Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance
Kara Wada, MD: Welcome back everyone, and welcome to our new listeners to the Becoming Immune Confident Podcast. I'm your host, Dr. Kara Wada. I am board certified pediatric and adult allergy immunology, lifestyle medicine doc and autoimmune patient. And I love welcoming amazing colleagues to the podcast to share their expertise and wisdom and I am so excited and honored to have Dr. Dawn Baker join us today. She is a physician, a writer, speaker, and a lifestyle design coach behind Practice Balance. She helps physicians and other professionals step off the treadmill of achievement, rediscover their true selves, cultivate a practice of balance that's right for them. She's the author of Lean Out: A Professional Woman’s Guide to Finding Authentic Work-Life Balance
Dawn is also a certified yoga and meditation instructor who's passionate about living off the grid, homeschooling, fitness, and travel. Dr. Dawn, thank you so much for getting up extra early to join me this morning and to talk with us today.
Dawn Baker, MD: Absolutely. It's a pleasure. Thank you for inviting me.
Kara Wada, MD: I would love to hear how you ended up doing these cool things that you're doing.
Introduction to Location Independent Physician Dr. Dawn Baker
Dawn Baker, MD: Yeah, of course. It's a really long process to describe that, but what I would say is, I split my time between doing part-time clinical anesthesiology. At this point, I am a location independent physician. I was not always this way, but I live in a rural area in the mountains, and so I travel to do my work. I work approximately what I think people would consider to be quarter time, so about a week a month. And that is clinical work. So I have these other passions and work that I do that I've cultivated over probably the last 10, 12 years and I can explain why. But the reason is that I really enjoy writing. I really enjoy speaking and helping other professionals to try to find their type of work-life balance, which is really individual for everyone. And I started out my medical career as a second career physician. Actually, I was an engineer for a while and so I was a what they would call maybe a cubicle jockey.
I found it super boring. I decided that I really needed more and I was at the same time doing an intense period in my life of rock climbing. And it was something that my husband introduced me to before we were even married. And it's a kind of a sport that makes you want to carve your whole life around it. There are other sports like that. People who are ski bums or surfers have described that, and so it's unusual to become a doctor in that space. But that's what I did. And the reason is because as an engineer, I found that I had to live in various specific places to do the kind of engineering that I had studied.
So I had studied chemical engineering and depending on what industry you go in, you really pegged to living in very specific places. And so when I started traveling and going to all sorts of places, countries, and other states, both rural and big cities to do rock climbing, I realized that I wanted to find a job that had that science aspect and also had a community aspect more so than what I was doing as an engineer, I was at the time making semiconductors that were faster for computer chips and it wasn't, I don't know, it just wasn't as fulfilling. And so I went into medicine and I had no family that was in medicine or anything like that.
I found some mentors and went to medical school and really with the idea that it was going to give me some more location freedom and partway through my medical training. I would say I was maybe halfway through residency. So it was toward the end of the training. You do all of the medical school and then you go to your residency for a number of years, at least three or four years, I started having some problems and they were very non-specific and I chalked them up to stress and they were something that was related to fertility, so I was having trouble getting pregnant and deciding that I wanted to become pregnant. I was a little older since I was a second career physician, so I was in my mid thirties. I also just had energy issues. Really weird. Not able to rock climb in the same way that I was not able to do the fitness things that I was really interested in, which, of course, people blew me off ' Oh, but you're so healthy and you look great', and that kind of thing. But I didn't feel like myself.
Sleep disturbance, a depression that I had never felt before. Like a, I don't want to get out of bed and go anywhere, kind of depression. And anyway, to make a long story short for that, I ended up with a diagnosis of a very large pituitary tumor, which is a pretty serious brain tumor because it involves all of the hormones that are going through your body and are signaling to your other things in your body, like your blood vessels, your blood sugar, your thyroid, your reproductive organs, and it was also because of the mass effect of the tumor. Even though it's a benign tumor, it needed to be surgically removed because I was going blind and I didn't even realize it. It was something that came on so slowly that I didn't really notice, but I knew that I was having trouble with my procedures at work, and some of the attendings and the people that I was training with were like, 'What is wrong with you? Why do you not understand this ultrasound?' Or things like that. And in retrospect, it all got better after I had my surgery. So I think it was related to that. Yeah, which is really my diagnosis was protracted by my own lack of ability to take care of myself. I didn't get the tests and get the scans that I was told to get on a timely basis. And so it was something that took a really long time and that was something that I really learned from too.
So all of that was my wake up call to realize that I needed to get back on my train of working towards freedom and not going towards a very specific subspecialty in my field, which was the path that I had been taking mainly because I was on what I call a treadmill of achievement. Where people tell you're good at something and they give you more work and they give you research projects and it's 'Oh, I'm a resident and I'm not getting paid for any of this and I'm spending a ton of time doing this, and then this is gonna peg me into working in some big city', which is exactly what I was trying to get away from.
So I took myself out of all of those things and I went back to deciding to finish my training, which I wasn't sure about at first, and then go into basic general bread and butter type of anesthesia, focus on my clinical work, hone that, and then build my family after I was finished with my training. Fast forward, it's been about 10 years and now I have transitioned my career to be that location independent physician that I think I envisioned when I was first going into medical school.
Kara Wada, MD: That's super cool, that despite kind of some of these huge roadblocks, stumbling blocks, hiccups, however you wanna phrase it along the way, that end, goal or vision that you imagined is where you find yourself now. It's interesting, I hear so many similarities in my own resistance to getting some repeat labs and like looking into things a little bit more in my own diagnosis story as well. I would love to talk a little bit more about this idea of balance and maybe some of the, some insider wisdom you might have on cultivating balance what it means. Maybe we can start with that.
Dawn Baker, MD: Yeah. Okay. My balance is definitely not gonna be your balance, and it's not going to be anyone else's balance, and that was one of the things that I learned when I had my health crisis. I was really in this shame cycle of what is wrong with me and why is no one else affected so much by this stress or why do I need to slow down or why do I need things to be a certain way as far as the number of roles that I take on. So that was my first lesson and that was one of the things as to why I wanted to start writing about balance. And I started that. I left this outta my story, but I started that when I was at the end of my training and I had these problems because I really thought that all of it was related to burnout and I started studying it. And just like you, I really wanted to help myself by helping other people, and it ended up morphing into a lot more than what I expected.
Besides the fact that it's really individual and it's very relative between people, is that it is something that is mainly I like to call it like an orchestra. It's a lot of different roles that you're taking on. It's a continuous moving process and a moving mechanical thing. And I use the orchestra analogy because there are lots of different instruments in the orchestra. So those go with your different roles that you have. So you're a mom or a dad and you're in your profession. You have your job, you have the things that you're interested in personally, like athletics or like doing art or some other hobbies or things like that. And you have all those. And then on top of that, you have other roles in relation to other people like you're a daughter or a son or a sister or brother, or those different things. And so sometimes the certain instruments are going to be playing louder than other times, but not at any sustainable period are all of the instruments playing at once. Now there are times, in an orchestra, and I actually grew up playing in an orchestra, I played the cello, but in a really smashing symphony where they're all playing at the same time, but it's not for the whole song because that would be crazy. So that's the way that I like to put it and it's an ever-changing thing.
Kara Wada, MD: That is such a beautiful analogy, and I think it's in such contrast to my very initial conversations I can remember having about balance, in particular with one of my dear college professors. I went to a really small college where it was actually smaller than my high school, so I had really meaningful relationships with a few of my professors that I still keep in touch with. And I remember one of those mentors she was a mom of three boys, I babysat for 'em on occasion, and I had this vision and the analogy that I thought of as balance as a plate and my plate or whatever it is that we're supposed to be using now for nutrition, maybe. And shifting pieces of the pie. And I remember her telling me that, there's no such thing as like a singular balance that it will always be evolving and changing. And but I think that, taking it to that next level and really thinking of the symphony and I had Beethoven's fifth coming into mind, we were talking about that. Or the occasions when my daughter's trying to practice the piano but asked me to pull out my old flute and play a little bit and and how that all just beautifully we can turn down the volume, pick up the speed, and it's just brilliant.
Dawn Baker, MD: Yeah, and the other thing is that if you know anything about those symphony and music things the thing that you say that you're doing when you're not playing is called rest. It's very appropriate. We all need to rest certain roles at times. We even need to rest our whole bodies at times. And I really like using that analogy and it was part of what prompted me to want to write my book, Lean Out, to describe that because I think a lot of people don't like to use the word balance anymore.
But I still like it. And I like it in this context and using that analogy, and I still use the word all the time, it's in my book title, but some people are like, 'Balance is a bad word. It's not realistic'. And it is. It's just that it's ever changing. And your balance is not always going to feel necessarily great, but it is what it is at the time.
Treadmill of Achievement
Kara Wada, MD: I have to say, I personally am a big fan of the word balance in lots of contexts in this context, but I also will joke about using it rather than immune boosting. We like to talk about balancing because so often, you know what we're talking about with allergies or autoimmune situations or other inflammatory diseases, as the volume's turned up, we wanna turn it back down or get that, get things back into more of like homeostasis. It's just what our bodies aim for when we have the right environment and tools and things to help us get there.
Let's go back a little bit. I would love love to talk a little bit more about the treadmill of achievement because I think that, obviously, as you were talking about it, I was like, "Oh my gosh, totally hits here". But I think also is a big thing that comes up with a lot of our listeners too, and of our a plus personalities in the traps that has us falling into sometimes.
Dawn Baker, MD: Absolutely. So the treadmill achievement is something that I decided to call this thing that a lot of us get on and achievement is something that we are very used to in medicine and in other fields as well. It's something that we really like. It's something that brings us purpose. It's not a bad thing. I'm not saying that achievement is a bad thing. What is bad is getting on this hedonic treadmill, so hedonic adaptation is where you have something like, let's use it in terms of buying a new car. You buy a new car, you've been really wanting it, you've been fantasizing about it. You think about the car, and then you get the car. Finally, your happiness is boosted for a period of time, or your feeling sense of purpose or sense of fulfillment in terms of if you analogize it to achievement. But over time, that goes back to your baseline level. And this is something that psychologists have found in their research.
And it's the same with achievement where you achieve and you get that sense of purpose or you get that sense of value and that feeling of fulfillment, but then over time it fades and then our work changes, our work. Something like work roles are shifted without us even, having a say in it, those kind of things. And then they can really upset people because over the time on that hedonic treadmill, their sense of self-worth has really gotten wrapped up in that achievement.
And then on the external side, as you achieve more, what are you rewarded with? More work. You're rewarded with more responsibilities and more things to do because, 'oh, you can handle it. You're doing great. Oh, we would love for you to chair this committee or do this other thing'. And we want to say yes because we want to help, we love that feeling, but we don't always, we should not always say yes, basically.
Kara Wada, MD: Yeah, I think one thought that I continuously have been trying to get my brain back to over the last couple of years is when I'm asked to do something, 'is this an opportunity that has has my soul lit on fire? Is it something that you know is 'a hell yes'?'. As opposed to, 'meh'. And then the second thought is like, 'Is this in line with how the values that I want to really lean in towards?' And if not, then it is, to use your words, something that I wanna kinda lean back from or lean out from.
Dawn Baker, MD: Yes. Now you're getting to the title of my book, and the reason I chose Lean Out is because, If you read Lean In the famous tone by Sheryl Sandberg came out in maybe 2012. I can't remember exactly. She talks about the opposite of leaning in as being leaning back at the boardroom table, shrinking back 'Oh, I don't wanna take on that responsibility because it's, I don't think I can do it. Or not having the right level of confidence and those kind of things. And I definitely think that confidence can be an issue for women professionals, but I do not like the term lean back because to me that implies laziness. That implies that they are that whoever it is that is in this position, choosing to lean out that they are lazy that they're being selfish, things like that. And so I wanted to choose leaning out because I feel like it's mixing lean back and opt out. Sometimes you have to just say, 'I'm not gonna do that'. You have to learn how to say no. In my book, I do have a whole section about different ways that people can learn how to say no and what you just mentioned, the hell yes or meh. That idea I think is very important and there are a lot of things written about that. I don't actually talk about that, but it's implied in my book and yeah I really like the concept of the idea that leaning out is that it's okay to be different, it's okay to do something that is not in line with what everybody else is doing. And so a lot of the steps to leaning out are really learning about yourself and making sure that you know yourself and that you accept yourself, and that you understand that it's okay to be different and you give yourself permission to be different. I think that's so important to consider.
Kara Wada, MD: Especially when you may already be, like for instance, both, my husband and I were really fortunate to have moms that stayed home with us when we were young.
And were full-time mom and also, taking care of all the household tasks that there are. And as we formed our family, we had different ideas of how we both wanted to work and both have strong professional interests and yet we also want, a great environment for our children to spend time with our children, to have meaningful relationships with each of 'em. And here comes back to this idea of balance that, okay, there's only so many hours of the day and we only have so much, bandwidth for things. So where do we turn the volume down on certain responsibilities or things?
And one of the biggest things that we had trouble accepting for a long time was getting help with cleaning the house because our moms were the ones that did it. And so we felt for a long time we had this preconceived notion that also had to be on our list. But what we realized was our bigger priority was to be able to spend that time with our kids but also give our kids a clean, a relatively clean space to live it. And that was one of the first trade offs that I can remember of being like, 'Okay, we do have to let go of some of those preconceived notions that were just what we knew.' and we don't have to fall into the default.
Dawn Baker, MD: One of the things that I talk about a lot in the book that's I. One of the first steps of leaning out and finding the work-life balance that's right for you is addressing your shoulds, your rules, and the thoughts that are holding you back from what you really want and what you're describing, ways that you grew up and that your husband grew up with, and then you're combining those two is, it's a rule, it's an unwritten rule that you're following. 'I need to clean the house as part of my duties of being a good mom'. Or you could say that's a rule' you could even write it down and say, this rule that I'm following is, in order to be an effective parent, I need to do X. I need to be able to clean the house once a week, or it needs to be me, it needs to not be outsourced'. Those kind of things and then you question it and say, 'Is this really true?' ' where did this rule come from?' And then identifying where it came from. 'It came from where I grew up and the kind of environment that I was in and my kids are not in the same parenting milieu that I was in', that kind of thing.
Kara Wada, MD: Yeah. This is, it's one of the things actually that we go through, that I go through with my coaching clients too, this idea, and another way that I've heard it described as like the manuals that we have for people and yes. This rule books. That we they're always unstated. But then when you dig in, you're like 'oh yeah, I do have kind of this idea that someone should do this for my birthday or that, I should be cleaning, or we should have a home cooked meal every evening', whatever that may be when you really stop to think about all the things that we just run on autopilot.
Dawn Baker, MD: Definitely. Yeah.
Living off the grid: Dr. Dawn's personal story
Kara Wada, MD: Would you be willing to talk? I have this like initial like curiosity of like the living off the grid and homeschooling. I think because a little part of me is like, How would that be? Would I, I'm curious about it personally. I don't know that I'm at a point ready to make that leap, but I would love to hear, how you, how that works, how you ended up in living that lifestyle?
Dawn Baker, MD: Sure. So after I had my daughter, which is something that I had worked for so long to have a child, it started with that initial fertility workup, innocent fertility workup that turned into a brain tumor diagnosis and all that. I knew that after I dealt with that and got healthy myself, that it was going to be a big undertaking to have a child. But I went through it, I went through three years of infertility treatments and once I had her, I just was so in love and I actually wanted to stop working. We had saved a lot of money, had lived well below our means. I have a husband who works and he had already gone down to part-time. He's an intellectual property attorney and he started his own, a micro firm where he had a very select number of clients and because of his job, was able to work anywhere. And so combine that with having a child that I was just smitten over, I started deciding that I wanted to change my work-life balance because I had been working at an academic center and I was working part-time and I had a great job. In fact, a lot of people were like, 'Why would you wanna leave this job? This job is perfect. You don't have to take call, you don't have to work on the weekends, and you get these three days and you have a guarantee of this many hours a day and that kind of thing'.
We wanted to be able to live anywhere that we chose and this was pre COVID. So I will say that COVID changed a little bit about what we decided to do. We had thought at that time about living nomadically living in different states, maybe traveling by an RV. Some people live full-time in an RV or we had thought about living in different countries and doing the kind of things that people do where they do a home exchange or they live in Airbnbs.
For a really long time, we had loved slow travel since we had been rock climbing, and we don't do that as much anymore, but it's the kind of thing that you do when you go somewhere to rock climb, you tend to stay there for a period of time and learn the culture and be in a certain area for some period and we had really liked that. And so I negotiated a leave of absence with my academic job to try out to test out the waters of doing locum tenens work. And I don't think that I would've wanted to do that straight out of my training because I did not have the confidence, I didn't have the volume under me. The procedures and seeing the things and then going and being in an unfamiliar environment. So I'm really glad I did things the way that I did. But I do feel like I'm where I had initially envision to be now, which is moving around, traveling around to different places to work. I tend to work in, so as far as now, what my life looks like because of COVID we bagged the travel.
We decided not to do that because that was too hard to go around to different places. Now, we could have maybe done the RV type of life, but my husband has always had this dream of wanting to own a ranch. And we are Western people at heart. We're mountain people, and we were living in Utah. We started to look around in the more rural areas and the more mountainous areas of Utah, and then we went out on a radius from there to some of the surrounding states. But we ended up finding what we felt like is the perfect property for us to live on. And we bought it a couple of years ago. So this was summer of 2021, we found this 80 acre property.
It was at the right elevation. It has multiple species of trees from juniper to forest, like evergreen type pinyon pines and ponderosa pines. And it's just wonderful. It has varied topography, it has hills, it has meadows. There's water. Not only is there water rights on the property with a spring, but there's a stream on the property, which is very unusual to find, especially in the West, to be able to have that abundance of water. So we hopped on this property and we pivoted to doing that instead of the travel thing. I have to travel for my work, but my husband just needs to have the internet. We do projects on our property. We're building a greenhouse. Eventually maybe we'll have some animals. We like doing physical work. We're very into the fitness and being able to hike and being able to do those things.
And the homeschooling is part of living in different places and being location independent basically. But we have a town near us that we can go to, and my daughter has a lot of different social things that she's able to do. It's about an hour drive, so you have to be choosy with the days that you go to town. But we do that, and it's a bit of a trade off to drive far to go to buy your groceries or to go to a for her, like a gymnastics class or a jiujitsu class or something like that. But on the other days, we don't drive at all. We are just on this property and hiking around and we have our own hiking trails and we really like this mix. It's really fun.
Kara Wada, MD: That's super cool. We are in the early stages of I think on the whole, my husband and I tend to be more in town suburban folks, but since Covid too, have really loved spending time in the backyard and working on growing some fruits and mostly veggies, I should say, not so many fruits in Ohio, at least not in a home situation.
So as we're in the early stages of looking to build a home and kind of start from scratch with a backyard and planning a garden and these different things it's exciting to consider the possibilities and I think, let go of, going back to some of those, like those limiting beliefs or those preconceived notions of how we think life should look.
And I love just leaning into that dreaming and the possibility stage of things.
Dawn Baker, MD: Yeah. I think it's wonderful. Everybody has a different dream and a different vision. Yeah. And my lifestyle is not necessarily for other people. I've shared where we live and the kind of things that we do with people in different online Facebook groups for physicians.
And some people say, 'Oh, that sounds really dreamy, but I could never do that'. And I totally respect that. That's great. I think our parents think we're crazy, but it's been really fun.
I like to call it counterculture professional because nowadays counterculture is not hippies and biker gangs nowadays, it's doing something that's a little bit off the beaten path of that typical treadmill of achievement.
Kara Wada, MD: Yeah. And I think what I get sometimes is folks look at me like, 'Okay, what are you doing? You're in academics, but you have a business and you're doing kind of some of this other stuff'. They don't know what to do with that' I've had that response from, for instance, certain nonprofits that I've looked at trying to partner with and they're like, 'We don't really know what to do with you. Are you for profit or are you for academics?' And I'm like, 'I'm both' like...'
Dawn Baker, MD: Yeah. Everybody wants to label and they want you to fit into an easy category and into an easy box. The question I get a lot nowadays when I go and work at a hospital in the city is, 'Oh where else do you work?' And I'm like, ' This is it'. This is like what I do. I have a regular locum position right now that, I have two different ones and they're just recurring at two different locations. And people are like where else do you work? What is your other job? What's your...?', they just they can't get it. And when you tell them they, it's just like a blank look on their face.
I enjoy like doing coaching like you do and doing speaking engagements. I'd like to start offering mindfulness and yoga at retreats if I could, or 'maybe have a retreat on our property.
Kara Wada, MD: That's what I was thinking.
Dawn Baker, MD: There's so many. We just have a lot of work to do. It's very wild. And so we need to build structures and build platforms and improve roads and things like that, and then we could do something like that. There's so many options and it's fun to dream about it. But at the same time, if it doesn't happen, 'That's okay'. We can pivot to something else.
Kara Wada, MD: Just pop up a few yurts, we'll be good to go.
Dawn Baker, MD: Yeah, we've thought about it for sure. Yeah, it may happen.
How to connect with Dr. Dawn and her ventures
Kara Wada, MD: You'll have to keep me in the loop because I think that would be incredible. And admittedly, I have not spent really much time at all out West. Like the little sprinkles of experiences I've had have been wonderful.
But that is an area of the country that, I had never been west of Iowa until I was in medical school, so kind of depressing. Dr. Dawn, this
has been a true delight. I am so glad that we were able to connect and talk this morning. And I would love, I'm sure our listeners are wondering how can they find, where can they find Lean Out?
Where can they connect with you? And continue this conversation with the awesome things you're putting out in the world.
Dawn Baker, MD: Thank you so much again for connecting with me too. I really appreciate it. It has been such a fun conversation, and I would love to have you on my podcast.
As we discussed offline, I have a podcast called Lean Out as well. My book is available on Amazon. It's currently in print and e-reader format. Audiobook to come and everything. If you forget the name can be found on my website, which is a longstanding blog called practicebalance.com. That's the name of my company that I started many years ago when I was wanting to share all of these wellness types of experiences and information with people. There's 10 plus years of content on that blog of all different types of subjects from infertility to stress, work-life balance, wellness topics like fitness. Even just the kind of things that I follow and experiment with over time with health and nutrition and you can find me on the most active social media platform because I love taking photographs of my property, you can look at those on Instagram and my handle is @ practicebalance
Kara Wada, MD: Awesome. Oh I can't wait to finish reading lean out. It is in my e-reader which is my part of the finding that balance of before bedtime and yeah.
Thank you so much Dr. Dawn. I can't wait to talk again. And we will link to all of those in the show notes so that you don't have to go looking for 'em anywhere. You can just click on the links and we'll talk again soon.
Dawn Baker, MD: Thank you so much.
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