Thriving or Surviving with Dr. Tess Fitzpatrick

“This whole process, even with all the support, is very isolating. Having someone to talk to and having people around you is critical” - Dr. Tess Fitzpatrick

In this episode, we chat with Dr. Tess Fitzpatrick, a neurologist working in the GTA. We learn about her journey with IVF, being pregnant and a full-time physician, and the importance of role modelling.

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Contact Information

Dr. Tess Fitzpatrick, M.D.

Email: tfitzpatrick@qmed.ca

Twitter: @tessfitzneuro

Dr. Tess Fitzpatrick completed her Neurology residency at the University of Ottawa in 2019 and a stroke fellowship at Sunnybrook Health Sciences Centre in Toronto. She is passionate about teaching medical students/residents and is especially interested in acute stroke therapy and cerebrovascular disorders in the young. 

Transcript

Radha Sharma: Welcome to Season 1 Episode 7 of Family Planning for Docs - Thriving or Surviving. This podcast is an extension of our platform at www.familyplanningfordocs.com a website created for Canadian medical trainees to highlight useful information about family planning in a medical career. Our research has demonstrated that personal stories are highly impactful, and we hope to provide access to a diverse number of stories, to current trainees on our podcast we hope to capture the stories of medical professionals who have navigated the training process and a medical career while planning parented parenting and the supports along the way. In this episode we have Dr. Tess Fitzpatrick. We are thrilled to have you on our podcast. Today. And again, thank you. Thank you on behalf of our entire team for taking the time to share your journey today.

Tess Fitzpatrick: Perfect. Thank you so much for having me.

Radha Sharma: So we'll start with the first question, what does a day in the life of a neurologist or Tess look like?

Tess Fitzpatrick: So my week's kind of vary - I have clinic weeks and during those weeks I'm in the neurology clinic. I work at Mackenzie Hospital. and I see patients, general neurology patients as well. I completed a stroke fellowship. So I see a lot of stroke as well, and then we kind of rotate into weeks of service where we're covering the inpatients at the hospital. There are 2 hospitals. One of them is kind of the stroke center, which is very busy, and we run code strokes. And we see also general neurology consoles, and then the other hospital, which is a little bit less crazy in terms of not having code strokes. But I'm busy with the inpatient service as well. So we rotate doing 2 weeks at a time of that and then, of course, doing stroke call at night. So that's roughly what things look like for me.

Radha Sharma: So busy, busy, busy. It's what it sounds like. 

Tess Fitzpatrick: Very busy, but good - it’s rewarding.

Radha Sharma: Amazing. You mentioned that you've done a fellowship, or are you currently in your fellowship right now?

Tess Fitzpatrick: No, I'm done. I've been working for a few years now. So after residency, I completed a stroke fellowship at Sunnybrook, and then I've been working for the last few years. 

Radha Sharma: And for our listeners that may be interested in neurology, or just want to know how you got to where you are now, can you walk us through what the training process from start to finish, kind of looked like for you.

Tess Fitzpatrick: So after medical school, I did a neurology residency, obviously, so that was a 5 year program. And after that I did a one year stroke fellowship. Certainly you can do 2 years from fellowships that are more focused on the second year is often focused on research. But I just wanted to focus more on clinical things. So I just did a one year fellowship. And after that was able to get a position at a hospital and have been working since that time, and I worked for a short time at Sunnybrook, and now I'm at Mackenzie, which is more of a community hospital, which is sort of what fits best for me. I like some scholarly aspects of Academia. But I also just like being a clinician, and I'm not as much of a researcher. So I wanted to go into the community. And I'm very happy with my decision there.

Radha Sharma: So our goal on this podcast, like I mentioned, is to chat with people like yourself and others who've kind of fit family planning within a medical career. What sort of inspired you to want to have a family one day. What was your motivation?

Tess Fitzpatrick: I think I just always wanted to have kids. It's something that I, you know, always felt it was in the cards for me, especially if I found the right person to share it with, and I met my husband, who is just the most amazing human ever, and he's meant to be a dad, and just no, no question. Early on we wanted to have a family and have kids. So that was, it was just something that we always wanted.

Radha Sharma: That's awesome. So shout out to your husband on the podcast. Before the podcast started, we've been chatting. And you talked a little bit about how you're pregnant, which - congratulations! Can you walk us through what family planning looks like for you specifically.

Tess Fitzpatrick: Yeah, thank you. We're very excited. I'm 27 weeks pregnant now. So expecting a baby in October, baby boy. So we had a long and difficult journey to get here. So we essentially started our journey about 4 years ago, after we finished residency, my husband's also a doctor. So we finished residency and started fellowship in Toronto, and essentially at that time decided that we wanted to start trying to have kids, you know. Residency was finally over. And this would be a good time. And naively, we kind of thought, okay, perfect, I'll get pregnant and fellowship, and have it timed, so that I deliver right at the end of fellowship. Then I'll have my mat leave, and then try and find a job afterwards. That was the ideal plan that we had laid out. And unfortunately, things do not go to plan. We essentially couldn't, you know, struggled with getting pregnant. And very early on we went and had some tests done, and. Long story short, we ended up needing to go through a fertility clinic and needing to go through IVF to get to where we are today and it wasn't even a straightforward IVF process, if there is such a thing. We we actually had to go through 4 cycles of IVF and really, really hard journey over those 4 years. I think it's hard to fully appreciate and understand how hard infertility and IVF is, unless you've been through it. But it was certainly the hardest thing that we've ever been through in our lives, and a lot of grief and loss and sadness. We've had a really, really heartbreaking traumatic miscarriage in there as well, about a year and a half ago, and took a long time. To be honest, we're still healing from that, and I think we'll still carry the pain of that forever with us, even though we're very excited and happy about where we are now fortunately in our journey. But anyway, so we went through a lot. And in there, in those 4 cycles, you know, there's a million appointments which are really hard to navigate, especially for anyone, but especially as a physician. When you're in an IVF cycle, you have an appointment at some point every other day, and you have to go and get monitored with ultrasound. You're doing injections multiple times a day that are timed at a certain time. It's not easy to be on stroke call and be in the middle of a code stroke, and your cell phone alarm goes off that it's time for your this injection or that injection, and you have to run to the bathroom and lay out all your syringes on the floor and try and do it, and then run back to manage the patient who you're giving TPA to. It's a lot, I think, for anyone. But it was especially challenging as a as a doctor to balance that, and we kept a lot of it very private from people, especially to colleagues. And so it's difficult to keep coming up with excuses as to why you need your call shift covered, or why you have to have your morning clinic cancelled last minute. It's certainly challenging not to mention the physical aspect of it and the emotional aspect and navigating that while trying to be a good doctor is challenging. And so it was a long, long road. And you know we can talk more about how especially what it that was like as a doctor balancing that. But in any case, all of that, you know as well as you know, embryo transfers and failed transfers and miscarriage I mentioned, and everything. So long, long road. But eventually, we are very fortunate, and so grateful that with our last embryo transfer that we did in January was successful, and everything is looking good with baby boy, and we're you know, on the road to finally becoming parents. Tough, tough journey to get here, for sure. But we're just ecstatic about this next chapter of our lives that's coming up.

Radha Sharma: Firstly, Tess thank you so much for sharing what you've been through, and I'm so sorry to hear about your challenges with infertility and your miscarriage. It's hard to hear for some of our listeners. But I think it's something that is the reality for so many. And so you're helping do the work you know, bringing awareness to those things. 

Tess Fitzpatrick: Yeah, no. I think it's very important. And that's part of the reason. I agreed to do this podcast because to be honest, there's a lot of shame and stigma around fertility, and people don't talk about it. And until recently I was one of those people who never talked about it either. but I think it's very important for people to start having conversations about this, and it's just as important as so many other medical things that we do feel so open to, you know, comfortable talking.

Radha Sharma: Yeah, definitely. How did you access IVF? Was it something that you were referred to by a family physician? 

Tess Fitzpatrick: So we actually went through the initial testing through the family doctor, it's kind of ironic, but my husband was at the time doing an infertility fellowship, which was very challenging for him to navigate as well, because going through it and suffering himself, and then seeing patients with the same or, you know, slightly different journeys. It was very, very hard for him. But anyway, because he was in this field very early on, after a few months of trying, he convinced me that we need to go see our doctor. And I was like, listen, relax. It's been a few months but we we just wanted to get a head start on things. And at that point new kind of based on our test results that we probably need to go through, we got a referral to a fertility clinic. We had to wait a few months to be seen there. But, all things considered, a lot of people don't start at the fertility clinic until they've tried, for like a year or 2. At our age - we were at that time just turned 30. So I thought, you know, usually you try for a year or a year and a half at least before you start to even get referred to the clinic. But we had been referred and seen at the clinic within 6 months of starting to try, just because we had a head start with everything. And so then we so saw our doctor at the clinic and had to go through, you know, go through a bunch of tests and work up and ultimately, applied. The first cycle of IVF is through the government. So you have to wait for that. So it's a lot of waiting in between right, all of this. and and and still, as you're waiting you're still trying and hopeful, and hope that you're one of these cases that gets pregnant. And then you can cancel your IVF cycle and and every month it's just just heartbreak and and it's really disappointing to go through that basically month after month of kind of trying and failing, and especially as 2 very type B succeeding types of people. We're used to you know, you work hard at something and you achieve it. And this is something where we have no control over so ultimately, though, we did get our funding for our cycle. And so we were able to do our first cycle, you know, just over probably like 15 months after we first started on the whole journey. And and then beyond that once we used up all our embryos from that cycle and we had to pay out of pocket for the rest of the cycles, which is another burden, like as if the psychological and emotional and physical side of things isn't enough it's extremely expensive, as I'm sure you've heard. And so we had to pay for the rest of the cycles, and you pay for all the medications as well, which are not covered and are another several $1,000 per cycle. So it's a lot. But we're very grateful and fortunate that as 2 doctors, we you know, have the means. No one wants to spend the money on this kind of thing. We'd rather spend, save it and go on multiple trips or buy a new car. But here we are.

Radha Sharma: Thank you for sharing that Tess. Yeah, I was gonna ask you how the coverage works, the first cycle being covered by OHIP and then subsequent costs that aren't. Are the medications covered by OHIP, at any point, or are they always out of pocket costs?

Tess Fitzpatrick: They’re pretty much all out of pocket costs. So, even it depends if you have any benefits. You know we had some benefits through OPIP but very minimal. They cover the first I forget how much, but very little. There's a max that you reach right away. It doesn't cover half of the men's needed for a first cycle, and each cycle was between $5000 to $7,000 of meds

Radha Sharma: Wow! I think that's important for our listeners to hear. Definitely something to keep in mind, especially if you're considering it or that's something that you're planning for later.

Radha Sharma: You talked a little bit about the psychological, and you know physical challenges of dealing with the IVF, and then also the waiting and this constant like back and forth with things that are out of your control. How did you cope with those things who were your support systems at that time?

Tess Fitzpatrick: So we kept it really private at first for a long time, and I think you know, obviously, it's all the power of retrospect. Looking back now I wish we maybe we're more open with people sooner. But ultimately we did open up to our families and some of our best friends, and those were very important supports for us to have. Very, very important, wouldn't have gotten through all this without them. There were a lot of low and difficult moments. So having supports was critical but also both of us have therapists. I'm a big advocate for that. And that has helped me immensely, and I still see my therapist. And even now, even though I'm pregnant and kind of almost on the other side of this, but it's been really helpful to have a professional to talk to about all of this. There's a lot of grief and trauma and things that we've each gone through. And obviously my husband and I have been through this together as a couple. But we've also had individual experiences. And so we each have different therapists and to deal with our own emotional pain and in different ways, and that's been very healing. And then the the other thing that I can't forget to mention is that I had, I guess I could call her like an IVF mentor. So I got connected with a friend of a friend pretty early on during the whole journey, and she is also a physician, and had gone through IVF, and was the only person I knew who had gone through this, and she has been like my rock through this all honestly. It's been very helpful to have someone to talk to each step of the way and have someone actually understand, because she's been through it, too, so I would call her many times crying or upset, or anxious about an upcoming procedure or test, and she was very, very, very helpful to have there as a resource. And then, finally, I did join some support groups. There are specific women, physician infertility IVF, kind of the groups. And that's also something that was very helpful to be able to have a forum, to discuss things with other people and feel less alone.

Radha Sharma: I'm hearing that the support systems were really critical to your journey and having them kind of ready at the go.

Tess Fitzpatrick: Absolutely, absolutely huge. And this whole process is, even with all those supports, it's very isolating and having someone to talk to and people around you to help you through it is, is critical. I don't think we would have survived, or had the strength to keep going or try another cycle if we didn't have the support.

Radha Sharma: And how did you get connected with your mentor? 

Tess Fitzpatrick: yeah, I got lucky. I mean, I told very few people at work about this, but there was one colleague of mine who's a good friend, and I had to ask him to cover quite a few of my call shifts last minute, just because you don't get necessarily the exact date of your egg harvest, or something in advance, like you kind of roughly know, but it depends on your ultrasound and and blood work and things as you're going through the stimulation cycles. And so I would have to sometimes last minute get someone to cover call, because I'd have my egg retrieval, or something like that. And so this one colleague of mine was very kind, and often helped me out, and I decided to be honest with him and say, listen like the reason I'm asking you to cover my call again is because this is what I'm going through. And one of his best friends was the person that I got connected to and had also gone through her own challenging journey of IVF. And I knew her kind of peripherally, but didn't know her too well, and so he connected the 2 of us that way.

Radha Sharma: Amazing. I'm glad that you had someone to kind of talk to that's been through that journey before, because I can't even imagine how isolating that is on its own.

Tess Fitzpatrick: A hundred percent. And now that I've had you know, the relationship with her, and that's helped me so much. I'm currently trying to be that person for other people. Recently my husband and I decided to be open about our journey and post on social media, about what we've been through, which is a really big step for us. And you know, we kind of decided, we're done cowering in shame. And it's a big step to put it up on social media. I got a lot of messages from people that I know, and I have no idea that they're going through similar but different journeys. And with some of these people who have reached out to me they have expressed how isolated they feel, and how much it helped to see someone talk about it openly. And now we're texting and talking all the time, and they're telling me about their anxiety for their upcoming appointment, and I'm hopefully going to be able to pay forward a little bit of what my IVF mentor did for me because she was honestly, very instrumental to the whole process for me.

Radha Sharma: I know you said. You're 27 weeks pregnant. How has pregnancy been treating you? Has it been smooth sailing? Has there been challenges that you've been navigating through?

Tess Fitzpatrick: So I feel pretty good right now. I can't complain physically, I feel great. I think the early parts of pregnancy, especially you know, of course, physically challenging, first trimester is just brutal, but beyond, you know honestly, what was worse for me than all the morning sickness and fatigue was the anxiety because of everything we've gone through. I think any newly pregnant person has moments of anxiety, but It was really hard not to be hypersensitive to everything that I felt in my body, because you feel it in your stomach, I would get worried that something's wrong, especially with our experience and previous miscarriage. So I there was a lot of anxiety early on, and still now. But it's getting kind of better now that I feel baby moving and kicking all the time. And you know I'm more and more reassured that everything's going to be okay. Hopefully, you know, knock on wood. But I think especially early on that - all that uncertainty was challenging. But luckily, right now I feel good, and physically it's like good energy and you know. No, no complaints yet I'm not. I'm close to third trimester, but not huge yet. So I think the back pains and all that is probably coming. 

Radha Sharma: You'll have to update us on how the third trimester goes? How has it been, you know, working and also being pregnant? What's the environment like? Is it a supportive environment would you say?

Tess Fitzpatrick: yeah, very supportive. Everyone at work is very happy for me and I have a lot of, in particular, a lot of female colleagues who have previously taken maternity leave and have babies or kids that have grown up. And so they're all very supportive of that, and it's been really nice as well in the upcoming month, especially, it's hard to be on the call and jump out of bed for code strokes. So a few of my colleagues have reached out and offered to take some of my calls, which is really nice, and I'm grateful for that.

Radha Sharma: If you did have a magic one and you could go back and change anything about your journey thus far. Would you change anything? If so, why?

Tess Fitzpatrick: You know, I think my answer to this question is probably semi irritating, but I'm sure that one of those people who feels like I don't think I would change any of the big things. I've certainly gone through tough things in my life, and IVF being one of them. But I look back on it now, and I really see that that difficult journey that we took led to so much growth for me as an individual and so much growth for my husband and I as a couple. So, even if I had the power to wave a wand and get pregnant that first time we tried almost 4 years ago. I honestly don't think I would do it because I don't think I would be who I am today if I hadn't had these last 4 years and who I am today, I think, is someone who's a better person, a better doctor, a better wife, and hopefully will be a better mother.

Radha Sharma: I love that. I love the way that you phrased that. Do you have any advice for medical trainees that might be, you know, in medical School, residency or earlier in their career that you would want to share with them today?

Tess Fitzpatrick: I guess the only thing I would say is that like we talked about earlier, I found the whole process of infertility, especially as a doctor to be very isolating and for the first few years, especially, we kept things to ourselves because of a lot of shame around all of it. And obviously it took a while to get to this point and a lot of work on myself to become more open about it. But in doing so I realized that there are a lot of people out there who are going through similar experiences, and I've gained a lot from connecting with them. So I guess the piece of advice that I would give to you know, to other people would be to you know who, if they're going through anything similar to to be more open and kind of seek support earlier.

Radha Sharma: The last question for today, in the name of the podcast we ask all our guests, are you currently thriving or surviving?

Tess Fitzpatrick: I'm happy to say, I feel I am thriving. I am right now, the happiest I've ever been, in a place of excitement. We're setting up our nursery, and we're discussing baby names, and I love my job, and I'm very satisfied with the career side of things and my relationship with my husband. So I am just, you know, very good place. So currently thriving.

Radha Sharma: We want to give you another thank you, Tess. It was an absolute pleasure chatting with you today and thank you for being so vulnerable on our podcast. You can find Dr. Fitzpatrick's contact information in the notes from today's show. This is Tess and Radha signing off.

Tess Fitzpatrick: Thank you.