EP161: Finding Strength in Vulnerability: Dr. Dympna Weil's Journey

Balancing Healing and Doctoring: Insights from Dr. Dympna Weil

In this episode of The Girl Doc Survival Guide, Dr. Dympna Weil, a former Ob/Gyn hospitalist, discusses her experiences with vestibular migraine and how these challenges reshaped her approach to physician wellness. Dr. Weil highlights the complexities of navigating the healthcare system as a physician-patient, the emotional toll of health-related identity crises, and the importance of self-advocacy and coaching. Through her journey, she founded The Physician Wayfinder to support healthcare professionals in cultivating resilience. Insights on the importance of harmony over balance and the need for emotional support in the medical field are shared, emphasizing the shared humanity among physicians and patients.

00:00 Introduction to Dr. Dympna Weil

00:39 The Unspoken Struggles of Physicians

01:31 The Dual Identity of Doctor and Patient

02:40 Personal Health Battles and Professional Identity

04:19 Therapy, Coaching, and Mindset Shifts

06:22 Redefining the Role of a Physician

08:42 Navigating the Healthcare System as a Patient

13:24 The Birth of The Physician Wayfinder

18:26 Wellness Practices and Self-Advocacy

21:28 Final Thoughts and Encouragement

Transcript

Christine Ko: [00:00:00] Welcome to today's episode of The Girl Doc Survival Guide. I'm joined by Dr. Dympna Weil, a former Ob/Gyn hospitalist whose personal health journey transformed her approach to physician wellness. After experiencing debilitating vestibular migraine that took nine months to diagnose, she founded The Physician Wayfinder and now coaches healthcare professionals on cultivating physical resilience and self-care. Today, she'll share insights from both her medical background and her personal journey of physical recovery. Welcome to Dympna. 

Dympna Weil: Hi. Thank you for having me. 

Christine Ko: Thank you for being here. I really appreciate you sharing your story and your medical journey because one thing I've realized is, physicians being part of the general population, there have to be many more physicians who have chronic illnesses, diabetes or high blood pressure, but also acute ones, cancer. But it's not [00:01:00] something that I think is commonly talked about. 

Dympna Weil: Absolutely. I can attest to that, just going back to my infertility journey. I'd be in the office with my head down, like nobody sees me, and meanwhile, it was a lot of my colleagues in the office with me. So yeah, we don't really share those kinds of things. And I think the more that we do, the more we realize our shared humanity, and it makes things a little easier to muddle through. 

Christine Ko: Yes, I think that's true. Shared humanity. I've recently been thinking about the concept of splitting. As the doctor persona, we tend to split ourselves off from the patient persona, and so it's an odd thing to grapple with literally being both at the same time. At least, for me, that's true. 

Dympna Weil: Oh, I think it's absolutely true. It's a very humbling experience. During the [00:02:00] pandemic, it was especially humbling because I could, on the one hand, understand why there was a shortage of doctors, and you couldn't get in to see anybody. So I could feel the heaviness and the weight of it from the doctor's perspective, and yet I could also feel the frustration and the almost desperation, at some points, for care that a patient feels. And sometimes you're right in the middle. I don't know your experience, but, wanting to be treated like a patient but yet, being treated almost like a colleague, you're in a limbo space. Or a liminal space. 

Christine Ko: Yes. I was diagnosed with breast cancer, Stage 1, in late 2022. So much of 2023 was treatments, and it was the first time, other than having kids, where I was really a patient. I worked through that experience as a doctor because I wanted to. I'm lucky I didn't actually [00:03:00] have to, but I wanted to maintain a sense of my life isn't really all that different, feel like I was maintaining some sort of control. And yet it's interesting when I look back, and I see photos of myself, and not to put myself down, but I looked terrible. Just really tired and just not healthy. It's just interesting, when I reflect, what I needed to put myself through to, I don't know, to be able to get through. 

Dympna Weil: Yeah. To speak to that, one, I'm glad you're doing well and that's a chapter in the past. The issue I find that we have when we are sick ourselves, or we're dealing with a medical condition, I remember so distinctly thinking like, if I'm not wearing my white coat and I'm not doing surgeries and I'm not delivering babies, like what good am I? That was a really [00:04:00] dark thought to have, but it really got to that point because, at least for myself, I was just so used to that being who I was as opposed to what I did. It really started to change the way I looked at things quite a lot. 

Christine Ko: Yes. How did you get past that thought?   

Dympna Weil: There were a handful of things. First, therapy was really critically important. If I was moving too much, I felt like I just been spun on like the teacups. I couldn't do any of the normal things, and so therapy was the first part of it. And then I realized that only helps while you're there chatting with your therapist, and you do build on that. But I was with my brain 24 7, and that thought kept coming up. I entered into the world of coaching and personal development, really working on mindset, and that's really I think what [00:05:00] shifted things for me. Recognizing that yeah, there's the clean pain, and there's dirty pain. Being a psychology major, I was like all geeked out on it, but it sucked to be sick, and that's the clean pain of it. But my thoughts about it were inflicting dirty pain or suffering upon it, keeping it on top. Once I figured that out, it made it a lot easier for me to start letting go of those thoughts that were making it harder for me.

Christine Ko: That's insightful. Was that the most shocking realization about being a patient, that feeling that you were really defining yourself as a physician?

Dympna Weil: For me, becoming the patient and being still, and not having that, it was really an identity crisis. That's what I felt part of my identity was doctoring. And the other part was [00:06:00] dancing and being a mom. I'm an Irish dancer. I was an Irish dance teacher. And none of those three parts of my identity were normal. The one that really was so blatant, because it was just the autopilot, was the doctor part of me. 

Christine Ko: That sounds so hard. Did eventually, with this journey, did your perspective as a physician change? 

Dympna Weil: Oh, it's evolved. Initially, my definition of doctor was very narrow. To me it was, if I'm not in doing that work, I am no longer a doctor, which of course is not at all true. But at the time, it felt true. And that really, I think, made the experience even harder than it needed to be. But you don't know that going through it, of course, right? It's like a grief, you don't know. You're just doing the best you can to get through it. And it evolved from there. Beyond the [00:07:00] grief part of it, it was a matter of learning who I was. As to, like I said, as opposed to what I did, like who am I now that I've gone through all this training? Who am I? Because I didn't know. I didn't know that I could have dreams beyond becoming a doctor if I wasn't gonna be able to clinically practice anymore. Those are things I would never have thought about.

Christine Ko: Yes, absolutely. Maybe, this kind of thing goes back to when we're young, and we just ask kids, what are you gonna be when you grow up? As if whatever occupation you choose, or what you're doing with the majority of your time, that is actually your identity. So it goes back to your saying it's like an identity crisis because you realize that can't really actually be who I am because I'm still here. Maybe I can't be a physician or at least be a physician like I was before I got such and such diagnosis or before this event happened or before I have a child who [00:08:00] like needs me 24 7 or something like that.

Dympna Weil: There are so many different circumstances, like you just mentioned, where our situations change, and it does not take away the fact that you are still a physician. For me, that was a big hurdle to overcome.

Christine Ko: Would you say there were positives about being a physician and going through this healing journey? There was an identity crisis, and there's the dirty pain as well as the clean pain, but were there positives as well?

Dympna Weil: Absolutely. I developed a whole new appreciation for the patient experience in a very deep way. Even with my physician knowledge and my training, I still felt tousled about, like I was being handed off to different people, and things were so disjointed. I could put those pieces [00:09:00] together. I could go to the next specialist and say, okay, I'm this many years old, this is my situation. This is what I've had done. And I could present myself to the next person I was seeing. But one, I didn't want to do that necessarily. I wanted to be taken care of because it was scary what was going on. And two, I really felt for patients who have no idea how to navigate the system because it's a really complicated system to navigate. 

Christine Ko: I completely agree with you. You could present yourself as a patient, so you could be your own physician translator and translate yourself to another physician, but you would've preferred to just be taken care of by the doctor, by the system, by healthcare. And I agree with that. I had great doctors and good care, but you're right, the system is still really hard to navigate. There were bright spots where I [00:10:00] felt the system really just helped me and guided me. Other things in the experience were so not like that. 

Dympna Weil: Absolutely. My father went through cancer treatment at Sloan Kettering, and it was very much in that way. It was cohesive, and everyone speaks to everyone else, and they make the appointments for you. Communication is great. Not only is the care superb, but the patient experience, even though it's an awful experience that they're going through, they really do a great job, an excellent job, of trying to make it as good as it can be, as easy for patients as possible. That's something that our family was very grateful for in that experience. 

Christine Ko: Yes. Cancer centers have that kind of advantage because in some ways, even though there's many different types of cancer, it is like one kind of entity in [00:11:00] the sense of you need probably a medical oncologist, and maybe you'll need a surgical oncologist, and maybe you need a radiation oncologist, and various things. They've done a good job, sounds like definitely at Memorial Sloan Kettering, of recognizing through experience what a patient needs and how the system can make that journey easier. Versus, it sounds like a condition like yours, which I would assume is relatively rare, or at least the system isn't used to like dealing with thousands upon thousands of patients a year with it, the care is not coordinated well.   

Dympna Weil: I do have wonderful physicians. I ended up having great physicians. It was just a matter of trying to find them. Ultimately, the diagnosis being made from a New York Times article. I reached out to the author and got some resources from him. It was that kind of bizarro situation where you call in all the [00:12:00] help you can get and the resources you can gather. 

Christine Ko: Your story really speaks to the fact that there are rarer, more unusual diagnoses. Most of medicine and training is about training to recognize what's more common. There's a lot of knowledge and understanding that needs to be gained about the common diseases. It's hard to train and be prepared to recognize the super rare. You wouldn't wanna sacrifice all that we need to know about common things just to focus on rare things. But I think then it does really contribute to a more difficult patient experience for anyone who does have something that's not as common or even very rare.

Dympna Weil: It goes back to you have to trust yourself when something isn't right. You have to speak up and keep going with the assessments and second opinions and all of those things. [00:13:00] In practice I was always the please get another opinion person, right? I would much rather send somebody for a second opinion and have them have the comfort of confirmation of something I'm saying, or even another recommendation added. Self-advocacy was one of the greater things that came out of it. Advocating more for myself. 

Christine Ko: Yes. Advocating is very important. It also sounds like something very positive that came out of this is The Physician Wayfinder. 

Dympna Weil: Yes, absolutely. My coaching endeavors initially were for my own personal use, and what I realized was that, if I had a lot of those tools in earlier iterations of my life, it would've been really helpful, and it would've served me quite well. So I ended up training as a coach with Martha Beck, whom I adore. I went on to then train as a master coach with her and started using those skills [00:14:00] with my colleagues in medicine because we all needed as much support as we could get. And so that's how The Physician Wayfinder was born. It's been very fulfilling to still feel like I'm doctoring, just serving my colleagues instead of my patients. It's been very fulfilling. 

Christine Ko: Yes, absolutely. I would call that doctoring. My idea of a physician. I'm not sure if I ever really had a solid definition, but I really do think it is about helping someone become more healthy, in whatever way that is. There is definitely a very significant sort of emotional component too that is not well recognized by traditional medical training. 

Dympna Weil: It's largely the way that our system works. Really just precludes that component, from even being touched upon. There's too [00:15:00] many patients to see. There's not enough time. 

And I don't know that's all true. There's a way to incorporate it and whether it's from the physicians like ourselves and seeing patients or it's bringing in other sorts of methodologies. There is a way to to bring that into your space more frequently in your interactions, but it's not something that's taught really well at all.

Christine Ko: Yeah. I think you're touching on the fact that the environment, the medical culture of medical practice contributes to us not being optimal in our own health. 

Dympna Weil: Absolutely. 

Christine Ko: There is a better way, but I wouldn't say that I know what it is.

Dympna Weil: I think everybody has their own way that works for them. But I believe that there is a better way for everyone. I think we incur so much harm [00:16:00] during our training because the culture is so toxic. And we are not even really aware of it because it's just the norm. I've thought a lot about this and written about it. I'm working on a book actually about the whole concept, but we take this oath to do no harm, and yet we incur so much harm in the process of becoming the physician that it's really important that I think we start to look at that and like, how do we undo that? The way to do that is to look for harmony. We're all so bent on looking for balance and trying to balance all the things and we can't, and we feel like a failure. And the system is telling us we're a failure. You can't find balance, but balance doesn't really exist. You know, it's temporary and fleeting. But harmony does, and I've adopted that as my mindset, and that has really [00:17:00] opened things up for me. 

Christine Ko: Yeah. I agree with you. I was trying to seek balance for a long time, and then I realized relatively recently, I'm like, yeah, that doesn't really exist. Do you think there are some warning signs that we should pay attention to? Before we actually really do have some kind of diagnosis or some diagnosable health problem? 

Dympna Weil: Yeah. I think that when we find ourselves just not acting like ourselves. We all went into medicine because we wanted to do good in the world and to help people. And when we find ourselves no longer having that sentiment and we're like, Ugh. When it's the Ugh, what's going on, right? And yes, the system is terrible, but there's ways to find joy in what we're doing, even if the system is terrible. And so I think those little subtle shifts in how we are [00:18:00] interacting with our colleagues or our patients or our family members. Are we short in conversation? Are we intolerant of simple, really trivial little things? It's those subtle things, I think, it's the relational things because we lose patience really easily for that the closer to burnout or the further into burnout we go. 

Christine Ko: Yes. What are some maybe wellness practices that have been most helpful to you? Or that you think are helpful to people you've coached?   

Dympna Weil: There are several things that have been really pivotal for me. The first was that nobody gets to make me feel any particular way. They can say things, the environment can be awful, but it's my decision to how I choose to show up. And that really afforded me [00:19:00] agency where I felt so out of control and at the whim of the situation, my circumstance, of my body changing. That was a profound change in how I looked at things. And the other practices that I do, they're little things, but they're important. So it's getting a little bit of nature into your day, whether that's even just going outside for five minutes and getting a little sunshine, or taking a walk at lunch, or just taking a little bit of break just to literally go outside because nature has that kind of calming effect. And there are several tools that I've created. One being this, I call it the dimmer switch. And I came up with it when I was going through my physical therapy for my vestibular condition. What I learned was if I did too much, the therapy didn't work. It would like overstimulate, and I'd feel awful. If I did too little, I made no [00:20:00] progress. So I started to see like this little switch, like a dimmer switch, of how I had to really control things in real time to make sure that I could amp it up enough to get better, to improve, but not to go so far as to make myself ill. So I started wondering what would happen if I applied that to everything? And so I started applying that concept to how I was feeling, when I started feeling really sad or upset about my not being able to be working or missing that social component of work. It's okay to be sad, and I would allow the sadness to be there, but I didn't wanna wallow in it. I would use my dimmer switch and dial down the sadness, and offer myself a little compassion, and dial up the compassion. And so [00:21:00] it was just my way of lending a little bit of a visual to how I had a little bit of control. Maybe not a ton, but I had some control and agency. 

Christine Ko: Yeah. It gives you a space before you respond completely. Like to just think about, how am I gonna manage this sadness? How am I gonna manage compassion? How am I gonna manage? Yeah. So that's nice. 

Dympna Weil: Yeah, it's the response and not a reaction, right? 

Christine Ko: Would you have a message to physicians who feel depleted physically or mentally or emotionally, but doesn't really know how to prioritize themselves?   

Dympna Weil: Yeah because I was them. 

They're not alone. There's nothing wrong with them, and I think that's the most important message I can give them. There's nothing wrong with you. It can get better. Reaching out for some support and just talking to [00:22:00] somebody about it is the first and most important thing you can do because you absolutely can feel better. I'm proof of it.

Christine Ko: That's great. I think you shared in terms of tips that really helped you.... One of the things you initially said is you were exploring coaching to help yourself. Some of the things you've learned through coaching and through coaching others and your own journey is the concept of that dimmer switch. And you just said, you're not alone, and things can be better, there can be a better way. Do you have anything to add to that? 

Dympna Weil: Life really is beautiful, and medicine is a wonderful profession. We went into it for a reason. If we can go back to our values and think about the core of things, like when I went into this, why did I go into it? And that's still there. Most of us will still come back and say, I would love to be back doing that. And I'd say a lot of our colleagues that are in that state of almost burnout or [00:23:00] burnout, if we could clear away the cobwebs, so to speak, that passion is still there. It's just, it's been buried under a lot of layers of other things, training, the system, the pressures of just regular life. It will get better. Just dig into the goodness and the things that you do every day that make a difference. Think about the wins that you have every day, the little things that you do that make a difference to somebody else. That's a big deal. And we don't at all give ourselves credit for that. 

Christine Ko: Yes. So even in a bulky system, a system like a medical system that doesn't work all that well, there are still ways in which, for sure, physicians are helping patients or colleagues every single day. That goes back to your comment about in Covid, how you really felt for both the doctors on that [00:24:00] healthcare side, but as well as patients, the patients who would just really be desperate, I think that is an accurate word, of just someone care for me, someone figure out how to help me get through this health issue. It's a difficult thing. 

Dympna Weil: Yeah. That connection with others. That shared community of talking with others that have been through it, I think that makes all the difference. It really does. That's one of the things that when I coach one-to-one with people, that's really beneficial. There's something magical about when we do that in group, the shared experience is something that's undeniably powerful. 

Christine Ko: This has been great. I appreciate your comments. Do you have any final thoughts? 

Dympna Weil: I just wanna let everyone know that that they're not alone. Reach out to friends, family, a great therapist, or check out a coach if that's something that might serve you. There's no [00:25:00] shame in asking for help. Not at all. It's a sign of strength and I think that's something we have to just remind each other of.

Christine Ko: Awesome. Thank you. Thank you so much.   

Dympna Weil: My pleasure. Thank you for having me.