every I. Brilliant thing that happens in the world and our lives starts as a thought, right?
And so, um, the thought to have a child, you know, the thought to create something beautiful, the thought to have a great work, everything starts in our heads. So if we can change the way we think or continue to think in a [01:11:00] positive way in ways that serve us, then that'll put us light years ahead if, if we're not there yet.
So I think that all of our potential is infinite to create a life that we love. No, we can't do every single thing. No, we can't. But we can hold gratitude for the things that we can do. We can hold space for the people that are important to us. We can. Remove people who are toxic to, to the way we think. I mean, I, I hate to say that.
Um, and it took me a long time to be okay with removing toxic people from my life because you sort of feel like you're abandoning somebody, but at the same time, it's not helping them either. Like nobody's winning in that situation. So I think removing toxic inputs, whether they're a person or a substance, or the way we [01:12:00] sleep or don't sleep, you know, all of these things can make such a big difference.
And we all have the power to harness all of those things. And so I really hope that you guys leave this conversation recognizing that power and, um, finding ways to harness those, those strengths and those powers that, that we have within us.
Sydney Ashland: Yes, agreed. And you're not alone.
Arti Thangudu: Absolutely not. Come slide into my dms.
We can chat if, if you're, um, having a struggle or certainly you can reach out to Sydney because she is, she is the real expert here. Um, Sydney, any, um, last thoughts you wanna leave with our audience before we let you go? I.
Sydney Ashland: I think my last thought is just, you know, to take a moment to pause from time to time and reflect on all you've accomplished.
Sometimes when we're striving, striving, striving, [01:13:00] and we keep going to the next, oh, you know, now we want a child, now we want a different type of practice now. We want and, and we don't take enough time to just reflect on everything that we have done. And so everyone listening, you're amazing. You've done incredible things.
Take time to reflect and write those down. Also, keep track of all the many words of appreciation and gratitude that you've received along the way, because that can be part of the fuel that helps you really, um, engage with life in a way where you feel supported and where you feel good about yourself and confident.
Arti Thangudu: Yeah, that career achievement escalator can be, uh, a joy stuck as well as the, the comparison that we talked about earlier. So really identifying when we get stuck in those, those places is so important. Um, I love that. [01:14:00] So thank you so much Sydnee, for being here with us. Where can our audience find you if they wanna get in touch?
Sydney Ashland: Well, you can find me@sydneyashland.com. S-Y-D-N-E-Y is my first name. And, um, you know, you can text me, you can, um, find my number on my website. Uh, you can email me. Uh, I look forward to connecting in the coming years with many more successful physicians and meeting you in the struggle and then applauding the transcendence that I get to experience all the time when I see you soar.
Arti Thangudu: Thanks so much and we can't wait to connect with you more in the future. Have a wonderful day. Thank you so much. [01:15:00] Bye-bye.
Resources & Links
Connect with Sydney:
Facebook: Sydney Ashland
Instagram: @ashlandsydney
LinkedIn: Sydney Ashland
Connect with Dr. Arti:
Instagram: @drartithangudu
LinkedIn: Arti Thangudu, MD
YouTube: @drartithangudu
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