 Hello, everyone. I am always loving this and loving the most the most fun part about it is I get to talk to friends. So it's kind of like you get to jump in on a coffee chat with Dr. Gottfried and I. And I don't know, Sarah, for sure, when we first met, but I remember A4M. I think we've traveled in the same circles for like a decade now. And I have always admired you because one thing about you, you're successful. You are a great teacher. I love that you love this science. So a lot of times there's there's a lot of stuff out there and there's a lot of doctors I think sometimes compromise on the real good truth of the science. And yet we can have that and then also come to the stage with authenticity and empathy and some of these characteristics that we'll talk about today feminine versus masculine and how we try to bring our information to the to the audiences that we teach and and to the public. But I am delighted to have you here today. And I want to just introduce you first. And then we'll die right in. So many of you have read Dr. Gottfried's books and know her well. She's a wife, mom, yoga teacher, physician and scientist who graduated from Harvard Medical School and MIT. She's the author of three New York Times bestselling books, including the hormone cure, the hormone reset diet and younger. Dr. Gottfried practices integrative and precision medicine mostly via telehealth appointments, as we all do nowadays, right? That's right. You can find her website is her name. It's Sarah Gottfried essay r a G o t t f r i e d m d com. And I know she's got a wealth of information there. And I know you are in for such a treat today. So welcome, Sarah. Thanks so much for joining me today. Oh, it's it's a thrill. It's such a thrill. I mean, I, I just have been so grateful for our friendship over the years. And I just I love, you know, kind of sharing this forward, which I hope we will do today as we usually do. Yeah, I feel like, as far as the books, your success, the way you've changed and touched the world, the way you impact your patient's lives, you're one of those women that I just have always admired. And I think the world of you. And I think one of those things that I really admire is a lot of people out there know how to do the business, but they miss the heart or they get so involved in the business that they lose the reason why they first started doing what they were doing. And I love and admire the fact that when I see you, whether it's your speaking or your writing or our conversations, I see this genuine heart of service and love and this desire to impact the world for good. I'd love to go back to your story like how did you get into medicine? And where did you start? Yeah, I didn't start in medicine. I started as an engineer. And I was I was getting a PhD in bioengineering. And at the time, my beloved grandmother was sick. She was diagnosed with Alzheimer's disease. And it was one of those diagnoses that I think many of us have had a brush with where the medical system just completely fails us. So I watched her, you know, she she used to pick me up from school from the bus stop and drive me home. And I watched her just decline. She was unable to drive me home from the bus stop. She and then as I as I progressed and she progressed in her disease, I could just see this personality draining out of her. So that's what first got me into medicine. I ended up dropping out of this PhD program to go into medicine with the intention to become a neurologist, which you know, just feels so foreign to me now, Jill. Because I think neurology is really changing. We're seeing that with David Perlmutter and with Dale Bredesen and many others. But at that time, as I got to know neurology back in 1989, it was just, you know, audios, diagnose and audios. There was so much focus on the intellectual part and not enough solutions. So that's what got me into medicine. Then once I got into medicine, I just fell in love with women's health. You know, I practice precision medicine for both men and women. But I really felt like the personal was political when it comes to women's health. Gosh, and again, that's kind of one reason we've connected and been here today. I know recently we've been active on Instagram about some of the stuff. Let's talk just briefly about what happened with the vat journal vascular surgery and how just because it's so I remember medical school and at the time I was so naive. And so interestingly enough, I was bioengineering background too. So when I heard that I'm like, no wonder you connect is like an analytical heart, how do we combine like I love that. That's actually quite a rare major. We don't I don't come across many bioengineers. So that's really cool. I love it. Too geeky. I think for those of us who do systems medicine, systems biology, it makes total sense, right? You know, kind of breaking the body into modules, but also just really understanding that the whole is much greater than the parts. I think you and I definitely have that in common. Yeah, and really, at the courts, problem solving and pattern recognition, right? Like, I love to just listen to the bits and pieces and let my mind percolate. And then there's this recognition of patterns. Then I compare it with the labs in the science. And I'm like, oh, yeah, aha, here's the bingo moment, but it's all pattern recognition. And it's that's very similar in that way to analytical engineering types of processes. So I love that. And I think it's a really valuable tool to bring to functional and integrative medicine, especially because in my experience, the way we analyze data, I think we bring a lot more pieces of data in. So we have to be like a super human computer in order to versus just, you know, in the silos that we were taught of practicing medicine, where there's just a very, very narrow area focus, we're really broadening that area focus, aren't we? We totally are. And I'm glad you brought this up. We can talk about like what happened on social media. I'm excited to talk about that. But it's, I feel like the way that you take care of patients, the way that you conceive of it, and the way that I take care of patients, the way that I conceptualize it is so similar. And it's it's this, you know, I think of it now as kind of deep phenotyping where we're pulling together all of these streams of data, the wearables and the aura ring, what's happening with your sleep, what's happening with your heart rate variability, your what's happening with your food, I wear a continuous glucose monitor. And all of these streams of data, we want to like put that alongside the patient's story, the patient's narrative, you know, connecting from that heart place. So it's it's not like 100% tech. It's this integration where I think the really juicy experiences come from and the healing. Yeah. And what I've noticed that's interesting is, and I want to get back to the medical school stuff, because I know we have some experience to share, but it's relevant in medical school. So I came into medical school, I didn't know any of this back then, but I was a super sensitive empathic soul. And I went into medicine because I wanted to be a healer like I was I think you and I, those who have of us who have really embraced this, we were born healers, we just didn't know what we kind of discovered it along the way. And what happened in medical school to me, and I'm curious to hear your experience, is I was all of the empath and the intuitiveness was kind of trained out of me. I was in this very masculine dominated world, very hierarchical, very paternalistic, extremely regimented, extremely science based, which I love the science as do you. But what happened is I stopped trusting my own heart, my own soul and my intuition. And I literally I remember times like looking back, it was actually a quite abusive environment in so many ways. And I didn't know any better, right? So I just thought, oh, this is how it's supposed to be. I'm supposed to feel shame and guilt and I'm supposed to feel bad for being a woman and I'm supposed to be a man and be pretend like I'm very masculine. And I took on all those traits and I kind of suppressed the side of myself that's very sensitive, very empathetic, very intuitive, and the true healer within us. And I tried to become something that I was never meant to be, which is a machine and a driven producing kind of person, right? And then I've rediscovered that and I found so much joy in that and so much happiness and ability to have really helped people because when we look at data, if we have a set point of 100 pieces of data, that's easy to use science and use technology to analyze. But when we have millions of pieces of data and they include the shape of the eyes and the smile on the face and the twitch in the mouth, our intuitive mind that's not analytical at all, our heart in our intuitive sense is actually seeing those pieces of data and putting them into the picture. And when we open ourselves up to that part of the data, I find I get way better answers and way better outcomes. And I'd love to know if your experience was similar with medical school and some of that. It was very similar. In fact, I wouldn't every time I talk to you about this, I get kind of misty because I still have grief for medical school. Yes. And I still have grief for all of those years that you experienced and I experienced and I know people who are watching us right now probably experienced of giving up something so true to ourselves at the time in the service of what we thought was the greater good, which was, OK, I'm going to pass this board exam. I'm going to like move forward with this medical information. And I would, you know, you said it was borderline abusive. I would say it was downright abusive. I mean, part of subsuming your intuition and your sense about like what to ask next to probe further. Part of that is is what's required when you're working 120 hours a week. You know, when you can't go to the bathroom, when you need to go to the bathroom, when you can't sleep, when you need to sleep. So you have this kind of override that happens. And if you're not careful, and I would say I wasn't careful enough about this, in my 20s, I gave up my 20s for medical education. I think you did too. If you're not careful, it sets this this set point for your physiology where you're just used to, you know, kind of this constant stress, not enough sleep, not enough inputs to deliver the outputs. And I remember one of the ways that you and I talked about this before, which I think is a great visual, is our black power suits. I love this. So I, you know, I think you had this too. I had a series of black suits. You know, I remember when I gave my first abstract, my oral abstract towards the end of medical school, I did a year of a research fellowship with the American Heart Association. So I was at Harvard and I did this research fellowship. And I was invited to give a talk. And I remember practicing and practicing that talk so that I knew it stone cold. I had the black power suit. I took a beta blocker because I didn't want it like show my nervousness. And I just contrast that with how I show up for a talk now, which is completely different. Like I show up for a talk now with the goal of coherence, you know, with the goal to like show up fully as Sarah, like show up fully as myself, you know, to be impeccable with my word, we could go through the four agreements. That's one of the things I love to do before a talk. But I just think about how much I gave up in that abusive as you describe shame cycle that we had through our medical training and unfortunately, how long it took for me to kind of realize the harm in it. And how it was holding me back from more authentic, loving, healing connections with my patients. And it's it's really the integration that I think makes us better clinicians. I love that, because it's exactly so similar to my experience for the first five years of teaching, I had the black pants suit, nonetheless. And I thought I was, you know, the same thing, this calm demeanor, all statistics, analysis, maybe once in a while, a little bit of patient vignette, but there was no story. There was no heart. There was no like this patient just lost her father and she's experiencing chest pain, like this piece of connection, even in the patient's story. And I remember the day where, well, first of all, I remember training in my earliest training. I was with a group of movie six or seven women in a very small group that was training to speak, and they were all so polished. They were beautifully and packably dressed. And here I was like a girl from farm country, Central Illinois. I felt so out of my league. And I was like, as I was speaking, sometimes I'd have a tear because I felt something in my heart. And I remember like the trainer there was looking at and they said, you know, these, there's this polishness that can come across, but Jill has this heart piece and people are going to lean in and say, I want to hear more. And I almost cried because I felt so inadequate. I felt so much shame about who I was and I wasn't enough. And then I started to slowly, slowly wear dresses and tell stories and share very intimate details of my health history with the audience. And when I started to see Sarah, and I'm sure you've seen this too, all of a sudden the. This is the typical audience, right? And the walls would come down and people would lean in and then we'd start to cry and they would hear this. And what it was, it wasn't even about me. It was about me reflecting their stories to them and their lives. And what I started to do was think I want to give them permission because we all are in this culture of putting on a mask and appearing like we all have it together and then we all have all the answers. And remember the time when your friend or your family member or yourself, you had a crisis medically and you didn't have the answer. I remember that. And I remember being like, oh, my gosh, I don't know the answer. And I'm supposed to know all the answers. And every one of us in medicine has felt that a million times. And every one of us, I think has to have permission to know it's OK to not have all the answers. That's part of the journey. And so part of what I love to do is like say, hey, we're in this together. You're probably biggest struggle is someone you love who you can't fix or heal because we're supposed to write or it might be yourself and just giving that permission to the audience to be human because again, there's been this ingrainedness of we can't fail. We have to be perfect and all of those things that are false stories. But what happened is as I started embrace and as you started embrace yourself, people started to see our souls and ourselves for who we are. And that's attractive. People want more of that. It's not about us. It's about just coming as we are. And I'm sure have you experienced that too, that transition in the audience and how they hear you and how they respond to you. Oh, definitely. I think it's it's a head connection versus this kind of whole body, heart centered connection. And, you know, I love that medical schools are starting to choose for this. You know, it used to be that it was just your scores and what was your GPA and, you know, how are your letters of recommendation? And now they're choosing for empathy and for curiosity and some of these qualities that have been called more feminine, but I think are a sign of balanced, mature, masculine and feminine. That's the way I think about it. But I agree with you. I think, you know, in some ways, trying to show up and be sort of the person who goes through the statistics and has this absolute level of certainty about exactly what's going on in the human body is exhausting. Like for me, it caused HPA dysregulation, like dysregulation of on my HPA. Right. It was trauma, frankly. And, you know, I'm still there's still some ways that I'm recovering from it. But I think once you call it trauma, once you start to, you know, kind of deconstruct it and and learn how to become fully embodied again. Yes. And connect from others from that place. It's it's so much more powerful. And it's, you know, the blessing is that even if you don't do it for the sake of authenticity and heart centered living, you can do it for the sake of just it's more energizing. It's not going to deplete you the way that that immature masculine way was depleting me. Right. Absolutely. 100 percent. I'd love to hear about I mean, we've both gone through a lot of different transitions, but as there has there been any either health events or live events that started to shift that for you, I do remember any points in life where you're like, oh, this is a big shift. And the sad thing is often they come through difficulties, right? Like obstacles or things that appear to be really difficult. But I'd love to hear if you have any stories of how you how you've been transformed through that process. Yeah, I have a lot of those stories. And I write about them the way that you do. And I think, you know, we're taught in medicine that you don't talk about yourself. You always talk about cases or patients. And I think this is another example of what I've heard described as, you know, kind of vulnerability together with competency. And I think when you bring both of those, that's really where the best healing occurs. So, you know, the most recent experience that I've been thinking about is growing up with a grandfather who was black. And he was the person in my family that I was the closest to. He was an engineer trained at MIT. And he's I think I got I have the black race on both sides of my family, but he's the one that I was closest to. And I started to really think more of racism in medicine over the past year and a half. And I felt like I needed. He died a few years ago. But I feel like his DNA lives on in me. And it lives on with a leg legacy and invitation to address the racism, the racial disparity, the social determinants of health that still exist in medicine. So I think that's the most recent example. And I'm happy to go further with some of those things. But other health issues, you know, you and I connected talking about breast cancer. My story is not as dramatic as yours. But I had this experience of a lot of breast biopsies followed by discovering that I had a high risk gene mutation and then going through bilateral mastectomies and you know how traumatic that is having tubes in your chest wall for weeks on end three times. You may have had I think you even had more than that. And then one of the things that came out of this as I was healing from the the mastectomy I got treated with antibiotics broad spectrum antibiotics for a month. And it was the first time in my life that I had broad spectrum antibiotics for so long. And it really, you know, it's like a spray and pray phenomenon where my good bacteria just got wiped out. And I ended up having anxiety and insulin resistance and eventually got diagnosed with SIBO small intestinal bacterial overgrowth. So that, you know, that was a challenge that I went through just three years ago. And I think you and I connected quite a bit about that. The other one other story that I'll mention, you can kind of tell me which door you want to go behind. When I was in my mid thirties, I was still practicing as an allopathic OBGYN and I had I gave birth to my first daughter and I really struggled after giving birth to her. So I went through a divorce. I I had postpartum depression and I was struggling with my weight. I couldn't lose the baby weight that I had. I had terrible PMS and I went to my primary care doctor who said, you know, why don't we start you on Prozac and why don't you take a birth control pill? Because that's also a very hormonal problem a woman has. And, you know, you just need to exercise more or need less. So that's that's the pivotal moment for me. That was the epiphany where I left his office, you know, kind of ashamed and feeling guilty. And then I got angry and I realized, oh, my gosh, if I'm being told this and I'm a physician, there are millions of women who are being told this and it's the wrong thing. I did not have depression. I did not have you know, a need for a birth control pill. And I was already running, you know, like four miles, four times a week. Exercising more was not necessarily the right answer. So that was when I really would say I had my greatest epiphany and I went to the lab and checked my hormones and discovered, you know, a whole bunch of hormones were out of whack. I mean, my cortisol was three times what it should have been. That was going to be part of it. Yeah. Yeah, cortisol, you know, pretty much every female physician that I know who's still in that male model has a cortisol that's three times what it should be. 100 percent. I would live that my whole life. So totally get it. I'm glad you bring this. I'm sure people listening, this is very relevant, whether you are, you know, just starting, you know, college and your woman or you're in your mid thirties and you're having babies or you have a few children at home or in your forties or still have children or whatever stage of life or even past menopause. This is relevant because so many of us are especially in the times we're living in right now. There's so much. So there's an acronym I learned by Tan Celia years ago. And I love it. It's called NUTS and UTS. And these are the predictors of things that raise our cortisol and change our HP access and cost stress. And it's novelty. So something new, unpredictability, threat to ego and sense of control. And I've often thought right now during the pandemic and all the stuff that's happened, even in regards to Black Lives Matter and the trauma and all the things that people have been going through. Novelty, unpredictability, threat to ego, sense of control, every single stress trigger that we could have, most every one of us have all four. So is it any wonder that we're seeing? I don't know about you, but the people I'm seeing come into clinic nowadays, they are under so much stress and the old traumas are coming out. And like, I really feel like I have to be even more centered, more grounded, more empathetic than I've ever been. And even part of why we're doing this is talking about how do we deal with this stuff? We're two successful women who, you know, see patients for a living and we're still navigating some of these things ourselves. We don't we don't have all the answers and we don't have it all solved, but we have learned. Have always there in our lives like you, we've got to really control that cortisol. I love what you mentioned too about the doctor saying, you know, runny, go do some more exercise and eat less. That mentality is so prevalent and I might have shared this with you in one of our personal conversations that I was shocked in my forties to learn. I had been doing orange theory running all this high intensity, high cortisol driven activity. And as I worked with a trainer, she said, you need to slow down. And I was like, no way. But as I did, I basically joke about I stopped exercising and I got in the best shape of my life. Like I lost a large percent body fat by basically stopping the exercise because it was driving the cortisol, which was my weak link. And same with you, the blood sugar issues where I've reversed all of that by controlling the cortisol, which is stress. So I'd love to talk about all of your stories. So I might come back to those, but let's talk right now. Stress, this whole what's going on now. There's I don't know if there's been in my lifetime, a bigger world stressor and the level of stress and unpredictability and uncertainty that I see in everybody's lives, the fear, the anxiety is what I've seen at all time high. What would you say is some of the advice that we could give people right now? Not that we have all the answers, but because this is tough. And those of you listening, some of you might have lost jobs. Some of you have known sick people are still, you know, friends, family that are sick. There's so many things going on. And if you're not dealing with something now, you either just got through something or it's coming. That's just how life is. Right. But what are some of your best tips to deal with the kind of stress that we're living with today? And I'd love to know. Well, I agree with you. And I think the statistics that have been gathered about the pandemic and our response to the pandemic is is really daunting because we are facing a tremendous period of stress, a period of trauma that I would say is on par with some of the wars that we've fought. So it's it is a difficult time, but I would also say the techniques that work now are the same techniques that you and I were talking about a year ago, five years ago, 10 years ago. And for me, it starts with being able to step outside of yourself, not dissociating, but being able to get a little distance from the exigencies of life, you know, kind of that crazy town that's happening right before your eyes. So being able to develop some of that witness consciousness, that's kind of the fancy term for it. But it's it's really about creating a little distance with the voice that's in your head, with the drama that's unfolding in front of you. And there's so many ways to do that, you know, for some people, it's mindfulness for others, it's meditation. I'm a fan of yoga and meditation. So I think there's there's many ways to practice this. What I found during COVID, for instance, is that I I need to meditate for saying the morning and again before I go to bed, because if I don't do that, there's a way that I'm perseverating. I think because I'm staying home right now, that I know is not good for me. I know it's leading to me grinding my teeth, it's leading to Bruxism and some other things. So I find that adding a little extra meditation during the day is very helpful. I've got my iPhone right here. Every time I type my code into my iPhone, I pause and take a deep breath. I think that's a really helpful technique. But I also would say extraordinary times call for extraordinary measures. And there's there's some things that I think can be helpful if you want to take it to a more advanced level. You know, I can talk about gardening, like I just love gardening and I've done so much more of that since the pandemic was initially claimed at the beginning of March. I can talk about the exercise that I'm doing. I can talk about, you know, kind of the zoom hangouts that you and I have done, which I I know help me with my cortisol. What we know, especially for women, is that if you can activate the tendon befriend, that's a very helpful way to deal with stress. And it can be as simple as, you know, a FaceTime call with someone that you really love to talk to. I've got those set up weekly for myself. I've got yoga every Sunday with my friend, Joe, and we always talk either before or afterwards. The other thing, this is a little deeper, but I feel like I can go deep with you. I think getting back to the point you were making about nuts and that sense of control. I think the sense of control in some ways is like a total illusion. And I I would say a big part of the challenge that I had as I was going through my medical training was because I was taught that I needed to control everything. You know, at that time, we had these note cards. I don't know if you had those where you do all the checkboxes for what your patients need every day. You know, like you had this idea. I'm going to control everything on this note card. You know, I'm going to do everything on this note card and then I'll be able to leave at six p.m. after working 36 hours. And it turns out that like control is a total illusion. And the more that we can surrender to it and just kind of dance with what's unfolding. It's just so much better for your cortisol. It's so much better for the way your brain talks to your gut, talks to your microbiome. It makes a huge difference. And I think it's relevant here with COVID-19. What do you think? Oh, I love that because gosh, I'm a recovering perfectionist, recovering control freak. So and not that I have it all made, but I think that those are some of the most important things that I've learned is letting go of expectations. And I'll tell you whether it's your work life and your clinical staff or your patients, especially because we can give them information and help them and love them and encourage them and give them resources. But ultimately it's in their control and even if even the things that are in their control, ultimately the outcome is up in the air that we can't control those outcomes. And I know I'm sure you've had this before when the first patient you love and have cared for for years passes away or something happens that is tragic and there's a sense of like, oh, my gosh, could I have done something different? And usually the truth is we've done the best we can and they have to. And these are things that just happen obviously in life. I find with the relationships to usually the things that really sabotage whether it's romantic or friendships is expectations. Right. So if we can give the people we love freedom to really be themselves in all their glory and all the other parts, right, and allow them to show up as themselves without expectation, not that we can't say, hey, let's, you know, have dinner every Friday night at date night. We can have those kinds of expectations or agreements between us. But the expectations of making them into something that we want versus who they really were or created to be. I love continually reminding myself to let people be themselves and love them just where they are. And one thing I feel that when I see friend, family, new person I meet, I have the ability I suspect you do to to see the soul level. So people can be like even patients, they can be coming in, they're really critical and they're hard to talk to and they like got this, you know, the near up of like, don't mess with me. And I see right through that I'm like, they're hurt, there's some trauma there, there's something else going on. And I actually find this little inner challenge like how can I love them in order to break down that barrier? It's like this little secret of my like, I want to really break through. And the other day I had a patient who was almost competitive on the phone and she everything I would mention, she was Zoom. And everything I would mention, no, well, I can't do that can't do that. This is why. And I just kept coming back, coming back in the very end, I said, okay, let's pause. I can see that you've been traumatized by the system. And I can see that there's a lot of lack of trust and there's a lot of anger. And I know it's not directed towards me. I said, there's nothing you can do or say to me that will make me love you any less. And I said, I'm here for you. I'm not leaving. You can say anything you want. I'm still going to be here. And I'm going to take care of you. And I'm going to love you. And you could not imagine immediately your face changed. She started weeping. And I don't know if that will permanently change her interactions. But I saw her soul. It was broken. It was hurt. It was like an animal who's been hurt and cornered and tries to lash out. And we see that in people that we love. We see that in our patients. And if we can start to see people just in that place that we're human and there's trauma and there's pain and see past that to the soul. And for me, I love to see what the potential is in human. And I actually do it to the fault because some people who maybe don't deserve a second, third, fourth chance I tend to give it. But I much rather be that and assume the best and expect the best because I've seen miracles in my patient's lives and my friends and family lives and relationships because I have this expectation of good and what they're capable of. And it transforms people to be seen that way. Well, this is why we love Jill Carney on so much. It's it's a beautiful testament, I think, to what you've overcome. In your experience and how you bring that forward to patient care to teaching to your friendships. That moment that you had where you asked that that patient to pause. To me, that was a moment of undefended love. Like no defensiveness about all the excuses she was giving you. No defensiveness about how she was treating you or blaming her or blaming someone else, just like this pure light of undefended love. And to me, that's that's our job on this planet is to get to that place of undefended love, even in the moments where you are fully tested to be able to show up with that that level of connection and love. That's to me, that's that's our highest purpose. I would say service and undefended love. Those are our highest purposes. I love that wording too. I love it and you're making me cry. I'm very touched by your words. And I do. I know you do too, but like I really I don't always do it right. But I so badly want to show up with light and love in every encounter. And it's so funny because our humanists gets in the way right because even when this patient like I could feel myself getting riled up and I could feel myself getting like almost anxious because it was so hard to keep the calm demeanor. And then I just hit me wait a second. This is not about you're getting triggered. And this isn't about that she wants to trigger you because that's she's she's corner. She's scared. And but it doesn't always happen that way. But when I can see past that and then show up with that's where the healing starts. That healing starts because this person no amount of supplements or suggestions or lifestyle changes would have helped. What was there at the core was old trauma and old anger and a whole situation I won't go into. But when she started to share I realized how much unresolved anger and bitterness and unforgiveness were there. And really the course you with her healing wasn't about a pill. It wasn't about a lack of sleep or a diet change. It was about those emotions that she was harboring that were keeping her in bondage. And I hope that maybe somehow we open the door just a little bit for her to know that it was safe. Because really that's the other thing if we can create a place for our patients where it's safe. We talk about the pandemic and all this. It's really this danger response that we're feeling it's unsafe. We can't go outside. We can't touch a human being. We can't you know breathe all these things that we did like breathing is pretty important touching human beings. And I love I think you and I both either I know you met Dr. Nadine Burke and then I read her book and I was impressed that you had connected with her. But I love that book it's called the deepest well if you haven't read it I highly recommend it really touched me because number one the inequalities with race are very prevalent there and it's not that all trauma is race face but there's certainly a larger degree of trauma in certain races and that's so sad because it definitely I think the statistics show and you can correct me or share your thoughts. It is the biggest predictor of mortality or morbidity is an addressed childhood trauma. Would you agree or at least one of the biggest well it's hard to do you know sort of a side by side comparison but the work on adverse childhood experience I think is really interesting because in Nadine Burke Harris has been such a great advocate she's the surgeon general for the state of California which is how I met her a few months ago but one of the things she's done is she wants every physician in California to start screening for adverse childhood experiences. And so what we know with ACEs is that having a score of one or higher puts you at this greater risk of a long list you know I think there's like 46 outcomes that are associated with it. She starts off her book with this incredible story of a man who's in his 40s who wakes up and he can't move his arm and his leg on the left side and it turns out he's having a stroke and she overhears his wife takes him in the ER and she overhears the doctor saying you know 42 year old male status post stroke no risk factors and his greatest risk factor is that his score is elevated. So it's one of those risk factors that I think we don't consider enough how that compares to other social determinants of health. It's a little hard for me to do a side by side comparison. See I just got out of my parasympathetic and I went into my sympathetic drive to answer that question. I know I want to take this back to a couple of things you said about this experience with your patient because I want to honor you. You know you were talking about how you were starting to get triggered which I think is the normal response for so many of us especially on zoom where it's a little hard to read the body language of another person and if someone freezes for a few seconds you're like oh my god what did I say. But I think you know the work of Eckhart Tolle I think is really interesting here he talks about pain bodies and how it has a result of trauma and maybe abuse we have this reservoir of pain and we can try to activate it in other people because it makes us feel better and I think to notice that happening on a zoom telemedicine appointment to notice that you know there's a little triggering happening here is very advanced and to be able then to kind of take it down a few notches and ask to pause and kind of break the energy of the pain body and then speak more directly to her soul. That's very beautiful and what what it does just like what I just did talking about ACEs I think it helps us with that limbo or balance that we want between the parasympathetic nervous system where we do rest and digest and healing that's where all the healing happens versus the sympathetic half of the autonomic nervous system which is fight flight freeze and we want as much as possible especially when it comes to healing to be in that place of the parasympathetic nervous system. So what I hear you saying if I put it in you know medical language you were having this interaction with the patient she was pushing back and combative and it was starting to take you into the sympathetic nervous system and you said no wait hold up pause let's go back to the parasympathetic and I just want you to know nothing you say will make me love you any less like that's that's like pure language from the parasympathetic nervous system. Wow in fact are speaking like that's not normal on the stage but when we can bring that piece to the stage and to the teaching and even to our writing that Sarah is what's going to transform people's lives the science is great because your analytical mind needs the background to have this foundation in order to believe what's true right. I love the science but that piece that you just described that is how we change our world and so I just continue I don't have it all but I want it so bad I want to be that yeah well I witness it with you I witnessed it May 2019 when you're on the stage in Orlando and you were talking about your story I could feel it I was listening to you gave a talk for A4M on the gut a few I think in May I witnessed it again you know you were talking about I think coconut oil and LPS and teaching a way that activates the parasympathetic nervous system you show up with that coherence that I think is so profound I just figured in my black suit yeah we just have to show up in our dresses and like be you have to be Jill and I have to be Sarah exactly unapologetically and I you know I remember the day when it shifted and it's been a process that I remember really clearly the day when you know years ago what I would do is like oh my gosh what if I trip what I fall is my dress okay is my hair okay are people gonna because women are kind of critical and they're looking at your shoes and they're gonna look at your hair and they're gonna look at your lipstick and so I you know I wanted to be put together and I was all worried about me my words my dressed it and then God just was like wait a second Jill I called you to touch people's lives and it's not about you I'm using you and I've given you a gift of words and voice and speaking and knowledge it's not about you if you just trust me and you allow me to speak through you I promise it'll be a better outcome and I really remember like that the surrender we just talked about that like before I went on stage that day I said a little prayer I'm like God this is all about you let me just be up there and I just let go of all expectations I surrendered to the outcome no you know no outcome no expectations and I didn't care I thought you know what if I trip I'll look human it'll be good people see I'm just a normal you know if my dress rips or something funny it's just okay and I just let go of all that expectation and that desire to be seen or heard as a certain way let it go and just thought okay how can I love the people that I'm in front of and it changed everything that day and from then on when I get before I go on stage I just have a little prayer of like this isn't about me whatever's supposed to happen let it be and I'm more spontaneous and what happens is I'll be on stage with a plan for what I'm going to say and I'll look across the room and see a woman in tears and I'll have a thought and I might go a totally different direction and tell a story on the spot and it'll be so much more impactful than if I planned it and I love living that way and again it's a practice but it's so freeing it's so freeing and I think it's really important for our listeners who maybe you struggle with I don't like this term adrenal fatigue but I think that's you know what it ends up getting named I like to think of it as you know I'm an engineer so I like to think of the control system for your hormones yeah absolutely too my hypothalamic pituitary adrenals thyroid gonadal gut axis is disrupted but I think for people who are really struggling with cortisol and with stress which is you know 95% of my patients this is the answer you know being able to kind of turn over the reins to be able to say I'm a channel you know it doesn't absolve you of responsibility I still have two daughters that I have to raise I still have a mortgage I have to pay but that idea that you don't have to do 100% of the work like you you do your 50% and you let your higher power however you can see that to be to the other half oh my gosh what a huge relief huge it is oh my gosh it is it's funny because as I've been writing my book there's these things that'll come out and I didn't really realize it's how I view life or see life but when you have to write it's like therapy right you have to actually put into formulation what you're thinking or feeling or how you're behaving and sometimes you see stuff you don't like and then you're like okay I gotta change that but one thing that comes to mind as you're talking is there's a chapter coming out talking about believing acting and waiting and I realize my whole life this is a lot of how I live I have this belief that miracles are possible that the unexplainable could happen and that beautiful things you know are possible and then I have to do some action you said it doesn't absolve of the responsibility so you have to do something you have to show up you have to do your part you have to have the faith and then the last part is the weight and that's the part we don't like and we don't like to think that it's part of it but so often you do your part and then you wait and you wait and the beautiful amazing things that happen are in the waiting and it's the part that we least like to either believe we need to do or actually do but that waiting is the part the surrender that actually rebalances our sympathetic parasympathetic system and allows us to go into this place of receiving and when we think about when you see a gift like that's the joyous time we receive this great thing and we're grateful for it and we know that the some of those emotions are receiving and grateful and love they're the best therapy for our parasympathetic system ever so it's kind of a neat thing that as we do our part and then wait for the part we can't do that's when we see really great things happen love that I'm trying to find something to disagree with you about because it you know makes for more interesting conversation but I can't find any but I I agree with you I think there's something about the waiting that as you said you know kind of this state of receiving that that's the piece that so many of my patients skimp on for whatever reason I'm a recovering impatient person and so I totally get it but when you're not tuned into that frequency of waiting and observing and kind of chronicling what's unfolding in front of you and instead you're just like looking for the flaw so it didn't happen again I you know my prayers weren't answered it's um it's almost like you have blinders on yeah and you can't see like this amazing thing that's happening in front of you yeah and what I find is never what I expect or necessarily even what I wanted it's usually better but I have to let go of what I expect is the right answer and be open to what might be different or better and it may not feel like that at the time but when I look back for example you and I have both been through breast surgery and scares with breast cancer and obviously I've had breast cancer but I remember 25 years old third year medical student talking about stress there's no doubt that there was a connection between the massive stresses my suppression of my true nature and my breast cancer but all that to say I was mortified I thought I don't know if I'm going to live six months or six years I mean it was it was hard right 25 and you're dealing with my breast which as a woman is our sign of our femininity and all this and the biggest lesson of that is looking back the doctor I am today is so much impacted by my experience with breast cancer it was literally the best thing that ever happened to me like literally the first of the best that ever happened to me to give me the type of ability to be the physician I am today at the time it was the worst thing that could have happened but God turned it into this beautiful gift in my life and I'm sure you've had some of those I mean you talked about them you know and I'm sure you know with your surgeries and then your HP access function think about when that physician told you you need birth control and you need antidepressant that had to be so like you said you mentioned shame and difficulty then but think of that allowed you to write to New York Times best sellers revolving around your experience and to change millions of women's lives to me that's just profound isn't it how those things that we think are not really the greatest outcome can be the best thing that ever happened absolutely right and I think in many ways for all the people who are listening or watching to us watching us your symptoms can be the same gift like their messages sometimes divine messages of something that needs attention in even you know if we talk about ACEs we were talking about adverse childhood experiences and how we've got this really good system for diagnosing those I would say you know my A score is six in terms of the amount of trauma I had growing up before age 18 and those ACEs were similar for me as the breast cancer diagnosis at age 25 was for you they made me exquisitely sensitive you know almost like I was walking on eggshells they got me disembodied so that I was in my head too much of the time and not enough in my heart but those symptoms that came from that allowed me to you know create integration and wholeness that I think makes me a much better physician than I would be if I didn't have an A score of six so I'm not saying you know I'm so glad I was traumatized when I was growing up but I think there's the opportunity to take these experiences that we have as you've done with your breast cancer diagnosis you've done this so gracefully and so articulately and as I hope to do with my ACEs I think when you can compost those experiences into something that's you know extraordinary that's where the real healing occurs I love that and that was so eloquently said and I see to the whole it's like I had some trauma in childhood too and maybe not to that extent but what I saw is it allowed me number one to for me it was funny because my outlet was reading and books and learning and I went into my head too and I would never be the doctor or the one the love of learning or books if it weren't for that trauma because that was my outlet was reading and learning so it's interesting how that all plays together but you put it so eloquently and I think that's with our listeners if as we wrap up today one of the things that right now if you're listening I guarantee most of you have some difficulties some relationship some job situation some life situation or some other thing that you're struggling with you probably wouldn't be human if you didn't and like I said if you haven't if you aren't right now you probably just got through something or you're headed towards something and I think Sarah what you just said might be some of the best wisdom that we could leave is that how would you say if right now you know I remember when I was in breast cancer and you probably remember some of your traumas in the midst of them what kind of advice can we leave people with if you're in the middle of it how do you navigate how would you have hope how do you see past it any advice on that when you're right in the middle well you know one of the things that activates my trauma response is when I get into a fight with my husband and fortunately this doesn't happen too often it happens like once every six months and we are less resourceful we're not sleeping or whatever so I would say number one strengthen your resources I think that the more that you are getting sleep which is as close to a panacea as we have the more that you're you know getting sunlight before 10 a.m the more that you are establishing your circadian rhythm and eating nutritious foods like all of those things make you more resourceful and the second part and this is you know it's kind of like when you were getting triggered by that patient and I could sort of feel this empathic triggering myself and remember like the scores of patients I've had in yes all it takes is like a little crack in the door to let the light in so you were able to activate that you were able to you know kind of pivot in that situation it doesn't take some grand gesture it just takes like opening the door a teeny little bit to let a little bit of light in like a little bit of fresh air a little bit of a new perspective so that you can get some distance from this thing that you're you know kind of gnashing your teeth with and and that's where the healing starts one of the things I did I've been with my husband for 18 years now and I need a little note on my iPhone what to do when I'm triggered by my husband oh I love it so good for us to all of us so I have a list of like all these things that I tell myself to calm down similar to how you calm yourself down with that patient and you know it started with just like five bullet points now it's like ridiculously long but a big part of it is get curious not furious oh that's I borrowed that from somebody that's not something I came up with but I think that's a big part of it is you know if you can flip into that place of curiosity about your symptoms about your adrenal fatigue or HBA dysregulation about your breast cancer diagnosis or whatever it is if you can get curious not furious it opens up you know the possibilities in a much deeper way oh that's beautiful it's a lever of listeners with because that's really at the core that like you said the crack I love that analogy because you can just see it with the sun kind of filtering through you can see the dust in the air through the the ray of sunshine but I can so see how that's really a piece you don't have to feel super on top of the world joyful about your situation all you have to do is think like you said be curious what if what if there was something good here what if there was something more than I'm seeing what if there was something that's going to come from this that's really beautiful so I love that what if what if what what possibilities are here and that's the getting curious I think that's a great great place to leave you know we you shared about your grandfather and how we impacted you and I love that you share that especially in this time and how important it all all of us to be aware of racism and even examining ourselves in our own hearts because it's easy to point fingers and I find the most important thing is to look at ourselves say how am I contributing but I'd love to know and partying was there any words of wisdom you remember from your grandfather anything like real special you had a really close relationship with him what were what was one thing that he really taught you in life well I dedicated my first book to him he died just before that was published and I feel like more than anyone else in my family he understood how I ticked like he he understood my mind and my heart in a way that others were too busy to understand and what we know is that it only takes one person growing up to kind of get you and be able to reflect back who you are to you a mirror and that's what I got from my grandfather so it was incredibly profound and and you know I whenever I do I do a lot of guided visualizations and meditations and whenever you're supposed to pick a benefactor yeah he's my benefactor he's always my benefactor I love that and I bet you feel him I mean I know some of the I just I've had those experiences where there's someone I have a great great grandmother and a grandmother and they're both very very precious and in difficult times I've literally felt their presence that's a whole nother story but I remember for me learning to have a voice as a woman and stand up for abuse when I filed my first restraining order that's a whole nother story but my visual part too Jill I'm like okay we're gonna leave you guys hanging to come is the the bad relationship choices of Dr Jill oh I've got them too all the bad boyfriends that raised my cortisol that'll be a really fun one all I just say those people came before what I remember about her coming was like I felt the strong sense of she didn't have a voice and she couldn't stand up to situations where she was you know treated unfairly and she was like saying will you please rectify this for our whole lineage and I was able to do do something that really changed my entire lineage of women so I love that and I love you right now can take and pass on this incredible spirit of your grandfather through your books through your teaching through your love for people and your patients and I'm sure that he is smiling down on you and so proud of you Sarah thank you I mean what I could hear him say as you were talking was keep going honey there's a lot of work to be done can I please borrow him because I love keep on working I love it well we will leave you all with that and we'll have to continue someday because now you want to know the stories thank you for joining us today Dr. Gottfried where can people find you and more about you the best place to go is sarahgotfreedomd.com and if you're you know one of the things we didn't talk about is I'm going to start seeing new patients again I've been closed to new patients for a number of years and the place to go for that is sarahgotfreedomd.com forward slash patient oh that's exciting so we'll be sure and put the links in here and on YouTube my YouTube channel you can find me at jillcarnian.com of course thank you all for joining us it has been such a joy Sarah thank you Jill