← You Are Not Broken
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- [00:04]
A
Welcome to the youe Are Not Broken podcast. I'm your host, Dr. Kelly Casperson, a board certified urologist, thought leader, and conversation starter on midlife living, hormones, and sexuality. Enjoy the show. So what do you do when everything you've done to be successful is starting to backfire in midlife? What do you do when you get to the top of the mountain and you're like, what else is there? Today we're gonna figure that out with Dr. Tiffany Moon, who's joining us today of her very newly published book, Joy Prescriptions. Welcome to the youe're Not Broken podcast. Thanks.
- [00:38]
B
It's so nice to be here with you.
- [00:40]
A
I'm so glad you wrote this. And I feel like joy is happening right now between you and Judith Joseph's books about joy and, like, really boiling it down to, like, what's the point of doing all of this? I feel like joy's having a moment. Is that too cliched?
- [00:55]
B
No, it's not cliche. And actually, I'm gonna go ahead and say that I think there's a cultural war on joy. We're writing these books about joy, but, like, I feel like as a whole, our country lacks joy. There are so many things that get in the way of us experiencing pure joy.
- [01:16]
A
Yes. I don't need you to explain what's happening now in the news. Like, people get it, but, like, why now? We've got five years out from the pandemic. The economy was going pretty good. It's a little rockier now. But, like, have you thought of, like, why is now joy being something People are like, yeah, yeah, we need to talk about this.
- [01:33]
B
I think the pervasiveness of social media keeps everyone in a cycle of compare and despair. It keeps you thinking that everyone is on vacation, celebrating a milestone in love, publishing a book, getting a promotion. And you're like, what the fuck am I doing wrong? You know, in my book, I wrote that happiness equals reality minus expectations, and everyone's expectations are so damn high for a multitude of reasons. And then reality doesn't measure up in your. Joy goes down. I mean, it's a simple math equation really. And the only part of that equation that you can really control is the expectations piece, because reality is going to be what it's going to be. You know, the country is in shambles. There was another mass shooting. It's like, oh, my God, you know what I mean? I don't even want to turn on the news anymore.
- [02:23]
A
Yeah. And then the brain, when it's stressed, at least, like our brains the analytic brains were like, if we can solve for everything, if we can control it, if we can have a plan, it helps us feel safe. But it literally is all consuming then and then. Like, that's not where joy lives.
- [02:39]
B
Yes, exactly. And I mean five, six, seven years ago, I was, quite frankly, very joyless. I was going through life on autopilot. I was working full time as an academic anesthesiologist, running clinical trials, head of resident recruitment, interviewing everyone, making our rank order list every February and hoping that I wasn't shattering any dreams. Had a resident OD on fentanyl die. Had to look his parents in the face and tell them that their son was trached and pegged and had no probability of practicing anesthesia. He went on hospice and ended up passing. And I had twin toddlers and they brought me a lot of joy, but also they didn't. I love my children, I love my husband, but I would come home after working 10, 12 hours in the operating room and was potty training my toddlers and teaching them that biting is not a form of communication that we tolerate in this household. And I was just like, what the fuck? What the fuck? Like, I have worked so hard my entire life. I sacri so much. I was 23 when I graduated from medical school. And I just thought that, like, when I got to the top of this mountain, there would be a pot of gold for me and like confetti and champagne and people like, you did it. You're amazing. You're our hero. And it wasn't like that.
- [03:59]
A
Yeah, it's just another Tuesday, right?
- [04:01]
B
I know. And then I just, I got resentful. I got angry. I was like, oh, I should have taken a semester off and studied abroad. I should have had a one night stand. I should have all these things that people talk about. Like I barely have any, like a life. College memories. Yes. Like actually, you know, making the connections and having moments of laughter and connection. But me, I was. My head was in the books all the time. How do you think I got to graduate from 23? Like, that didn't just happen. Like, you sacrificed so much and then you get to the top of the mountain, you look around and you're like this. It shit.
- [04:40]
A
Yeah. The time is now for doctors to become more real because it's killing us not to. And it's too bad that it had to come to that. Like, it's really bad. And your book helps explain it. People don't understand. Like, they just see you as this expert in the pre op area and like, everything that you sacrifice to be that expert in that moment is, Comes crashing down for a lot of people. You did a statistic in your book that 30% of female physicians leave full time medicine by six years. It's probably higher, but like, that's absolutely true.
- [05:17]
B
Some of those go part time, some of them leave medicine entirely. And you have to wonder, you know, to get to where we are and then go part time or quit altogether. Like, we are not broken. As the name of your podcast. The system is broken. They make it quite untenable for a woman to work full time who has children. I mean, you can do it, but it's gonna suck your soul.
- [05:41]
A
Yeah, I mean, it's this crazy paradox too, because it's like, med school costs the same no matter how long you're gonna be a doctor for. So you got $400,000 ballpark now to train to do this job that literally you can't have a family with the increased burden of work at home unless you are real clear upfront with your partner about, we gotta watch this because it's slippery slope towards societal norms of like, it costs the same and you don't want to. Tiffany, what would have happened if, when you were 19, people would be like, this is super hard for a woman. Like, we would have doubled down.
- [06:14]
B
Oh, for sure. I was going to do what I was going to do anyway, but I just wish that I had a little bit more clarity going into it.
- [06:22]
A
Yeah. And like, you want the actual system to get better for everybody. Men are suffering too. Like, the male physician suicides is insane. So it's like, you wanted to get better for everybody. You don't want to tell women not to do it. I think that was like how the 70s and the 80s and the 60s was like, tell women not to do this. And now we're like, well, women are doing it, but the system's so inhospitable to humanity. At some point you get enough self realization. I can speak for myself, but I want to know your journey too. You get enough self actualization and realization to be like, I don't choose that anymore.
- [06:57]
B
Yeah. I think for me that was somewhere in my mid to late 30s where I finally figured out that I am not the sum worth of my achievements. And when I finally believed that, then I allowed myself to not run at 60 miles per hour every damn day and to go part time. I used to think that part time was a death sentence in terms of academic achievement. And in many ways, perhaps it was because after I went part time, I Was not promoted. I was denied promotion, actually, because I was part time. Like, I actually have a paper that says that. That I could post online.
- [07:40]
A
You don't get the ladder anymore. The ladder's for these people to climb.
- [07:43]
B
Exactly. Yeah. So it's crazy. I just one day decided that I was worth more than just clocking into the operating room every day.
- [07:52]
A
I got to the point where, like, I was already kind of transitioning to the second part of my career, but I was like, two in the morning, scoping in irradiated prostate, difficult Foley, zero people helping me in the er. So the ER calls for my help. I show up at two in the morning, zero help. This guy's, like, desaturating. He's satisfied, sick. And it was like, this is not worth it any. Like, I have the skills to do it, but this part of my life is no longer worth it for me. You know, it's such a. It was such a dramatic thing. I'm like, oh, my God. I get to choose to not choose this anymore. Fantastic.
- [08:31]
B
Yeah.
- [08:32]
A
You took a burnout test. And I was reading that because I'm like, putting myself in your shoes the whole time, and I'm like, how did you not think that burnout test was bullshit?
- [08:42]
B
I mean, I did think it was bullshit. That's why I never took one. I never took one before. But then for whatever reason, it was like, you're like.
- [08:48]
A
I'm like, I like to take tests.
- [08:49]
B
I do like to take quizzes, you know, back when we were 16. And you take those Cosmo quizzes. Yeah. And I kind of was surprised by it because, I don't know. Burnout's such a buzzword these days, But I really used to believe that it was a cop out. I honestly used to think that if you said you were burned out, then that just means you weren't a hard enough worker or you sucked and you just couldn't cut it, and that was your excuse to not rise to the top, you know? Like, it's so weird how your mindset changes.
- [09:18]
A
Yes. Thank God for maturity and coaching. I mean, I think burnout, for a long time, that was the individual's problem that they had. Like, that was your genetic predisposition to burnout and blah, blah, blah. And now we're like, no, no, no. That's a systems problem. These are just the humans within a system that dehumanizes you and hurts you. I want to see data on the amount of female physicians with autoimmune diseases and infertility, actually, and infertility Yeah, I
- [09:49]
B
mean, I'm not gonna blame the siboflurane for my infertility issues that I had that I talk about in the book. But, like, just the cortisol levels. You know, I'm taking overnight trauma call, then doing a liver transplant. We do inhaled induction. Sometimes there's gas going everywhere. It's just. I don't have statistics on this, but I think the incidence of fertility is higher in women physicians than the general population.
- [10:14]
A
Interesting. And not just because they're older.
- [10:16]
B
Certainly that contributes. Right. Because we were, you know, in residency, whatever, and we delay childbearing because we were busy. But I think there's something else, too.
- [10:24]
A
Were you aware? Because, like, I'm more aware of it now. But I'm wondering with your journey, like, how long it actually took you to, like, be okay with not being busy. Because our busyness is a coping mechanism so that we don't actually have to do the work of, like, being alone with ourselves and, like, figuring out what you actually want. But, like, how long did it take you to actually be okay with not being busy? And do you still struggle with that?
- [10:48]
B
Oh, every day. I mean, how long? I was like, present moment. I mean, really? It started seeping into my brain maybe around the age of 35. And, you know, now I'm in my 40s, but I still struggle with it. Some days I'm like, oh, I need to do something. And then I'm like, wait a minute. No, I don't. And I also have two little girls looking at everything that I do and do as I say, not as I do, does not work. Your children see the behavior that you model and pick it up consciously or subconsciously. And I don't want my girls to grow up feeling that they have to be busy all the time or that they're equal to their achievements, you know? So I'm always praising my kids for being kind and curious and creative. When I was a young girl, I. If I brought home a 96 on a math test, the question from my parents would be like, what did you get wrong? What did you miss? Why did you only get a 96? Oh, my God, you missed that question. That's such an easy question. Let's do five pages of it so you never miss that question again. My kids come home now with a 96, which they don't even get grades half the time. I try to praise the effort and, oh, I saw you studying last night doing your flashcards. I'm so proud of you, you know, but sometimes I'm still like, oh, you got 100.
- [11:58]
A
Great job.
- [11:58]
B
And I'm like, oh, I'm not supposed to praise the hundred.
- [12:00]
A
Shit.
- [12:00]
B
You know?
- [12:01]
A
But it's so, like, subconscious, right, that you're doing that. It's hard to watch it in the moment. My daughter brought home a 96 yesterday. And I was like, okay, great. She actually brought home a math test and she didn't do or. I wasn't a test, it was a worksheet. And she didn't do the second half. And we're like, why didn't she do the second half? And she's like, it was too hard. And we're like, okay, well, that's not really something we do in our family. Like, we try to figure stuff out, we ask for help. How can we work through it? Right? So my husband has a master's in physics from Stanford. The dude can math. And he's like, this is an unsolvable math problem in third grade. He's like, here, you try it. And I'm like, why are you giving this to me? I didn't go to Stanford for physics, right? And so I type it into chat GTP Evening.
- [12:45]
B
Buyer's remorse. Buy a new car.
- [12:48]
A
I'll be moving in.
- [12:50]
B
Let's get started.
- [12:51]
A
Sorry, I think there's been a mistake. I bought it from Carvana. You what?
- [12:55]
B
Yeah, great price.
- [12:56]
A
I even have seven days to love it or return it.
- [12:58]
B
So there's no.
- [12:59]
A
No, no buyer's REM remorse. More like buyers rejoice.
- [13:04]
B
I guess I'll let myself out. Congratulations.
- [13:07]
A
I mean it. Buyers rejoice. Buy your car today. On Carvana.
- [13:11]
B
Limitations and exclusions may apply.
- [13:12]
A
See our 7 day return policy@carvana.com. it's like a logic thing and all the blah. So I type it into chat GTP and finally get the problem right in Chat gp and chat GDP is like, this is an unsolvable math problem.
- [13:22]
B
And they're giving that to third graders. So was it supposed to be unsolved?
- [13:26]
A
Right.
- [13:26]
B
Exactly.
- [13:27]
A
I'm like. I'm like, are you with them? Like, is this. Is this like a psychological test? Right? So I emailed it to. And I'm like, just wondering. Seems to be unsolvable. Was that your intention? And she's like, oh, it was a mistake. And we like.
- [13:40]
B
You're like. Because you've upset a lot of children and their parents now.
- [13:45]
A
You know, we were gonna give our kid a hard time for, like, saying something was too hard and not working on it, right? And so I'm telling somebody this whole story and and he was very kind. And he's like, kelly, that was a nice example of good parenting, of like, you were engaged, you were trying to help out, you followed up with the teacher, you were just like hard on her for not finishing her math. Like, you're actually engaged. And I was like, yeah, but they're so. They're sending unsolvable math problems home. Like, yeah, accidentally. It was very funny to be like, okay, how are the parents gonna process this one?
- [14:15]
B
I wonder if other parents emailed too or if you were the only one.
- [14:19]
A
I know, I know. I'm super curious.
- [14:21]
B
I try not to be that parent. Always yelling like there was a mistake in the homework.
- [14:25]
A
Anybody else's hands on as us or anybody else type this into Chat GTP or just me.
- [14:30]
B
Okay. Are we worried that the children are using ChatGPT to solve things and like write emails, communicate? Because I'm already worried. I have 21 year old stepchildren and my 10 year old twins. I'm kind of worried because they use chat GBT for everything. And I'm like, what about your brain?
- [14:48]
A
Right? The emails that come from me that I filtered through Chat GDP are a better version of me, that's for sure. I'm a very short sentence declarative surgeon in my emails and people are like, whoa, whoa, whoa. And I'm like, I don't have time.
- [15:03]
B
I would prefer you email me like that. I hate how verbose chatgpt is. And I always tell mine because I've trained my GPT now and I call it like Tiffany's Voice. That's like the name of my custom GPT that I made. I fed it the PDF of my book and now it writes like me and it's succinct and it's like kind of funny. We'll throw in like a pun in there or something ironic. So I mean, I'm guilty of using AI as much as the next person, but I got to be 40 years old before, before I used it. And I'm just worried that these 20 something year olds that are using it are not gonna have developed the skills that you and I developed because they have this crutch.
- [15:45]
A
I mean, Gen X. Yeah, we're really unique because we were like, we toggled on, like we lived off and then we toggled on. That's a very unique generation because our kids and the 20 year olds, like, they're just on. They just have the ChatGPT to write the papers and I do not have answers to everything except for I saw Bill Gates. A quote from Bill Gates last week, and he's like, this is going to replace doctors, it's going to replace teachers, it's going to replace, like, it's going to replace all these things. And I'm like, and the relationships will become even more precious, and doctors who know how to communicate with people are going to become more precious. And it's like, it's going to be a great tool because doctors don't know everything and teachers don't know everything. But still, like, podcasts will not go away. People love hearing people talk to each other. They're like, we love stories that cannot be replaced. But, like, rote memorization in med school, what's the point?
- [16:38]
B
Yeah, and that's kind of how. I mean, in our era, being a good student was in large part memorizing and regurgitating it. I tell my children, my stepchildren and my biological children, I'm like, you need to develop skills that ChatGPT can't do, or else you're not going to have a job in the near future.
- [16:56]
A
Yeah, totally. Because it's like, even if school stays the way it is, which is rote memorization, the existential crisis of doing that, understanding all the answers are right here in my phone at some point, it just doesn't. The logic doesn't make sense. But, you know, the skills that doctors need and don't have, like, how to communicate, how to listen, how to problem solve, how to take care of ourselves so we can actually stay in a career longer if we want to. There's a lot of skills we don't have that. I'm like, maybe we could do some of those instead of. Instead of memorizing. Like, dude, have you ever used the Krebs cycle?
- [17:31]
B
I never. I mean, organic chemistry, like, even physics. I mean, yeah, Poissois law. We can talk about linear flow, laminar flow versus turbulent airflow when I'm dealing with critically genotic airways. But, like, I didn't need to do that.
- [17:46]
A
No, I know it's. It's going to be very interesting. And I think, like, for the cost of med school now, like, $400,000, Bill
- [17:53]
B
Gates, his daughter go to one of the New York City med schools. I forgot. So why is he saying, like, oh, it's going to take over and the doctors, but your daughter's a doctor. I don't know.
- [18:03]
A
Anyway, I know it's going to be, like, leading teams. And, you know, I've got a guy I know who's, like, building huge data centers in Texas to hand to be able to process and handle all of this. And he's like, you still need people who know how the sausage is made. Not everybody needs to know how the sausage is made. And they just have magic for everybody else. It's just magic, right?
- [18:21]
B
Like when the Internet was born. It's just magic.
- [18:23]
A
Yeah, it's just totally magic. Learning how to say no.
- [18:27]
B
Still doing it.
- [18:29]
A
Hard, hard. Super hard.
- [18:30]
B
I just turned down a speaking engagement because it was tight and they wanted me to try.
- [18:34]
A
I turned down your speaking engagement.
- [18:36]
B
Like, I know. I'm like, okay, this is me. I'm like, literally coaching women in my masterclass to like, say no, prioritize yourself, all this stuff. And then I ask you to speak at lead her summit and you're like, no. And I'm like, no, Say no to ug other people, not me.
- [18:55]
A
I know it's crazy. And like, but once you like, I am not good at saying no. But once you, like, get at least a little bit better at it, you're like, no, no, no, I'm.
- [19:04]
B
I'm not as good. I think you're like, this level of saying no, and I'm still down here where I'm like, saying no and I'm like, but, you know, and trying to still manage people, the pain of my husband.
- [19:16]
A
It's hard to be a single parent. And for me to leave is really a stress on my family. And so, like, I'd like to say it's because I have skills at boundaries and saying no, but, like, it's actually very painful for my family for me to be gone. And so for me, I'm like, that's such a real thing right now that I use that a lot of like, is it worth upsetting the apple cart?
- [19:38]
B
Right. It's not. And that was when I went part time at work is when I came to the realization that I was giving the best parts of myself away to people who barely gave a shit about me. And I was bringing home the shell of the person that I wanted to be for my husband and for my children. I would come home after a long shift. I'm tired. I don't want to run around outside and play. I want to pour myself a glass of wine. Because it's 6pm and your tolerance for
- [20:08]
A
stress is like, so gone.
- [20:09]
B
I looked at the way I was living my life and I was like, what am I doing? You know, I wake up at six o'. Clock. I don't even see my children in the morning. My husband wakes them up, you know, gets them Dressed for kindergarten, first grade, whatever. And I was just like, I never went any of the things at their school. I never chaperoned a field trip. I never went to the breakfast with mom on Fridays because guess what? I was in the or. And the OR is very inflexible. Sometimes I'm like, man, I should have been a dermatologist, because then I could just not take clinic on Fridays. You know what I mean? Like, you have a little bit more flexibility in your schedule. But I just loved anesthesia so much. I still think it's the coolest thing to, like, put people to sleep and then wake them back up. It's like magic. You know what I mean? People are like, what are you doing back there? I'm like, don't worry about it. Mind your business. It offered no flexibility possibility in terms of my life, and it was making me miserable. And that's when I cut back.
- [21:00]
A
Yeah, totally. I mean, to me, I'm like, urology is the best. I wouldn't have done anything else. I love all of it. But it. I mean, it takes so much from you. And then you realize, like, let's talk about you and me and doctors doing unconventional things. 2025, more normal than ever for doctors to be stepping outside the box. But even, like, my podcast is five years old, and five years, I was, like, looking for somebody to give me permission who's going to tell me I know enough that I can start a podcast. Like, I'm going to get kicked out of urology, probably for. And now I'm like, everybody's starting podcasts. But it's like, it was even five years ago, it was like, dude, that's not professional.
- [21:40]
B
Oh, okay, I have to step in now. I freaking hate it when people don't like what a woman is doing and they label her as unprofessional. I can't stand it. I have been the victim of it several times. When I started posting on social media, I was called into my supervisor's office, and the exact word he used was unprofessional. And I said, that's your opinion. You know what I mean? I'm not, like, doing anything illegal, like, crazy, you know, I'm posting fashion purses, my skincare routine.
- [22:16]
A
Like, you're punished for being creative.
- [22:18]
B
Yes. Punished for being creative. Punished for doing anything outside of the lane of medicine.
- [22:23]
A
Punished for not keeping your mouth shut.
- [22:25]
B
Yes. How dare you not stay in your lane.
- [22:28]
A
No, it's a silencing, for sure. I mean, professionalism is so vague, and
- [22:33]
B
they willed it against Women, Honestly.
- [22:36]
A
Oh, yeah. You know what a dude has to do in order to be labeled unprofessional?
- [22:41]
B
This guy has his beer belly out, is, you know, seeing how fast he can drink a beer and, you know, yelling things that are not nice because his sports team is losing. And that's fine. That's fine. That's sportsmanship. Whatever. They're just being bros, okay? But me posting all the outfits I wore is unprofessional. I can't. I can't.
- [23:03]
A
Yeah, it's. I mean, once you call it. Once you see it, you can't unsee it for. This was vascular surgery, man. Like five years the.
- [23:10]
B
Oh, my God. Bikini gate, Ned. Bikini med. Bikini med. Bikini girl. You're taking me way back.
- [23:15]
A
Yeah. What was that? It was pre pandemic. So for people who don't know a vascular surgeon, I think this is what it was.
- [23:23]
B
It was like a medical student and a resident. This was their research project. You guys been putting research in quotes right now? Yeah.
- [23:29]
A
So they had, like, people who were doctors who had published images of them at the beach wearing beach wear were labeled as. They did a research project to see if that was unprofessional. And they said, yes, a woman wearing a bikini at a beach who happened to. Happens to be a doctor, that is unprofessional. And they basically. I think they got it retracted from the journal.
- [23:49]
B
Yes, it was retracted because there was a whole litany of backlash when that got published as a poster and then in a vascular surgery, peer reviewed. And me, I mean, I have over 50 peer reviewed publications, blah, blah, blah, whatever. But I'm like, okay, how did this get through the peer review process? Because it's not like a blog where you open up a website and you, like, send it into the atmosphere. Like. Like peer review. I have some statistician up my ass about, like, a Whitman pee test, and he's like, questioning me, and I'm calling in a statistician. I'm like, I don't know, make it seem statistically significant. I don't know. You know, I mean, up my ass about just minutiae of my research paper I'm trying to get published. But this thing where a bunch of med students in Residents, like, made fake social media accounts to troll women on social media. I was like, this is what? The fact that it got published goes to speak volumes about what the men. I'm presuming the peer reviewers were men, thought that this was academically worthy literature that needed to be published. That speaks volumes about, you know, that, and, yes, it was subsequently retracted. And so the whole, like, hashtag medbikini thing was going on for several years. And I chimed in on it, like, anytime anyone had anything to say, I'd be like, oh, smells like med bikini all over again.
- [25:10]
A
Yeah, totally. In reading your book, you're telling about, like, the grind of what it takes to basically compete academically at the level we have to, to get to where we are and going back to, like, you know, us with infertility and inflammatory diseases. But it's like, you can only do this in your 20s because the body's still so resilient. But it's like the crappy food, the massive stress, the lack of sleep, deep. It's grinding on the bodies. And I think there is more and more data on doctors aren't the healthiest people at this point because we just. We don't recover. There's no recovery to any of this.
- [25:46]
B
Yeah, it's like all systole, no diastole, you know? And what does that result in? Heart failure.
- [25:52]
A
Totally. I'm completely obsessed with heart rate variability right now.
- [25:56]
B
Me too. And mine is so low, I think I'm gonna die. Kelly. I'm not even kidding you, Kelly. This. This is some wild shit right now.
- [26:04]
A
What do you got? You got the whoop? What are you doing?
- [26:06]
B
I have a.
- [26:07]
A
You have the OURA ring? Okay, I got the whoop. Good. Let's talk about this.
- [26:10]
B
Okay. I was one of the earliest adopters of OURA ring. I got mine in 2020, and I was part of a multicenter trial in which healthcare workers wore the OURA ring to see if the ring would be able to predict you being sick from COVID before you felt Sick. It's the TempRredict study. The main PI was from UCSF. I was the PI here at Miami Institution. And we found that it can predict you being sick, like, an average of 24 hours before you feel sick.
- [26:47]
A
That's incredible. It's incredible. It's so, like. It's so amazing. We've never been able to do that before.
- [26:52]
B
It's so cool.
- [26:53]
A
Okay, so what does it tell you about your heart rate variability?
- [26:56]
B
My shit is shaming me. Look at this. My sleep score was a 45.
- [27:00]
A
Oh, that's not. We got to get that up. I speak whoop, though, so I don't want to interpret my. I don't want to order or ring through.
- [27:07]
B
My heart rate variability is in the team, and I know there's, like, in. It's not like, oh, you're 30, I'm 16. So you're better than me. It's like trend in your individual variability. But I still think I'm gonna die.
- [27:19]
A
We gotta get you sleeping. Are you on progesterone?
- [27:22]
B
No, I need to get on progesterone. I need some testosterone cream. My libido is in the trash can. But also, sleeping three and a half hours doesn't make me horny.
- [27:31]
A
Yeah, yeah, yeah, yeah, yeah, dude. So I was talking to the Woo people and because they. People track their meds and I'm like, do this on and off progesterone. Because they didn't know that progesterone helps sleep so much. And I'm like, dude, you can watch the REM sleep measure what progesterone's doing. That would be amazing data. So they were looking into it and I was like, give one to me. I'll do two weeks on, two weeks off of progesterone. And then I got to the. I'm like, I don't want to do two weeks off progesterone. For data.
- [27:57]
B
Okay. I'm definitely like perimenopausal. But I've always been irregular. Weird cycles, infertility. I have pcos. People don't think I do. Somebody I told somebody that had pcos and they were like, no, you don't. And I was like, oh, excuse me. I didn't know that you had an MD and had access to my labs. And yeah, they're like, well, you're not fat or hairy.
- [28:21]
A
Yeah, thank you for noticing. But I mean, to clarify for people listening, that's the stereotype, but that's not everybody. You have friends in your town who can give, who can sue for harm.
- [28:30]
B
Oh, for sure. This is so bad. I wrote an entire book about, you know, finding joy and connection and laughter. But, like, right now, because of the book launch, like, I'm not doing the things that I said, but it's just because right now, you know, but like, overall, I sleep well, I eat well, I exercise. But, like, for these two weeks, maybe the sleep score goes down a little. That's the truth of it. You know, I'm not going to sit over here and pretend like I get eight hours of sleep every night and wake up and someone came over to my house this morning and did my whole makeup. I was like, checking emails. It's the birthing. That's what I'm telling people. They're like, what's it like to launch a book? I'm like, it's birthing a baby. That's what it's like.
- [29:06]
A
Yeah. And you got to be okay talking about your baby a lot.
- [29:09]
B
Yeah. And you hope people like your baby and don't talk shit about your reading.
- [29:13]
A
When did you get to the point in this journey where you started trusting yourself?
- [29:18]
B
Only recently.
- [29:19]
A
I think it's a superpower, right? It is.
- [29:22]
B
And I still question myself. Like, I hired this new assistant, and I. I'm like, oh, I shouldn't have. Like, I knew it all my life. Like, I had a string of failed relationships. I just never knew what I didn't trust. My own intuition. I always, like, was like, oh, he's gotta be a doctor, and he. He needs to be Chinese. Know. And I just. And then I ended up marrying my husband, who's not a doctor and not Chinese. Like, I don't know. I wouldn't trust my own intuition because I always thought that, like, my parents knew what was best for me or I didn't ever listen to myself. I don't. You know, you said. When was your question? I think just recently. Two, three years ago.
- [30:01]
A
Yeah. No means an expert. I'm learning more and more. But I'm like, she knows the you of you knows. We just spend so much time. I'm talking over her, Right.
- [30:12]
B
Or gaslighting her, and then she questions herself.
- [30:15]
A
Yeah. Women are socialized that other people are the expert. And so we defer a lot. Or we spend a ton of time being like, what are you on? What are you doing? What? What's she doing? Blah, blah. And it's like, dude, it's so much wasted time. Like, gather some information. But that shouldn't be, like, the life plan of seeing what other people are doing, because that's what you should do.
- [30:36]
B
Yeah.
- [30:37]
A
Yeah. I love it. So I was thinking, you were talking about getting therapy and figuring it out. And I'm a huge proponent of both coaching and therapy. It changes your life for the better. But it's like you had two hits against accepting therapy. I think maybe pro, maybe more. But, like, what does the Chinese culture think about therapy?
- [30:54]
B
Oh, when I told my mom that I was in therapy, she was like, what? She was like, you're paying someone to talk to you. She was like, you pay me. I talk to you. I was like.
- [31:04]
A
I was like, no, no, because I have to talk about you.
- [31:08]
B
Yes. And then, you know, anytime, anything with my mom, she's like, how much you pay? I'm like, I bought her a sweater for Christmas. She opens it out of the box, she lifts it up. It's cashmere. She's like, hey, how much you pay? That's like, literally the first question out of her mouth for anything. Okay. My therapist doesn't accept insurance, so I'm paying her, like, 200 something. And I told my mom the truth. She was bewildered, bewildered that I was paying someone that amount of money for 50 minutes to talk to them. And I was like, it's changed my life. I've been able to understand the complicated feelings I had. My parents left me in China when I was three years old, and I didn't come to America till I was six. And I used to always, like, have abandonment issues, but I didn't know that they were called abandonment issues. And then my first boyfriend, I'd always, like, worry if he went out with his friends. And I just like, don't leave me. Don't leave me. And I'd hold so tightly onto people that I probably ended up driving them away. And I just could never understand, like, why I'm so scared that everyone's gonna, like, leave me all of a sudden. And then my therapist was like, do you think it has anything to do with your parents leaving you when you were three? And I was like, oh, my God.
- [32:19]
A
You're like, oh, there's the elephant in the room.
- [32:21]
B
I mean, why couldn't I figure that shit out on my own before I wasted, like, $10,000? I don't know. Know. I don't know. But I did. It was worth it, though.
- [32:30]
A
Like, between Chinese culture and then doctoring.
- [32:33]
B
Yes.
- [32:33]
A
We're like. We doctors literally have the threat of being told they're unprofessional or that you're mentally incompetent or what? You know, like, doctors have a stigma against therapy.
- [32:43]
B
Oh, for sure. And then if you've ever received any mental health treatment or whatever, when you get licensed, there's like, a sort of vague question that you're like, should I answer yes or no to this? Like, I had depression. I took an ssri. Like, do I answer yes to this? It's. And that's for your medical licensing. Like, it's weird, you know? Like, why are you asking that?
- [33:00]
A
Super messed up.
- [33:01]
B
Yeah, we don't need to be asking people that. Like, are you capable of practicing medicine? Do you have any activities that will preclude you from practicing? What? That's the question. But, like, have you ever received treatment for mental health? Like, get rid of that question. That's ridiculous.
- [33:14]
A
Totally get rid of it. It's like, everybody should be working on their mental health, and if you aren't seeking Help.
- [33:19]
B
That's a problem if you answer no.
- [33:23]
A
Let's say, let's flip it calm completely. I loved the way you spun Real Housewives of Dallas. And like, you don't know the how it benefited you until you've gone through it. And then you're like, that was kind of a transition for me for getting my life the way I want to live my life. But, like, you can't know that going into it like this will straighten me out.
- [33:45]
B
No, I thought that I would go on and make all these new girlfriends and get invited to, like, fashion shows and cool parties. This was like, my rebellion of having been a good girl my whole. I did not know that I would become a spokesperson for anti aapi hate. You know, I did not think that I would be explaining racism to my castmates or what anti racism is. I got made fun of for setting an alarm at 9:30pm on days that I had to be in the OR the next day. And they all made so much fun of me. They'd be like, oh, I hear the sound again. Tiffany's gotta go. You know, like, it just. Housewives was wild. Wild. It was. It was such a wild experience.
- [34:26]
A
It's gotta be so crazy that you understand it's not real, but it's real. You're living the life, so it is real.
- [34:33]
B
People are like, that shit's scripted, right? And I'm like, no, it's not. It's not scripted. Certainly they poke and prod you, and the producers are whispering in your ear, but it is not scripted. That's us being actually angry. But, you know, you poke the bear a lot and then you wait for it to have a reaction, and that's good for ratings.
- [34:51]
A
And you feel. Feed the bear alcohol.
- [34:53]
B
Lots of alcohol. My liver enzymes while I was taping that show were definitely high. I did not have them checked. Ast, alt, ggt. I don't even know it was bad. I mean, I was drinking almost every day, and on some days, three to four drinks on a weekend. Because on a weekend, we're filming for like eight hours. So you have a mimosa, you know, and then you have a whatever.
- [35:20]
A
And there's a lot of boredom. Like, there's a lot of downtime.
- [35:22]
B
There's so much boredom. What people do not understand about filming is that it takes like four hours to film something that's gonna show on TV for 10 minutes. Like a dinner party. They stagger the arrivals. I never knew this. Cause I was not a watcher of the show before I became a cast. Member. But they always stagger the arrivals. So it takes almost an hour and a half to two hours to get everyone into the venue. And then they don't ever feed. Feed you? They do not feed you. I did not know that. The one friend that I had, she didn't even warn me. I was like, you could have warned me. I was like, when is the food gonna come? And she's like, oh, it's probably not. And I'm like, but it's a dinner party. And the call time was 6pm and it's 8. And like, I worked all day and I'm starving. And she was like, oh, yeah, you have to eat before you come to these parties. I was like, what the hell? I eat before I come to a dinner party. It was wild. Girl. Housewives is so wild. I have so much tea that didn't even make it into the book.
- [36:17]
A
Oh, sure, sure.
- [36:18]
B
Because we had to pass it through legal. They nixed like, half my story.
- [36:22]
A
Did they?
- [36:23]
B
Yeah, we had to condense the Real Housewives chapter into. I couldn't call anyone out by name, which I didn't really. And then I stated some things that they needed me to soften and, you know, we didn't want any troubles or whatever. And what my legal counsel basically said is, no one can argue with how you felt about something. Something. Somebody did something. It made you feel this way. Period. End of sentence. Not arguable. Write that. And I was like, oh, okay, okay. I. I'm picking up what you're putting down. I got it, I got it, I got it. So then I had to massage that whole chapter eight.
- [37:01]
A
I love it. My other, like, favorite thing that I feel like I bonded with you in the book is stand up comedy. Because let's talk about what's not professional for doctors to do. But dude, we got content for days.
- [37:14]
B
Oh, yeah. I got called unprofessional because I did a bit about all the things I've extracted from people's rectums where they accidentally slipped and fell.
- [37:26]
A
Dude, so funny.
- [37:28]
B
And I was called unprofessional for doing that bit. And I said, you've gotta be shitting me. It's literally a joke.
- [37:34]
A
It's literally standup comedy. Understand the genre?
- [37:37]
B
Genre? Yeah. Like, we can't even. This is why we can't have nice things, you know, Like, Karen's always gonna ruin it for us.
- [37:46]
A
I did. I took my first out of comedy class. And they're like, kelly, you're a physician and you're a sex med doctor. You have Content for days. They're like. The problem with most comedians is, like, sure, they're funny, but they've never lived a life. They got no content. They're like, dude, between your culture and, like, the rigorous upbringing and then doctoring content for days.
- [38:08]
B
Yeah. Like, when is your Netflix special coming out?
- [38:10]
A
I know. Well, that's the. I'm manifesting a Netflix special.
- [38:13]
B
I'm manifesting it. I want to see more of you. Because when I. I didn't learn of you, I want to say, till, like, last year, I think I was talking about something, and somebody was like, oh, you need to check out Kelly Casperson. I was like, who is that? And then they sent me your Instagram, and I was like, I fucks with her. I like her. You know, like, certain people, like, I just saw your page, and I was like, I immediately want to be friends with this woman. Like, I get her. I just feel like. Like we're kind of the same, but different.
- [38:40]
A
Yeah, we're living, like, parallel lives. Different, but very parallel. And I think when you see somebody who is very comfortable with who they are, it's a very attractive thing to be. Like, I want to be around kind of that person who's got it figured out and understands what they're on earth for. And, like, there's a clarity there that's just like, let's hang out. And I see that with you. It's like, dude, this woman knows what she wants. She knows what she doesn't want. She's driven by herself at this point. And, like, I think your book is such a beautiful example of how people might look. Like, this is a work in progress. There's always work to do, but it's like, you know, the struggles are real. And I think some people assume, like, oh, Tiffany, she's had it so easy. Like, she's never struggled. The struggle is real. Even though people might look like they have it all together.
- [39:33]
B
Yeah. And that's partially my fault. I get it. You look at the Instagram feed, it's like, you know, my best hits. I definitely don't post when I look disheveled and crazy and I'm having a bad day. Like, I post when somebody came to my house this morning and beat my face with a lot of makeup on. So I get it, you know, But I. I do want people to know that, like, it's. It's not as it all appears. I struggle just like everyone else. I have days where my sleep score is 45, and I'm hustling and, you know, trying to do all the things. So part of the book is I wanted to get real with people and get beyond what I could communicate in, like, a 60 second TikTok or reel.
- [40:09]
A
Yeah, I love it. I think this. I think this book is a gift to your daughters, whether you intended that or not. I have daughters, too. They might not appreciate this book for a while, but, like, at some point, it's. So here I am. This is me. This is who I like. It's so beautiful. I can't wait for them to appreciate one of them.
- [40:30]
B
Read some. She kind of asked if she could read it, but I didn't actually think she would. And then, you know, I'm doing stuff around the house, and she comes up to me, she goes, mommy, what's infertility? And I was like, where'd you hear that word? I was like, I'm gonna kill somebody. I told you she shouldn't let her have the iPad. You know, I'm looking at my husband, like, giving him the stink eye. And she's like, I read it in your book. And I was like, what? Cause I had this advanced reader copy laying around for months that I was, like, making content with. And she said like, mommy, can I read your book? And I was like, oh, sure, honey. Like, I didn't think of it. And then I was like, okay, don't read the book anymore.
- [41:07]
A
That's awesome.
- [41:08]
B
But they're so sweet, dude.
- [41:09]
A
They're so like, my kids. Oh, this is a while ago now. They're like, how do you make a podcast go around the world? Oh, yeah. And I was like, okay, because they don't watch me podcast. They don't. And they don't know how big my podcast is, but they're like, how do you make a podcast go around the world? And I'm like, okay, how old are your girls? They are 7 and 9 with insolvable math problems.
- [41:31]
B
I know, I know. Your school system.
- [41:34]
A
Very good school. They're making sure the parents are paying attention.
- [41:37]
B
Mine are, like, learning in the capital of each state. So I'm getting quizzed at the dinner table, like, do you know what the capital of Tennessee is? I'm like, I sure don't, baby.
- [41:46]
A
I remember third grade learning that in third grade. So, like, now that they're doing it again, I'm like, it's taking me back to be like, it's like the Krebs cycle. Like, do you ever use the capital of Montpelier in Vermont? Do you ever use that?
- [42:01]
B
No. And. And I can't tell you what the distal convoluted tubule does. Like, the kidneys. They work when they work. They make pee when they don't. Shit's bad. I don't know how the Nephron works. I don't.
- [42:13]
A
Does anybody?
- [42:14]
B
Well, the nephrologists do. The nephrologist. The nephrologists are doing salt balancing equations and talking about dialysate, and I'm just like, okay, whatever. Is the patient going to be wet or dry? That's all I need to know for my anesthetic. Exactly.
- [42:28]
A
Do you need a Foley for this renal obstruction or do you not need a Foley for this urine or.
- [42:31]
B
No, they're anuric. Okay, cool. Got it. I won't give too much fluids. Cool.
- [42:34]
A
Is this post renal or pre renal? It's probably pre renal. That's. I, like, this is what the urologist needs to know. Renal, pre renal or post renal?
- [42:41]
B
Yes.
- [42:41]
A
That's all we need to know.
- [42:42]
B
Yeah. So.
- [42:43]
A
And if it's pre renal, don't call me we.
- [42:45]
B
I. I would love to work in the OR with you. I just think we would be such a hoot. Could the world handle it?
- [42:51]
A
We would basically solve all the problems of the world and listen to some really good music. I have playlists.
- [42:58]
B
Yes, I have playlists too.
- [42:59]
A
Yeah, it's very important.
- [43:00]
B
Depending on the surgeon. Sometimes we have like 90s hip hop and R and B. Sometimes we do. One of the spine surgeons I worked with loves Taylor Swift. Like, we just tay tay all day. And then one of the guys likes heavy metal. It's the only room. Bariatric surgeon. I'm like, oh, Then I have to listen to heavy metal. I'm like, my back hurts, my brain, my ears are bleeding. I got a to go.
- [43:19]
A
It's rough. You should see what your heart rate variability does on those days. That cannot be good for you.
- [43:24]
B
Does your whoop tell you how stressed you are throughout the day?
- [43:28]
A
Yes. Which is amazing.
- [43:30]
B
Like, that's not helpful. Like, to tell me that I'm stressed psychologically.
- [43:34]
A
I was wearing a continuous glucose monitor and it spiked during, like, a challenging part of a surgery. And I was like, oh. It knew when the Foley wasn't going in. Okay. So that was. That was super insightful.
- [43:48]
B
Yeah. I wore one too from levels for like three months and I'd like, eat an apple and have a huge spike and I'd be like, shit. I thought this was good for me. You know, white rice for me is
- [43:57]
A
like a Snickers bar. Unfortunately, I, like, had sushi. I'm like, I can't have sushi now. I just have to have the sashimi, and that's it.
- [44:03]
B
Yeah, I know. I learned a lot. I love all this, like, biohacking stuff. You know what I mean? I mean, it's science, and we didn't learn any of that stuff in medical school now, but I joined these sorts of conferences, and, you know, I read Peter Atiya's Outlive the whole encyclopedia of it. Because I want to be, like, 100. I want to be cranky, old Asian grandmother, great grandmother, bossing my kids around, telling them what to do. Like, I can't wait.
- [44:33]
A
And then you'll say things like, before
- [44:34]
B
the Internet, we used to actually memorize things. I got an iPhone My fourth year of medical school. That was my first iPhone ever. Like, I distinctly remember it because before then, I had a pink Motorola RAZR flip phone. It was hot pink.
- [44:49]
A
I had a Palm Pilot.
- [44:51]
B
Oh, my God.
- [44:52]
A
With the stylist, because that was required for medical school.
- [44:56]
B
Oh, my God. Okay, this is. This is it. Did you have a TI83 graphing calculator?
- [45:01]
A
Absolutely.
- [45:02]
B
That shit was $100. My parents.
- [45:04]
A
No, it was like, $120.
- [45:06]
B
I came home and told my mom that we. I had to have this piece of technology for math class, and she was like, absolutely not. That shit's $100.
- [45:15]
A
Can't you figure out a sign and a cosine in your brain?
- [45:18]
B
And I'm like. But it gr. Like, I don't give a shit. Like, use your babysitting money. I'm like, I got to use my babysitting money to buy this TI83 calculator. Like, I was hoping to get lipstick and eyeliner with my babysitting money. This life is so unfair.
- [45:32]
A
Yeah. This was not part of the budget. This was your budget plan, dude. At your conference. Let's do stand up. Have you done stand up at your conference yet?
- [45:40]
B
I would shit my pants.
- [45:42]
A
That's what we need to do. Tell people about your conference. What's happening?
- [45:45]
B
It's called Lead Her Summit. The first time we ever did it was last year. This year, we're doing it again in November 7th through 9th in Dallas, because that's where I live and it's centrally located. So the west people coast come and the east coast people will come. We have amazing speakers. I target it for not just women physicians, because the things that we're talking about are, like, building your brand. Betsy Grunch came. Sonia Ong came. Negotiation, how to market yourself. Ali Nowitzki talked about nutrition Fitness. It's for all women, not just physician women. And for the physician women, I would say it's probably those that are doing something else outside of just practicing clinical medicine. You know what I mean?
- [46:28]
A
It's like such a physician overachiever thing to be like, oh, the people who just do medicine.
- [46:33]
B
Oh, like you just do medicine. Like, you don't have a book, you don't have a podcast. Yeah. You don't have your own practice and are running. Yeah, we do it to ourselves. Crazy. It's. We do. It's all self inflicted trauma, I want you to know. And it's so fun. Last year we had almost 200 people in the room. This year I'm aiming for 300, which would be the entire. And it's a, it's a fun conference. I mean, I don't want to toot my own horn, but it's not like a basic boring conference. Like, it's lively. There were people networking. And now some of the people that came to the conference are now like besties and they've gone to visit each other and they talk and people are like, how did you guys meet each other? And like, oh, we sat next to each other at lead her summit. And I'm like, oh, I'm like a matchmaker, but for like adult female friendships.
- [47:17]
A
I feel like I need to be Betsy Grunch's friends, though.
- [47:19]
B
Do you not know her?
- [47:20]
A
No, I, I like on, on the Internet, I'm always kind of like, she needs to know that I'm here willing to be her friend. You know, like, you decide who is going to be your friend.
- [47:28]
B
I decided you were going to be my friend.
- [47:30]
A
Yeah.
- [47:30]
B
And then I reached out and I was like, hey, that's. How can we be friends?
- [47:34]
A
Then I said, yeah, of course. You're like, sure, yeah. I love people who know what they want.
- [47:37]
B
Yeah.
- [47:38]
A
Like, oh, you have your friend. Yeah, that sounds reasonable. Yeah.
- [47:40]
B
No, I remember DMing you and being like, can we be friends? And I was like, she is not going to respond. She's going to be crazy. And then you're like, like, no, it's cool.
- [47:46]
A
Yeah, let's be friends because that's how we adult.
- [47:50]
B
If you come to Lead Her Summit 2026, I will introduce you to Betsy because she's probably going to speak. She spoke last year, she's speaking this year. She'll probably speak. I mean, she had such a good talk. Betsy is just so authentic. Like, you are like, what you see is what you get. She doesn't try to like be this people pleaser, whatever. Like, she is who she is, and she's so funny.
- [48:14]
A
They're good people because they had to. They had to swim upstream. So fucking correct.
- [48:19]
B
And me and her have the same taste in music, which is like the wop. That's how we met. The first time we met, I had had a few cocktails and she and I were dancing. And then I don't know how this happened, but all of a sudden, dollar bills were being thrown in the air like this, and we were dancing to the wap. She can confirm this story. I'm not making this up. And now I'm like, you know, you meet certain people and you. You're just like, that's it.
- [48:45]
A
That's so good. We'll wrap it up and we'll say, joy Prescriptions is out now. It's such a beautiful cover and it's such an incredible story of what got you here won't get you there. Self actualization.
- [48:59]
B
Yes. Also, can I add that the joy is in the journey. Because for years I believed that it would be waiting for me at the destination, and it wasn't, and I was pissed. So now I'm just enjoying the journey when y' all see me. And I'm just cracking up, laughing, asking new people to be friends. I'm honestly just living my best life and I just want other women to do the same. That's it.
- [49:24]
A
It's so awesome. And you can't take yourself too seriously. Like, that's part of it, you know? And, like, in finding this standup and stuff is like, the world's actually quite funny. And, like, being able to find that and enjoy it, it's really a present moment thing, which I think is like, part of the spiritualness of this is like, this is actually ancient philosophy on, like, how to live a good life is like, present moment, present moment, gratitude and laughter.
- [49:48]
B
Because if for one moment you and I can laugh at something like that deep laughter, not a haha chuckle, but like, oh, my God, that's so freaking funny. You forget that we have differences because the world is so divided these days. Like, you can't do anything without somebody getting their panties in a bunch. But if you can have a moment of pure laughter with someone about something, it feels unifying in a way.
- [50:11]
A
Totally, totally. I love it. Oh, thank you for coming on today.
- [50:15]
B
Thanks for having me.
- [50:16]
A
Totally. So fun. Until next time.
- [50:18]
B
Okay, bye.
- [50:20]
A
Thank you for listening to this week's episode of youf Are Not Broken. If you want to dig deeper with me, sign up for my Adult Sex Education Masterclass where you learn adult things like communication skills, anatomy lessons and desire types, and how to talk to your doctor about sexual health concerns. If you want the Adult Sex Education Masterclass for free free. Join my monthly membership for more in depth exclusive content, more time with yours truly. A private podcast, coaching and educational empowerment and you can watch my interviews live and get them immediately without advertising. Head over to www.kellycaspersonmd.com for the membership and Adult Sex Ed Masterclass members. Get the Masterclass for free. This podcast is presented solely for educational, entertainment and informational purposes of only. I am a doctor, but not your doctor in this format and all of my platforms and guests including on this podcast are not giving individual medical advice or practicing medicine. See in Consult with your own care team for your individual needs and concerns. This podcast is not intended as a substitute for the care and advice of a physician, therapist or other qualified professional. This podcast does not constitute the practice of medicine in case you were curious about about that and no doctor patient relationship is formed. But I still love you. Using the information on this podcast or any of my platforms is at your own risk. Until next time, Remember you are not broken.
- [51:50]
B
The grill is shot, the chairs are held together by optimism and what happened to the rug?
- [51:56]
A
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B
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B
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- [52:18]
A
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