
Hosted by Kendra Harvey · EN

There is a word Aditi Pemmaraju refuses to use. "Trailing spouse." She won't say it. She says "lighthouse spouse" instead, and by the end of this conversation, I think you'll understand exactly why. Aditi met her husband in calculus class freshman year of college. He was all in on pre-med from day one. She was still finding her way, and she told me with a laugh that she still kind of is. Over the next two decades, medicine would shape not just his life but hers, one city, one overnight call, one pivot at a time. Residency in the Mid-Atlantic. Fellowship in Houston. An academic medicine career that has never really slowed down. And alongside all of it, Aditi, rebuilding from scratch in places where she knew nobody. She graduated law school the same year he started internship. She took the Texas bar exam pregnant with her second daughter. She worked as a legal editor, taught barre classes for a year, returned to a law firm, left when the environment became toxic, and eventually found her way into real estate, physician relocation specifically. None of it looked like a plan. All of it, she now understands, was one. The part of this conversation I keep returning to is when Aditi said she had always felt like a bit of a failure for not being able to sustain her legal career. And then she sat with that in her journal and arrived at something different. Those weren't wrong turns. Those were the building blocks. The negotiation skills from law. The ability to breathe through a high-stakes moment from barre. Every experience she had once written off as a detour had been quietly preparing her for Homes for Healers, for becoming the guide she never had when she arrived somewhere new and alone. We also talked about the spreadsheet. The one that supposedly proves a physician spouse shouldn't bother working once you factor in childcare and taxes. And Aditi said it plainly: you cannot put a price on what a woman needs to feel like a person again, not just a spouse on the sidelines. That doesn't show up in any formula. It shouldn't have to. And then there's the moment everything shifted. About a year ago, after two decades of standing in the wings of her husband's career, Aditi had a thought she had never let herself have before. He has done what he's wanted with his career this whole time. It's my turn. Four words. And she went all in. If you have been waiting for something outside of you to change before you feel like you can move, this conversation is for you. What You'll Learn [02:00 - 04:00] What residency really felt like: alone with a newborn, no family, overnight calls every few nights, in a city where she knew no one [05:00 - 07:00] The moment Aditi chose to follow her husband, what she gave up to do it, and why she doesn't regret it [13:00 - 14:00] What a financial spreadsheet will never capture when a physician spouse considers going back to work [18:00 - 20:00] The "it's my turn" shift, and the vision behind Homes for Healers and the lighthouse spouse [23:00 - 25:00] Why every career detour was actually part of the plan, even when it felt like failure [27:00 - 30:00] The Daily Stoic, radical acceptance, and what has actually gotten better Resources Mentioned Homes for Healers - Aditi's physician relocation resource in Houston, Texas Aditi on Instagram The Daily Stoic by Ryan Holiday Your Next Steps Take the Free Survival Mode Assessment Follow Kendra on Instagram Listen on Apple Podcasts Listen on Spotify

There was a stretch of residency when I couldn't tell you what month it was without checking my phone. The days just bled into each other. Getting the kids up, breakfast, nap time, pickup, dinner, bedtime, and then the same thing again. I was physically present in my life, doing everything that needed to be done, and I was completely, quietly gone. For years I told myself I was a homebody. An introvert. Someone who just didn't need a lot of social connection. I believed it because it was easier than sitting with what was actually happening, which was depersonalization. Physically present. Mentally checked out. Not breaking down. Just disappearing. Then I joined a book club, a small group of women reading the classics, the kind of conversations I hadn't had since college. I remember looking forward to those meetings in a way that genuinely surprised me. That book club wasn't entertainment. It was the first time in months I actually got to exhale. Around the same time, I heard an NPR segment on caregiver burnout, and something in me just stopped. That's me. I went home and looked it up and checked almost every box. The fatigue that sleep didn't fix. The blurred days. The going through the motions. I didn't have a clinical term that fit, so I made one up: protracted medical training spouse burnout. PMTSB. Not exactly catchy. But it was real, and naming it mattered. What I've come to understand since then is this: burnout isn't a character flaw. It's not weakness or ingratitude. It's what happens when the demands on your life exceed your personal resources for an extended period of time. Think of a scale. On one side, everything being asked of you: the household, the kids, the emotional atmosphere of your home, the unpredictability of his schedule. On the other, everything you have to give. Burnout isn't one terrible week. It's the slow, quiet tipping of that scale, weight accumulating on one side while the other side empties, until one day you can barely remember when it was balanced. This whole episode circles back to one question: are you adequately resourced? Not "are you okay," that one's too easy to deflect. I walk through two frameworks that completely reframed this for me. Emily and Amelia Nagoski's concept of human giver syndrome, the cultural expectation that women be pretty, calm, happy, and available at all times at the cost of their own needs. And Dr. Saundra Dalton-Smith's seven types of rest from her book Sacred Rest: physical, mental, emotional, social, creative, spiritual, and sensory. Not as a rest strategy, but as a resource inventory. Because if burnout is demand exceeding resources, the real work is knowing exactly where you're running low. That's where we start. What You'll Learn [00:00 - 01:30] What depersonalization looks like from the inside, and why it presents as "fine" to everyone around you [02:00 - 05:30] The book club that turned out to be social rest, and why proximity is not the same as connection [05:30 - 07:00] How I named physician spouse burnout in 2013 before anyone else was talking about it [07:00 - 10:00] The scale analogy, the three clinical components of burnout, and why this life qualifies [10:00 - 11:30] Human giver syndrome and why the physician spouse world is one of its most concentrated environments [11:30 - 17:00] All seven types of rest used as a resource inventory, and how to find where your depletion actually lives Resources Mentioned Burnout by Emily and Amelia Nagoski Sacred Rest by Dr. Saundra Dalton-Smith The Hidden Cost of Being the Strong One Assessment Your Next Steps Take the Assessment: The Hidden Cost of Being the Strong One Listen on Apple Podcasts Listen on Spotify Find me on Instagram: @Kendra_ItGetsBetterNow | @SupportingPhysicianSpouses

When we're deep in the hard seasons, we invest so much imagination in what's missing, what we don't have just yet, what life will look like on the other side. We almost never turn that same imagination toward the woman we're actually becoming while we wait. And here's what nobody warns you about: she doesn't just show up on the other side, fully formed, rested, and ready to receive the life you built. She has to already be there. This episode is about the thought "we'll do it later when the season is better," and what it quietly costs you while it sits there feeling responsible and true. James Clear writes in Atomic Habits that every action you take is a vote for the type of person you want to become. That idea stopped me. Because most of us are waiting to feel like a different kind of wife, a different kind of woman, before we act like one. When it actually works the other way around. You act your way into the identity. You don't always think your way into it. "We'll reconnect after residency" is a vote. "I'll rest when things calm down" is a vote. "We'll get serious about money once the attending paycheck comes" is a vote. And a decade of "we'll do it later" doesn't disappear the day the schedule finally clears. It becomes the identity. The good news is that the process of becoming who you actually want to be starts small. A 5-minute conversation where nobody mentions the schedule. Noticing what money actually means to you. Doing something that feels like joy, not another item on the list. That's the vote. And when the season does change, you want the habit already built so it can scale with you, not something you're starting from scratch when you finally have the room. What You'll Learn [00:02:00 - 00:03:30] Why we picture the house more clearly than the woman who will live inside it [00:05:00 - 00:07:00] How every thought and behavior casts a vote for the identity you're building, whether you mean to or not [00:12:00 - 00:14:00] The "same fear, new zeros" pattern and why attending life doesn't automatically fix your relationship with money [00:15:00 - 00:16:30] The fast-eating story and what it reveals about survival mode habits that outlast the season [00:17:00 - 00:18:00] The shift from "I am" to "I have a pattern of" and why it changes everything about how you relate to your own identity [00:21:00 - 00:22:30] The 2-2-2 rhythm and how to find the smallest vote you can cast for your relationship right now Resources Mentioned Atomic Habits by James Clear Sacred Rest by Dr. Saundra Dalton-Smith Your Next Steps Take the Free Assessment: The Hidden Cost of Being the Strong One Follow on Apple Podcasts Follow on Spotify Connect on Instagram: @Kendra_ItGetsBetterNow | @SupportingPhysicianSpouses

That gap, between how capable you are and how out of control your money feels, is exactly where James lives professionally. He's a fee-only fiduciary who works specifically with physician families. We started with the basics, why money is the number one household stress for most American families and why none of us were ever taught how to actually talk about it. But it moved fast into something deeper. Values. The real ones, not the ones you say out loud at a dinner party. James walked us through an exercise from the Gottman Institute, essentially money love languages, security, freedom, success, love, wellbeing, significance, survival, contribution. He has couples guess each other's top three before they even talk about it. Nine times out of ten, the answer traces straight back to childhood. Mine did. I grew up hearing save, save, save, like something terrible was always one purchase away. We also got into the law of familiarity, why the people closest to us are often the hardest for us to actually hear, and why sometimes you need someone else in the room to translate. And we talked, honestly, about trust. About the fancy dinner early in our marriage where someone sold us a bunch of products and called it a plan. About how a physician family can start to feel like a revenue opportunity instead of a person. James gave me the actual questions to ask a financial advisor to know the difference, and one of them might make you a little uncomfortable in the best way. If you've ever felt like you and your spouse are speaking two different financial languages, this one is for you. What You'll Learn (with Timestamps) [00:01:00 - 02:00] The real gap James sees in almost every physician family he works with, and why it isn't about intelligence [00:11:00 - 13:00] Kendra's own money story growing up, and how it shaped years of financial anxiety [00:13:00 - 15:00] The Gottman Institute's "money love languages" exercise, and what it reveals when you guess your spouse's top three [00:17:00 - 19:00] The law of familiarity, and why your own spouse might be the hardest person to hear you [00:24:00 - 25:00] The fifteen minute weekly money rhythm James recommends to every couple he works with [00:26:00 - 29:00] The exact questions to ask a financial advisor to know if they're actually a fiduciary Resources Mentioned Free Financial Wellness Diagnostic, IM Wealth The Life Well Lived: A Physician's Guide to Wealth, James Nutter's podcast Relationship Plans That Work More Than Money, Gottman Institute Your Next Steps Grab the Relationship Plans That Work Guide Take the assessment The Hidden Cost of Being the Strong One Follow James Nutter on Instagram Listen on Apple Podcasts Listen on Spotify

Three posts landed in my feed within a few days of each other. None of them were mine to write, but I couldn't stop thinking about how all three were describing women. If you see your spouse as a paycheck and he sees you as a role, you don't have a marriage. You have a transaction, and a transaction is the shallowest version of a relationship there is. I went looking at what the Harvard Study of Adult Development has tracked for 85 years, the longest-running study of adult life that exists, and the single strongest predictor of happiness isn't income or career. It's the quality of your closest relationship. I walk through what it actually looks like to self-fund that protection, in dollars, in babysitters, in a rule I call 2-2-2, and in one meeting a month that might be the least romantic, most important hour on your calendar. Grab a coffee and give this one a listen. There's a free guide waiting for you too if you want to take it further. What You'll Learn (with Timestamps) [00:00 - 03:00] The three posts that sparked this episode: the second-income math, the "doctor built for a wife" confession, and the comment about who the real gold diggers actually are [03:00 - 06:00] Why "house spouse" is the same job as a house manager, minus the paycheck, and how that framing turns a marriage into a transaction [08:00 - 09:00] What the 85-year Harvard Study of Adult Development says is the real predictor of happiness [09:00 - 12:00] Kendra's 25 years back, teaching financial workshops for women navigating the "three Ds": death, disability, divorce [11:00 - 13:00] Why divorce is five to eight times more likely than death or disability, and why no one will sell you a policy for it [14:00 - 20:00] The three-part protection plan: financial visibility, protected personal time, and the 2-2-2 rhythm plus a monthly relationship meeting Resources Mentioned Harvard Study of Adult Development (referenced in-episode) The 2010 Safeguard Wedlock divorce insurance (referenced in-episode) Relationship Plans That Work (Free Guide) Your Next Steps Grab the free Relationship Plans That Work guide Work with Kendra Take the Free Assessment: The HIdden Cost of Being the Strong One. Connect on Instagram @Kendra_itgetsbetternow or @supportingphysicianspouses Listen on Apple Podcasts Listen on Spotify

Someone looked at my kitchen and decided my inner life was solved. I've been thinking about that comment for a long time now, the way I do with the strange ones that cross my feed. Because it said something true about how we think about problems. What counts as one. Who gets to have one. And what it means when the house looks finished but something inside still doesn't feel right. I know that gap from the inside. We had done it. Training was behind us. My husband was a practicing neurosurgeon. We were building our dream home, every finish and fixture exactly as I'd imagined it for years. I drove out to that site more times than I can count, carrying a kind of hope that only makes sense when you've been waiting a very long time. This house was the reward for the moves, the resident wages, the loneliness, the decades of holding it together. And when it was finished, I felt exactly the same. Worse than that. I got self-conscious about letting people in, my own family, my closest friends, because the house was a visible marker that we'd crossed a line. Instead of arrival, it felt like separation. The house that was supposed to be the reward had made me a stranger. That was my first clue. My body knew before my mind did that the house wasn't the answer. So I walked through Maslow's hierarchy on this one, not as a lecture, but as a way of showing what problems actually look like at every level. Physiological needs. Safety. Belonging. Esteem and identity. Becoming who you actually are. Here's what I want you to hear underneath all of it. Every level is a legitimate need. Not just the visible, urgent ones at the bottom. All of them. And here's the twist I didn't see coming. I have a pot filler in my kitchen, the one that got the comment. The water that comes out of it is orange. We've never once filled a pot from it, because somewhere behind that beautiful backsplash, there's a galvanized fitting corroding quietly, invisibly, in the dark. From where you're standing, it's a perfect kitchen detail. From where I'm standing, I know exactly what it can't do. That's what happens when someone looks at your life and decides you have no problems. They're seeing the finish. They have no idea what's corroding behind the wall. The gap between how your life looks and how it feels to live in it isn't ingratitude. It isn't a character flaw. It's real, and it deserves a real response. What changed things for me wasn't a house. It was someone who could see me clearly and reflect back what I'd stopped being able to see in myself. That's the work I'm honored to do now, and it's available to you too. Not when training ends. Now. What You'll Learn (with Timestamps) [00:00 - 03:00] Why a finished dream home made me feel like a stranger instead of the reward I'd been promised [03:00 - 07:00] Maslow's hierarchy of needs, and why every level is legitimate, not just the loud or urgent ones [07:00 - 10:00] How an identity built around survival mode doesn't disappear once the money and stability arrive [10:00 - 13:00] Why these levels aren't linear, you can be stable and still completely lost at the same time [13:00 - 16:00] The pot filler with orange water, and what a corroded pipe behind a beautiful wall really means [16:00 - 18:00] What actually changes things, and why it was never a house, a kitchen, or more gratitude Resources Mentioned The Life After Survival Mode Guide Learn more about coaching with Kendra Your Next Steps Work with Kendra The Life After Survival Mode Guide Connect on Instagram: @Kendra_ItGetsBetterNow or @SupportingPhysicianSpouses Listen on Apple Podcasts Listen on Spotify

The quiet, invisible weight of living a life that looks charmed from the outside while you quietly hold it all together from the inside. That is where Hayley Harlock and I found each other, somewhere around 2018, sliding into each other's DMs because we were both building something for a community that most people hadn't even recognized as a community yet. Hayley is the founder of The Flipside Life, known as TFSL, a community that supports, connects, and champions physician families at every stage of training and practice. She started it in 2019, which means she was building before the research existed, before the accounts multiplied on social media, before medical education programs started asking whether the partners might also need something. She just knew. And she built anyway. This conversation covers a lot of ground. We go back to the pandemic, when Hayley jumped on Instagram Stories with almost no social media presence and said, essentially, "If you're a partner of a physician, come find me on Zoom." People came. And kept coming. For over three years, she ran weekly evening connect calls, and I was in those rooms. I watched her welcome strangers into safety in a way I have never quite seen replicated. We also talk about the truly unhinged thing we did together in the summer of 2020. Eight children between us. No budget. Two months. One virtual conference for physician spouses, the Better Together Project, that somehow drew over 150 attendees from Canada, the US, the UK, and Australia. We did not die. We are still proud of ourselves. But the conversation I keep coming back to is the one about mentorship. What it means to be just a little further down the road than someone else. Not to have figured it all out, not to perform certainty, but to turn around and say, "I see you. Here is what I know." That is what Hayley does. It is what I try to do. And it is exactly what so many physician spouses have never had. If you are still looking for your people, this episode is for you. And so is Hayley. What You'll Learn [00:00 - 03:00] The origin story of The Flipside Life and where the name actually came from [04:00 - 08:30] How the pandemic connect calls started and why 150+ people kept showing up [12:00 - 15:00] The Better Together Project: a virtual conference, two months, no budget, eight kids at home [16:00 - 20:00] Why mentorship is still missing for physician spouses, and what it actually looks like [23:00 - 27:00] What Hayley says to the woman who still hasn't found her people [28:00 - 30:00] The partner orientation program that's finally happening inside medical education Resources Mentioned The Flipside Life Hayley Harlock on Instagram The Flipside Life on Instagram Your Next Steps Download the Life After Survival Mode Guide Listen on Apple Podcasts Listen on Spotify

There is a comment I have been turning over in my mind for about ten years now. I heard it from a woman whose husband had chosen podiatry school over medical school, and the reason she gave has never fully left me. She said that decision was predicated on the fact that he loved his family too much. I have thought about that comment more times than I can count. Because the implication (the one she may not have even realised she was making) is that choosing a demanding career in medicine means loving your family less. And that is something I have never been able to agree with. Not because the hard parts aren't real. They are. But because I have watched my husband, a neurosurgeon, build something genuinely beautiful with our five children inside one of the most demanding specialties in medicine. And I think it is time to say that out loud. This week, Adrian is back. We talk about what fatherhood actually felt like from inside the training years: overwhelming, scary, uncertain, and deeply intentional. He agonized over choosing neurosurgery. He prayed about it. He watched the men ahead of him in the field and made a conscious decision about who he did not want to become. We talk about the kids, and what they said on the Father's Day episode that made him almost cry on the way to work. He talks about the small things he remembers building with them and the hotel dinner in Orlando where he looked around the table and thought, I have never been happier. And I talk about what I did not see during those years because I was too busy counting the hours and keeping my head above water to notice what he was quietly building beside me. There is a moment in this conversation where he says the thing I most needed someone to tell me when I was in the thick of it. He says the chances are really good. That a physician who has his priorities straight, who shows up when he is there, who talks to his kids and his wife, is going to be okay. That his family is going to be okay. I believe him. And I think you will too. What You'll Learn [00:00 - 01:00] The comment about podiatry school that stayed with Kendra for ten years, and why it matters [02:30 - 05:30] What Adrian was actually thinking when he chose neurosurgery — the agonising, the praying, and the mentor who made it feel possible [08:00 - 11:30] Why the kids remembered Adrian being home more than Kendra did, and what that difference in perspective reveals [12:00 - 13:30] What Adrian says he would do differently, and why it has nothing to do with the specialty he chose [14:00 - 15:30] Adrian's response to the idea that choosing a demanding career means choosing it above your family [22:00 - 23:30] What Adrian would say to the physician in the middle of residency right now who is wondering if his family is going to be okay Thank you for listening!

I have this photograph. My husband is lying on the couch in our little medical school house. Textbook open across his chest. Highlighter in hand. Our son, just small, completely out, asleep on him. No idea his dad was studying for an exam that would determine the rest of our lives. I've looked at that photograph more times than I can count. And for a long time, what I saw in it was exhaustion. Uncertainty. The quiet terror of having absolutely no idea how we were doing any of it. But lately I've been sitting with a different question. What did my kids see? That question is what this episode is built around. Five kids. Five conversations. One Father's Day tribute to my husband and, I hope, a gift to you. If you are in the middle of a hard season right now, doing more alone than ever felt fair, quietly wondering if your kids are okay, if they're missing him too much, if this is going to leave a mark… I made this episode for you. When I was in the thick of those years (medical school, residency, fellowship) I was convinced my children were experiencing what I was experiencing. That the absence was landing on them the way it was landing on me. That they were keeping score. They weren't. They were holding onto the mornings he was there, not counting the nights he missed. And I couldn't see that, because I was too busy surviving to look up. So if you are the one at home right now, carrying the invisible weight of everything, I want you to hear this: your children are watching their father become something remarkable. And they are going to remember it. You are not failing them by being in a hard season. And your partner, even with the brutal hours and the impossible schedule, may be showing up for your kids in ways you haven't had the bandwidth to fully see. Look up. There is more goodness in front of you than survival mode is letting you see. What You'll Learn (with Timestamps) [00:00 - 01:30] The photograph that started this episode — and the question that changed how Kendra sees it [03:00 - 07:30] Ethan, 21, on growing up inside medical training and the delayed reward of patience [08:00 - 14:00] Kate, 19, on bedtime books, the Disney cruise, and why absence felt normal when you don't know any different [15:00 - 19:00] Macy, 17, on races, souvenirs, and why the time he did show up always felt special [20:00 - 23:30] Sarah, 14, on what she didn't understand until she was 12 — and what she quietly noticed all along [24:00 - 28:30] Scarlett, 10, on visiting the hospital, the doctor's lounge, and why her dad would still be her favourite even if she had others to choose from [29:00 - 32:00] What five kids' answers revealed — and what Kendra wants every physician spouse in a hard season to know Your Next Steps Leave a review on Apple Podcasts Listen on Spotify Tag us in your photograph this week @SupportingPhysicianSpouses on Instagram

Twenty-eight weeks ago, I sat down in a dentist chair and said yes to something I had been quietly talking myself out of for years. This episode is the whole story and by the end of it, I think you're going to recognise something. Not about teeth. About that thing. The one that's been sitting in the background of your life for longer than you probably want to admit. A few years before that appointment, I was already in that world. Four of my kids were in braces, one right after the other, often overlapping. I sat in orthodontist waiting rooms more times than I can count, and somewhere in all of those visits, I actually looked into getting my own teeth sorted. I considered it. I met with the orthodontist. And then I set it back down. Not because it wasn't possible. Because it felt like too much. Too much money going in my direction when the kids needed theirs. Too much time. Too much me. That's the part I want to be honest about in this episode, because it matters more than the teeth. When I finally picked up that pamphlet and followed through, the only thing that had changed was this: I had finally given myself permission to just want what I wanted. Not because it was urgent. Not because it was medically necessary. Not because anyone else had even noticed the problem. Because I wanted it. And I decided that was enough. If something in this episode landed for you, I want to invite you to schedule a consultation at It Gets Better Now. It's just a conversation. No commitment, no pressure just an honest look at where you're starting and what the plan might look like from here. What You'll Learn: [00:00 - 03:00] The pamphlet moment and why picking it up the second time was completely different [03:00 - 07:00] The real reason she set it back down the first time (and why "it wasn't the right time" was only part of the story) [08:00 - 11:30] What the dentist analogy reveals about how coaching actually works [11:30 - 14:00] The stubborn tooth: what happens when the plan needs adjusting and nobody treats it as failure [14:00 - 16:30] Why "better than before" is not the same thing as what you actually came for [17:00 - 23:00] Why every woman she's worked with says the same thing at the end and what to do before you move on from this episode Your Next Steps Schedule a Consultation — just a conversation, no commitment Listen on Apple Podcasts Listen on Spotify