Dr. Kathryn Clancy—feminist scientist and author of Period, The Real Story of Menstruation—and Dr. Barbara Riegel—professor of nursing and co-director for the International Center for Self-Care Research—join host Dr. Charis Chambers to explore why women deprioritize their own health while being the primary caregivers for their families, and the importance of implementing health-focused self care into daily life.
Dr. Kathryn Clancy—feminist scientist and author of Period, The Real Story of Menstruation—and Dr. Barbara Riegel—professor of nursing and co-director for the International Center for Self-Care Research—join host Dr. Charis Chambers to explore why women deprioritize their own health while being the primary caregivers for their families, and the importance of implementing health-focused self care into daily life.
Tales from the Uterus
Episode 4: In Charge but not in Focus
Introduction
Dr. Charis
Welcome, welcome everyone to Tales from the Uterus. In this episode, we will be discussing how women are responsible for making most of the healthcare decisions in the home, but often deprioritize their own health. To start, I just want to really get a little message out there.
This podcast is for US listeners only and is intended to be listened to as it was originally produced by Pfizer and Sumitomo Pharma America. This podcast has been paid for by Pfizer and Sumitomo Pharma America, and the participants have also been paid by Pfizer and Sumitomo Pharma America for their time. The information provided is for educational purposes only and is not intended to replace discussions with a healthcare provider. This promotional activity is not certified for continuing medical education.
The deprioritization of women’s health in society
Again, welcome listeners. I'm so excited to be joined by two amazing experts as we discuss this important topic. So, I'd like to welcome Dr. Kate Clancy. Dr. Clancy is the author of Period, The Real Story of Menstruation. She focuses her research, teaching, and service on reproductive justice. She is a feminist scientist who specializes in how environmental stressors affect menstrual cycles. Welcome, Dr. Clancy.
Kate Clancy
Thanks for having me.
Dr. Charis
Absolutely. How are you today?
Kate Clancy
I’m doing well.
Dr. Charis
That's wonderful. So, I do want to hop right on in. I know that you have quite a bit of expertise in this area, so I'm excited to hear, your thoughts on this specific question. What are some examples of how women's health has been deprioritized in society?
Kate Clancy
It’s a…it's a big question with many, many prongs, right? In terms of how we address it. I think one piece of it is that we silo this concept of women's health to really just be about reproduction or just about the uterus. Not all women have uteruses, and not all people with uteruses are women, right? And yet there's this idea that like women's health is reproductive health is uteruses, and how uteruses affect our bodies. There are a lot of really relevant things we need to be talking about around the uterus, but the uterus is not just a reproductive organ. And so, we need to pay attention to the many other things that uterus does.
Dr. Charis
Yeah, I love that answer. So, you mean to tell me that women's health isn't just about reproducing and childbearing? And there's more to the female body? No, that's actually great, and I love how you stated that. I do want to touch on a piece of information that I think is interesting, that the large majority of clinical trials don't really look at how treatments affect the menstrual cycle or menstrual changes. Do you think that's important that we should be looking at this? Should we be seeing if there's an adverse effect of treatment as it relates to menstruation?
Kate Clancy
I do. And, you know, what's interesting about the history of this, right, is that the National Institutes of Health did identify that there was a problem with the fact that, you know, clinical trials, pretty much were just including cis men and white cis men to boot, for the most part. Right? And so, there was this, let's start including women and minorities effort that began in, say the 90s. The problem is by understanding these categories as binary male inclusion, female inclusion, white inclusion, minority inclusion, it creates these binaries that don't actually exist in our bodies. We need to think about, well, if we're including different types of bodies, are there different questions we need to ask?
Dr. Charis
Absolutely, and you're using some really, really key terms, and I'd love for you to just explain it, just in case some of our listeners don't fully understand this. So, you mentioned that, you know, some people think sex and gender are the same. Could you elaborate on that point, if you don't mind?
Kate Clancy
Absolutely. So, let's start with sex. People think, well, you can define sex many, many different ways. Sex can be about your chromosomes, whether you have XX, XY, X, XXY. We pretend again that there's only two sets of chromosomal sex when there's a huge number, right? There's actually a significant percentage of intersex people in the world.
Then you've got gonads. So those are testes, ovaries, and lots of variation in between that we pretend doesn't exist, but totally does. And then there's also genital sex. So how you appear on the outside. So, penis, testicles, vulva, clitoris, and again, everything in between that we pretend doesn't exist.
And so, you know, when we talk about sex. A lot of times we're talking about genital sex because people are obsessed with how we look on the outside in our pants. But, but sex can be about any of those things or all of those things, and they don't line up in every person? And then you have gender, which is all about like ideologies, roles, cultural constructions, the social category of being woman, and again, all of these other categories that we could think about. And the thing is, is that sex and gender are actually super mushy and interact with each other in really profound ways.
Dr. Charis
Wow, that was so beautifully done, and I knew you would do this so beautifully, which is why I wanted to ask that question. And I ask it because, you know, in this space, we talk about this so much that we understand the complexities, but that's not something that everyday people always understand. And it's partly because we don't do a great job of explaining it or attempting to explain it.
So back to clinical trials. You mentioned how it's important to increase representation from a sex gender standpoint, but specifically what we're talking about here is women. And the idea is, or this is kind of based on many drugs actually metabolized differently in men and women. There's some things that are actually approved that we are taking that have clinical trials that don't even account for some of those differences. Can you speak to that?
Kate Clancy
Sure. So, there's this term, I'm gonna use another big term, but it doesn't have to be but there's the pharmacokinetics, which is just how different drugs work in the body; is really different for people with different types of endocrine systems, people who already have different drugs that they take, people who might have external hormones that they're taking for gender affirming care, for contraception or more. All of those things are going to affect how you metabolize different drugs.
The other thing, you know, one of the great examples I think is of, there was a sleep drug, that there was a belief for a while that there was a sex difference in how it was metabolized in men versus women. So, they just lowered the dose for women. Didn't really do tests on it but lowered the dose. And, what ended up happening is they were wrong. The issue was a body size difference. And generally speaking, if you look at the average weight of a man and the average weight of a woman, there's a difference. But if you were to look at like how they distribute, right, there's tons of overlap. So, by making this assumption that it was a gender difference, they actually mistreated a bunch of people and underdosed them, right? And that also means probably overdosed a whole bunch of men.
So, we have to be very clear when we start to observe something we think is a gender or sex difference to inquire further, is it really metabolism? Is it really the uterus or menstrual cycles? Is it that generally we might have some general differences in behavior, right? Like, everyone tries to say, “Oh, well we see it, we observe a difference. It must be biological.” And like, half the time or more you dig in and it's actually not biological, it's cultural in some way.
How and why women deprioritize their own health
Dr. Charis
Thank you for that. That's so beautifully stated. I do want to shift over to our other expert today. We have Dr. Barbara Riegel. Dr. Riegel is a professor of nursing and co-director for the International Center for Self-Care Research. She is widely known for her studies of heart failure, self-care, and disease management. Welcome, Dr. Riegel. How are you?
Barbara Riegel
I'm good. Thank you so much for having me.
Dr. Charis
So, I'd like to start with this incredible stat. According to the U.S. Department of Labor, women make 80% of health care decisions for their families. However, women often deprioritize their own health. How do period health issues such as endometriosis and uterine fibroids and those things affect the day-to-day life of patients that have them? How can we kind of consider the way period health issues would impact folks on like a daily basis?
Barbara Riegel
It's such a great question and there are so many issues that are really packed into that question and it's such a wonderful segue from what Kate was just talking about with cultural issues, social issues versus the biological elements of gender and sex. Um, and so really this whole women being the caregivers of their family. Here we're talking about really the social elements of this because it's an expectation. It's the women who are usually expected to be the caregivers of their immediate family.
Dr. Charis
So, it's like, well, we can decide for everyone else, you know, what the healthcare decisions should be, but when it comes to the actual prioritization of health, that's not something that's always aligned. And I think you made a good point. We are expected to make decisions for everyone else but put ourselves on the back burner as some sort of like martyrdom, like this leadership that sacrifices self. Have you found that in your research and all of your expertise?
Barbara Riegel
Yes! Oh my gosh, so much, so much. And actually, I'm right now just wrapping up a long study on caregivers and how we can get caregivers to take better care of themselves. But the reality is that you know, it begins with the child rearing and then it goes into the parent caregiving and then there's the neighbor that you're taking care of and the friends that you're taking care of. And there's this whole series of caregiving expectations that we as women just leap in there and seem to take care of.
Dr. Charis
And so, and we talked about this earlier with Dr. Clancy, you know, we're saying women here, but we also mean the person who is often bearing the children, the person who is taking on the majority of the parenting role. And so, we know biologically, okay, you know, the person with the uterus is likely to carry the child, or we might have a gestational carrier surrogate.
There's a lot of ways in which families are formed, but it is that person who aligns with the nurturing role of raising the children that typically is then kind of pigeonholed in these other roles of saying, you're the one who sacrifices. You are this person. Be them identifying as a woman or not. You are this person. Congratulations. This is your burden to bear. And that's the part that just feels so unfair. After all of the burdens, all of the challenges, the cognitive labor, the physical labor of bearing children, that that would be such a discordant responsibility in the home. And as you pointed out, it's not like the other partner is incapable. It is a societal expectation that perpetuates this.
Barbara Riegel
Yes, I love your word, pigeonhole. That is exactly it. There are so many implications of this role and people are pigeonholed into it and expected to do it.
Dr. Charis
Yes, and I think one of the best ways that we can challenge this is by talking about it, by calling it out. I am in the process of getting married, and so the pre-marital counseling questions that we were given, one of them was, you know, what are you sacrificing to enter into marriage? And I let my lovely partner answer as I watched him, and I just kind of expected, and he did this. Where he's like, you know, men sacrifice so much from an independence standpoint. I said, I'm so glad you brought that up. And I just went to town. I said, what about the body? The physical body is no longer my own, caring of human, it changing, nurturing the human from my body. Like all of those things, I find it so remarkable that men can believe in this society that they are sacrificing the most in the system. In the partnership that is marriage and family building.
I find that remarkable. That was, it was a tough question, but I had not, without that question, I had not had an opportunity to even just bring it up, to just make it apparent and lay it out. And it was good. It was a good conversation to have in a partnership. Do you hear the words you're saying? You just adopted what society said. But if you really peel it back, what are the true sacrifices?
And I wanna pivot a little bit. I want to pivot into the period health issues. And I kind of brought that up a little early, but I think this is the appropriate time to really dive into it. So how do those period health issues, we're talking our endometriosis, uterine fibroids, how do those affect the day-to-day life of these caregivers, these mothers, these daughters, you know, these people that are just trying to live their lives? What are some of the things that we see there, Dr. Riegel, that would really put that prioritization of health kind of at the forefront of their mind?
Barbara Riegel
Yeah, another really great question. These are, you know, we ignore symptoms. I think people do it in general. Everybody ignores symptoms, but especially people who are menstruating because it comes every month or on a regular cycle. And so, we say, not important. Yep, yep, here it is again. And we just push it aside and go on with our societally attributed role of the caregiving. And, you know, I have to ignore this because it keeps coming back and I'm not going to pay any attention to it. How unfortunate is that? How rarely do we just stop and say, I feel awful today. I can't really do that today. I can't really take care of this person. I can't really engage in this. I need somebody else to relieve me, take over for me, give me a day off, because I really don't feel well. But it's so hard to get that out of our mouths. It's so hard to say it.
Dr. Charis
So hard to just admit it. I want to circle back to Dr. Clancy. Why is this so hard? Why is it so hard for the folks who are really in that caregiving role to say, I need care, or I'm not able to show up and be this person? I can't do this role today. My endometriosis, my fibroids, my period symptoms are too much today.
Kate Clancy
Well, if I may, I wanna back up a little bit from that question and say, does the evidence really show that people with uteruses deprioritize their own health? And that's not actually, you know, I wanna throw just a little bit of like an addendum or an addition to this conversation, which is that actually people with uteruses care very much about health. And yes, have they been taught to care about the health of others over their own, especially in caregiver roles? And then therefore to sometimes deny, you know, like care seeking behaviors that they might need, absolutely. Um, but also, they often go for days, years, decades, seeking care from medicine and not finding it. Many of these illnesses that we've talked about, endometriosis, fibroids and more, these are things that can take up to a decade to diagnose.
And it's not because they go to the doctor every 10 years. We're talking about people who are seeking care. Expressing discomfort, saying this doesn't feel right, I'm experiencing heavy bleeding, I can't function for a few days every month, and they're getting ibuprofen, they're getting, you know, it depends on, you know, it depends on the situation, but they're not necessarily getting the diagnosis that they need in order to move forward with some kind of treatment plan.
And so, I think we have to understand that when a person consistently experiences medical mistrust, and medical betrayal in a system, right? I'm not necessarily calling out any particular person, but in a system that is designed to give you five minutes with a provider and having to move on. Like in terms of the difficulties of actually getting that kind of quality care to a patient, but because this is an especially underserved population, they do eventually give up.
And yet we see, it's not that they stop prioritizing healthcare, it's that they go to the latest influencer telling them to try seed cycling or cycle syncing their workouts or whatever the coolest next thing is that is going to help their health, right? And so, we're driving them there.
Dr. Charis
You're so right. So, yeah, it's not that women or the caregivers are deprioritizing their own health. They have learned over repeated attempts that their health is not a priority. And so, for them to continue to prioritize it against a system that doesn't, just feels like insanity. It probably, the most, you know. It feels super unproductive potentially. And so, I'm so glad you pointed that out. Thank you for highlighting that. That's a valid and really important point in this conversation. I'm sorry, and I'd love for you to continue your thoughts if you had more to add there.
Kate Clancy
Just one last thought, thank you. And it's, you know, if I think about, I have two children, 15 and six, and I am required to get them physicals every year so that they can attend school. So, I get notifications, like if I don't do that, and then they get vaccines, they get various types of, you know, they get their abdomen palpated, we get whole conversations about things. Like it's a much more lengthy process than a lot of other care appointments.
And so, I know at least once a year, I am told I have to make sure my kids get healthcare. I don't have major caregiving responsibilities for elderly people in my life right now because I don't live near any because my job took me to the middle of the country. But I know from talking to them that, you know, they have required appointments with specialists that they have to go to all the time. Those of us who are in that middle, that sandwich generation who have the...some of whom have caregiving in either direction or both directions, what are our required regular appointments? There's nothing structurally forcing us to go. So again, over time, you get told enough times there's nothing really wrong with you, or we're not going to follow up on this, or we don't have time, you're going to stop going.
Dr. Charis
That's so valid. Yes, Dr. Riegel.
Barbara Riegel
But just one other, to add one other piece to that, and that is that when we go to a provider, oftentimes there's that, it's with a symptom, but the role of the physician is the diagnosis and treatment of disease, not necessarily the management of the symptom. And so here we are in that kind of, uncomfortable position of I have a symptom, well, I don't have a disease that goes with it, and so it doesn't really get addressed.
Dr. Charis
Yeah, that's so valid. And then, you know, in all of that, as you mentioned, it would seem as though the extra added burdens of having to care for your family's needs, having to juggle multiple priorities, all of those things would, you know, make it even harder. So, the challenges just kind of beget more challenges, which beget more challenges, which, you know, is very difficult.
We talked about just the ignoring of period symptoms, and I do wanna get dig a little deeper there. Because while there is a, I went to my physician or my healthcare provider and shared my symptoms, there is the other side of the coin where folks are just saying, I'm ignoring these. I'm just pretending they're not there and I'm pushing through. And there's also that normalization of pain and suffering, especially for someone who dares to have a uterus by society. Can we talk a little bit about that? Have you noticed that in your research and in your readings and expertise?
Kate Clancy
I do think, you know, again, partly because when we do present with symptoms, we're often just told to manage the symptoms with say a pain reliever or something or are kind of told to move on. So, part of it is that, you know, medically we're being told to move on. Culturally we're being told to expect that periods are painful. One of the things I find really interesting as a period scientist, is that most of the validated scales to study menstrual cycles are only framed negatively. So, they are symptom scales of all the bad things that can happen to you in the menstrual cycle. So, the way we frame the research is that you will have bloating, irritability, pain, discomfort, depressive symptoms, suicidal ideation, loss of libido. I can't even think of all the other many things you can find on the symptom scales.
So, I mean, if the research is framed around bad stuff, if the medicine is framed as, all I can really do is relieve a little pain, and if culturally we're told to assume that this is just our life. Yeah, of course, after a while, we're gonna be like, well, guess I'm just gonna sit on this toilet while I pass seven more clots. I guess that's normal.
Dr. Charis
Yeah, that's such a good point. It's the framing. If you frame something, you're telling people that you only can stay within this frame. So how bad is your bad is the question that you are posing to folks. You know, and that really teaches us where we are expected to exist. If the lowest number on the scale is still horrible or is still in pain, it normalizes pain. That’s such, such a good point.
Self-care is not selfish
Dr. Charis
Um, I want to pivot into a productive kind of discussion on how can we address this? How do we shift this narrative? You know, what does that look like? And you know, self-care is one of those buzzy words right now that's been reduced to manicures and spa days. But I know that self-care means a lot more, especially to you, Dr. Riegel. I want to kind of frame this conversation as self-care is not selfish. Um, but I would like to also have you define what self-care means for you and your years of research in this area.
Barbara Riegel
Thanks for asking that question because I, also just feel like it is very much of a buzzword right now. I feel like, you know, the marketing has taken over self-care and everyone wants to say, oh, this is self-care, this is self-care, and that's not really at all the way that we look at self-care. So really self-care is the whole idea of keeping yourself healthy and dealing with issues, with symptoms, with problems when they actually occur. That's really the essence of self-care. We like to look at it theoretically as this process of maintaining your health and then monitoring your body and then dealing with or managing illness when it occurs. So, these three elements of self-care.
But a lot of the buzzword and the marketing stuff that's going on right now doesn't really fit into any of those pots. It might fit a little bit in, some of these might fit into the, you know, maintaining your health kind of pot, but really not even that. Um, so, you know, getting a manicure is great. I mean, sure, we all love that, but that's not really self-care. So, self-care is really more of taking medications if they're prescribed for you, eating a healthy diet, getting on an exercise regimen. Those are self-care behaviors. But I really feel like the one element of the three that I've just outlined, the maintenance, monitoring, and management, the one piece that I've really come to believe at this point in my career as being so key is the monitoring piece.
That we so often just, you know, we're not really paying attention to our bodies. There's so much going on here. We can learn so much by just sort of stopping and listening to ourselves.
Dr. Charis
Oh, that’s good.
Barbara Riegel
And now there's almost nothing that you're seeing in the, you know, the everyday self-care marketing world that is really addressing that except for one thing that I think is really sort of a cool evolution. And I'll give the marketing people their due on this one. And that is that their meditation has become so commonly pushed by so many. And there is an element there, if you really pay attention to what's going on, they'll go through some of the meditation exercises and say, you know, like, pay attention. How are you feeling? How is the body feeling as if it weren't you, right? But still, that's a really important part of the whole self-care process is paying attention to our bodies.
Dr. Charis
That's so good. I do you believe, and I'll pass this to Dr. Clancy do you believe that ability to pay attention to your body and the ability to really kind of I guess achieve those tenets of self-care that were laid out by Dr. Riegel are affected by you know where you exist in society and how society sees you? And I know you believe that but I'm just kind of setting it up because I want to hear your thoughts. I'd love for you to go into the ways in which societal factors and barriers and certain things affect even your ability to meet the more authentic and scientific definition of self-care. What does that look like for you, Dr. Clancy?
Kate Clancy
Sure. You know, again, I'm gonna kind of in some ways, trot out some of the same things that I've already said, which is, or maybe I'll give an example of my own life. I'm someone who definitely does pay attention to what's, I mean, I study human biology, I study the uterus, like I'm paying attention to what's happening in here all the time, whether or not I'm using my meditation app regularly, you know? And so, I definitely hope I'm doing what Dr. Riegel wants me to do in terms of paying attention.
But when I bring that to my provider, I am treated like there is something a little silly about me. And I'll express, well, here are the symptoms, here's what I've been dealing with. And recently, I last, actually over a year ago now, because I have given up on this provider and I'm in the process of seeking a new one. I, you know, I was expressing that I was dealing with some symptoms, that they were completely unmanageable.
And I wanted to discuss alternatives to the, I have migraine, and the initial treatment option I was given, the only option I was given is one that is widely known to have very severe side effects that persist often even when you go off the medication. And I was interested in asking about some other options and I was like, I would really like some more insight into what's wrong with me. And he just said, “oh, I know what's wrong with you.” And then he just turned away from me and started writing something down.
And I just was like, well, I'm trying to advocate, I've made observations, I've even kept track over time. Here are some insights. And it was just, oh, I know what's wrong with you. You're refusing treatment. And I was like, no, I just don't wanna do the one that I did research on, and I know is not the one I would like to talk about other things.
So, you know, I think that we have to consider that we're asking, you know the other piece I would say, and again, this comes from studying pregnancy. Something else I'm very struck by is this call to pay attention, but then also this call that only a doctor really knows what's going on. And I think we have to, you know, and again, like to the really lovely points you both have already made around distinctions between finding symptoms and finding diagnoses and things like that. I think we go to our providers with one expectation that isn't quite what they can deliver. And that mismatch can be really distressing when we are like, well, we have these issues or we've been making these observations and either our experience is denied to their authority or again, we're told that doesn't really matter. You know, so again, there's like all of these compounded issues.
Dr. Charis
There's so many layers. I'm so glad you brought that up because I gave a talk at, um, my alma mater at Spelman College to students about unlearning the patient-doctor relationship that we were taught by our parents and grandparents, which was one that honored a patriarchal style of delivering medicine where the doctor is always right. I just said, you know, I really want to be very clear. We're not. And the reason we're not is because we're human. We are fallible.
And science is slow. And science is slow because science is ever changing, and it should be changing. But one of the important parts is you cannot look at the doctor patient relationship as I'm going to meet with the authority. You need to look at it as two authorities are meeting. One who has the authority of their body and the other one who's the authority of the current medical literature.
And when those two come together collaboratively to have a conversation, a meeting of the minds, a meeting of experts, that's when you get the best outcomes. But you cannot have that meeting of the mind and meeting of experts if that physician or that care provider does not acknowledge you as a colleague, as a collaborator, does not care about what you're saying, and you know to be true about your body. And so, one of the things I say to my patients is, the question is not, are you in pain? You are in pain because you told me you're in pain and I believe you're in pain. And that, in and of itself, that statement, that just stops them in their tracks.
Their moms are like, what did she just say? Because it feels so revolutionary to say, you are in pain because you say you're in pain and because I believe you're in pain, and you are the only person who can tell me if you're in pain. Now let me tell you, I have this list of things that could explain your pain, but if I fail to explain it, it does not mean it is not there. It may mean we have not yet discovered what is causing your pain. And I learned to give that disclaimer because I saw throughout training this dismissal of things because the physician could not give it a name. And we are taught that we are good if we can name it. We were given awards for diagnoses when you did do it. But what about that patient experience? Did we change their experience? Are they treated? Are they better? And what about all the patients that don't have a diagnosis? I say that to say, you know, the monitoring is really, really great encouragement. But what do we do when we find something? And if no one cares what we have monitored, we will stop monitoring.
Because we will be taught that it is not worth our time, and we're already overwhelmed with all of our other tests. So, I'm glad you brought that up. It feels like a dark, you know, observation, something that makes us sad, but there is an opportunity for improvement. There's an opportunity for improvement in everyone who cares for patients, who cares for anyone who is speaking from a lived experience, and we have the authority or the opportunity to advocate for them or validate it and that we should be doing that even if we don't have a name for it. Even if our goals aren't necessarily being met or we can't say I checked that off, it doesn't mean that what they presented to us is any less true.
Barbara Riegel
So, let me jump in by saying, well, first of all, Kate, I'm so glad you gave that story about yourself because I think as women, we can all tell very similar stories, and it just brings back a lot of bad memories that I won't go into. But I want to say one other thing about this whole process of self-care and that is that the last piece of it, the reason that we advocate so much for monitoring is that if you don't pay attention to your body and you don’t realize that something is wrong, then you're not going to seek care or do something about it. But interestingly, out of all these years that we've been studying this process, I could go through and list for you these behaviors that people do to maintain their health. Oh, tons of these.
I could also list for you all the things that people monitor in their bodies. Tons of those things. But actually, it's really interesting that the real thing that we're trying to get at is this management piece of it, because that's really important that once something happens that you do something about it, that you don't just kind of bury your head in the sand and go, oh, gosh, I hope this goes away, but you know, actually do something. And yet we recently did a study where an international study of clinicians asking, what is it that you advocate that patients do for this symptom, this symptom, this symptom, this symptom? And then we actually went to the patients and said, you know, what do you do about those symptoms? And it's really, it was very interesting to see the mismatch, the sort of strange things that people are doing about their symptoms.
Sometimes they go to a provider, sometimes they look up on the internet and they come up with some good ideas about what to do about this joint pain or this, et cetera. But sometimes they just, as you brought up earlier, Kate, that they go off with the next thing, that they found on the internet that has nothing to do with it. But that whole piece to the process is really important. That you're actually putting all of those pieces together, and that's true self-care.
Dr. Charis
Yes, love that. And the other piece that you kind of highlighted, you know, is really monitoring those symptoms and expecting and looking for and continuing to advocate for yourself until there's resolution or a place of management. So, you know, sometimes it's like, well, my pain was a 10 out of 10, and now it's a 9. So maybe I can chill. No, no. You are deserving of a pain level where you can still manage life, where you can be your full self and show up. And so, I do think it's important to say, even if symptoms improve minimally, you shouldn't just say that that's adequate because it's just a little bit better.
You deserve to be able to say, this is what I need to be my best self, to show up in this world, to show up for my family, if that's your desire. And, you know, it's not really that counterintuitive when you think about it. Your best self, that with optimal health, is the one that can show up. And be that person for your family and live long. And be able to nurture and care for and love the people who you care about in your life. And so, there is an ability to align those things and reconcile those things if we really try, if we really think deeply and modify our approach. Now, you know, the other thing I do want to talk about is the importance of a support system.
Dr. Clancy, you mentioned when you're reaching out to just one party, you know, a physician, you may say, wow, I did not get the response or support I needed. I love that you said, I'm pivoting and I'm looking for a new provider. That is a wonderful thing to do. And I encourage any and everyone to find someone that they feel will partner with them, who listens to them and believes them. But also creating a support system around you that can be, you know, family and friends, online communities. And so, I'm going to ask both of you, who makes up your support system. Your support system that says I can be my best self, that allows you to take a step back when you need it, to lean in when you want to, or really monitor and manage in a way that says I'm optimizing myself here. I'll start with you, Dr. Clancy.
Kate Clancy
Sure, I mean, I would say for me, and it's been a journey of almost 17 years now, would be my partner. You know, we live far away from family. A lot of us have jobs that don't allow us to, even if we want to, to stay near family. And so, I lived, you know, 1,500 miles from my parents and my sister and my spouse's family.
And, you know, I think as we've grown together in our partnership, we've had to figure out how to support each other so that we didn't fall into those roles where because I was the one gestating and lactating, I was also the one making all the appointments or I was also the one who when the kid was sick that I went home, you know? And it required, but it didn't happen just passively because we were good feminists, you know? We're both great feminists and guess what? In the beginning of our marriage, it very much fell into that until we had to have explicit conversations.
And so, for me, my support system has been around holding myself accountable, noticing my own internal bias, holding my partner accountable, making sure his own biases are in check. And then also, I'm very fortunate, I would say, to be in a workplace where, you know, I've been here long enough now that, for instance, last semester, so the spring semester of this year. It was the Omicron wave. I kept my kids home for an extra, like almost month.
And I was trying to have my administrative duties and finish a book. And it became impossible. And I reached out to my boss, and I said, I have to step away from this administrative role. And somebody in my department stepped in for the semester for me. And I was terrified of making that ask. I felt terrible for being that person letting people down. And yet people stepped up for me. And I will never forget that. Both that my boss never made me feel bad about it, both that my colleague immediately stepped into it and that it was a seamless thing that I could just trust that one thing got taken off my plate. And so, I think I learned that as much as we have to work around those structural biases. We also have to work on our internalized biases that tell us, no, you can take on this thing or you can hold onto this thing. And so, yeah, like it's an amazing thing to take something off your plate, isn't it?
Dr. Charis
Uh, isn’t it? That's beautiful. Thank you for sharing that Dr. Clancy. Dr. Riegel, can you tell me about the support system that allows you to show up as your best self?
Barbara Riegel
Well, again, it's my partner and I've been with him many, many years. I won't even specify how many years, but it's been a long, long time. And he is totally, as you say, a feminist and really my incredible supporter. I think the, um, and I also live very far away from my family of birth. Although I, I do get to see them, and I have my support there.
But I feel like the other major system of support that I have really is my students from years past. I have this whole family of students that I have mentored and like I gave a lot to them as they were going through the doctoral program and then they've come back and just never left me. And but of course I've never left my doctoral mentor either. So, it's this whole family of support system. And it's a strong support system. It's really a great support system.
Dr. Charis
Yeah, that's lovely. I think in summary, you know, the support and navigation of self-care and life and health requires partnership. It requires an understanding of roles. It requires reflection and checking one's own biases and really saying it's okay to challenge the narrative. It's okay to challenge the expectations that society has of us. And when we are in these places where you know, our bosses support us and our colleagues step up we can show up and we can say, hey, you know, that worked out. Maybe I'll do it again. And then maybe, maybe I'll do it for someone else. And maybe it will encourage someone else to do the same. So, I just want to thank you both, Dr. Riegel and Dr. Clancy, for your kindness, for your insight, for your vulnerability.
Outro
As we discuss this topic, I hope that the listeners really felt the sincerity of the conversation. And I hope that they left with some answers and maybe even some more questions. But really, I hope that they leave with, just a spirit of empowerment around prioritizing themselves and monitoring and managing their lives in a better way so that they can be their healthiest and happiest selves. So, I do want to also thank Pfizer and Sumitomo Pharma America for sponsoring this discussion and giving us this platform to have this much needed conversation Thank you for all who are listening and have a great day.