Thriving or Surviving with Dr. Liza Pulcine

“I think the best part about kids is sitting back and just enjoying life and special moments”. - Dr. Liza Pulcine

In this episode, we chat with Dr. Liza Pulcine, a pediatric neurologist and associate program director at SickKids Hospital. We talk about slowing down as a parent-physician, support systems that help them succeed and newborn cuddles!

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Contact Information

Dr. Liza Pulcine, MSc., M.D.

Email: liza.pulcine@sickkids.ca
Twitter: @lizapulcine

Dr. Liza Pulcine is a paediatric neurologist who specializes in caring for neonates, children and adolescents with stroke. Her clinical care and research focuses on all aspects of childhood stroke including etiology, diagnosis, early treatment, prevention and rehabilitation. She is an Associate Program Director for the Pediatric Neurology Residency Program and the Fellowship Director for the Children’s Stroke Program.

Dr. Pulcine completed her Master of Science degree studying the safety of antithrombotic therapy in children with congenital and acquired heart disease and stroke. Her research focuses on stroke prevention and management of cardioembolic stroke in children, including those supported with ventricular assist devices.

Dr. Pulcine is also interested in neurorehabilitation research. Her goal is to develop a cost-effective, home-based, virtual reality treatment therapy for pediatric arterial ischemic stroke survivors.

Transcript

Radha Sharma: Welcome to Season 1 Episode 13 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 and a medical career. Our group has a mission to inform medical trainees about their options regarding family planning while navigating training, career, and personal life. 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 career while planning, parenthood, parenting and the supports that they had along the way.

Radha Sharma: In this episode, we have Dr. Liza Pulcine. We are thrilled to have you the podcast. We just want to give you a warm welcome and a thank you on behalf of the entire team. 

Liza Pulcine: Thank you so much, Radha and again just wanted to thank you for having me on and inviting me to participate because I think this is so important to talk about. Yeah. So thank you for the invitation.

Radha Sharma: Awesome. So we'll get started with the first question, what does a day in the life of Liza look like?

Liza Pulcine: Yeah. So I guess just a little bit about myself. I'm a pediatric neurologist. And I currently work at the Hospital for Sick Children. And I also did some of sub specialty training in neurovascular neurology. So what that means is, I specialize in something very rare but not rare to a tertiary care center, and it's pediatric stroke. So my day in the life of a pediatric neurologist at a tertiary care center is, you know I run about 3, 2 to 3 clinics a week. Some are general neurology, some are more specialized in the pediatric stroke aspect and I have a dedicated day that I try to dedicate to research, our research projects, grant writing, publications and then in between all that I also teach. I was associate program director for the program and now I'm the competency by design lead and I also am the fellowship director for the pediatric stroke program. So I really enjoy teaching. So I'm an academic clinician by that definition. And we always juggle clinical, education and research in a typical week

Radha Sharma: That's awesome. And how did you know that you wanted to be an academic clinician? Was that something that you figured out earlier on? Or is it something that you always knew?

Liza Pulcine: So for me it was probably a great mentorship. So I actually, when I was in high school, I knew I wanted to become a doctor, and I knew I loved working with kids. So I innately thought, I'll be a pediatrician. My family at the time, knowing how difficult medical training can be, had actually tried to talk me out of it. That said, you know, if that's what you want to do, why don't you shadow a doctor so you understand kind of the ins and outs of what it's like, and there's no doctors in my family. So I ended up doing a CO-OP part of my high school, where I shadowed a pediatric neurologist and her name was Dr. Gabrielle deVeber and she was a pediatric neurologist who specialized in children with stroke and started the stroke program at the Hospital for Sick Children in the early 1990s.

Liza Pulcine: Immediately I kind of questioned, like I did not believe that children could have stroke, and it was such a weird concept to me. And then, just virtue of starting to work with her I became a summer student and then realized that I love neurology. And I love pediatrics. So it was natural to combine those 2. But because pediatric neurology is more, a little more niche in terms of what you could do for stroke. You know, most pediatric neurologists just work in an academic center. I realized that it's something that I'd have to practice only in a in a big hospital with a team, a multidisciplinary team, as opposed to community practice

Radha Sharma: And how did you get involved in being the - you said associate 

Liza Pulcine: Program director? I was asked when I came on staff in 2019. At the time our program was going through a lot of change, as you may know, that the competency by design curriculum was being transitioned to all Canadian residency programs. And ours was one of the problems that was supposed to launch in 2020. And low and behold, there was the pandemic, and so nobody saw that coming, and we needed more help and hands on board to try and really revamp our curriculum and really align it with the CBD curriculum. So I started in the role of a CBD or competency by design lead. And because I was so involved with the residents in a program that is smaller comparatively to like internal medicine. We probably have 10 to 12 residents in the full 5 years. So that kind of became a natural process, and worked very closely with the program director.

Liza Pulcine: Amazing. So it sounds like, you have a very busy schedule on on a weekly basis. Then.

Radha Sharma: And for our listeners that may be interested in learning about the training process. How many years did it take you - I guess from medical school to where you are now?

Liza Pulcine: Yeah, for sure. So I mean, for I think for any subspecialty it is a longer training process comparatively to primary care. So you know I went to University of Toronto for my undergraduate degree and then I matched to University of Ottawa for medical school. So that was a 4 year undergrad and then a 4 year medical school training. And after medical school I matched to pediatric neurology, which is it’s own program similar to neurology and instead of doing internal medicine, you actually match to neurology specifically. So for pediatric neurology, it's the same. There's 2 ways of doing it. One is a direct match to Ped’s neuro, and you do 5 years of that. Another way that's longer is to first due general pediatrics for 4 years now and then do 3 years of pediatric neurology training. So it's a way of if you know, that's what you want to save you those extra years of training. So it was a 5 year match and I became a resident at Sick Kids hospital, and that was a 5 year Residency, and thereafter I realized that I wanted to be even more specialized. And so then it was a year, actually a 2 year fellowship in pediatric stroke.
Liza Pulcine: So if you add 4 years of undergrad, 4 years of med school, 5 years of residency, 2 years of fellowship. Did a Masters during that time too - about 13 years of training from undergrad all the way to when I joined on staff in 2019.

Radha Sharma: Thank you for sharing that. I think it's really great to hear your stories and how you’ve moved through the training process, because, like you said, everyone's journey is so different and in the subspecialties of internal and then also neurology there's so many opportunities to do fellowship. So I think that's great. That You have the opportunity to do that as well.

Radha Sharma: I just want to tell our listeners that Dr. Pulcine recently had a baby. So we want to give her a congratulations on behalf of the team. 

Liza Pulcine: Thank you!

Radha Sharma: How has it been having a newborn in the house?


Liza Pulcine: So this is my second. And so with anything in life, perspective. Obviously, if this was my first born, I probably would not be doing a podcast right away. I was obviously much more like a deer in the headlines. Especially the first, you know, the first few months. But it's been wonderful. I realized how much I love the newborn phase. Everything about it. The cuddles - It's amazing just to see what a little human can do. And I think that it's easier this time around, because I know what to expect. The hardest part is the sleep deprivation. But even that is easier, because, you know, it's even though at the the first time I had my first son, I remember just being like, how am I going to adjust to this for the rest of my life. But then you realize everything is fleeting, everything has a season, everything changes. So even though I'm sleep deprived right now and the dark circles under my eyes. I love this phase, and I think that I know that in 3 months I'll be wishing to go back as they get sleep better. But you know every phase comes with its own amazing nuances and challenges. So just keeping perspective, I think it is great. But again, I just think that once you have one kid, it almost becomes easier to know what to expect.

Radha Sharma: I love your optimism. 

Liza Pulcine: It's true, though it's true.

Radha Sharma: Like I said before, our goals are to chat with you and others about how you've been able to fit having a family, building a family, and then also having this incredible medical career. Did you always know that you wanted to be a mom? Or was that modeled for you or did it come later in life?

Liza Pulcine: Because I had, you know, like, I said, I was very interested in working with kids. I always knew I wanted to have children and I always wanted to have a bigger family because I'm an only child, and actually both my parents are only children. As I got older I realized why it was so important to have siblings and the benefits of having siblings, I mean, as a child, I probably didn't realize that so much. So I knew that I always wanted to have a family, and was looking for a partner that would have the same values but I wasn't in any rush to be honest. And so, you know, when I met my partner it was towards the middle to end part of my residency. We actually got engaged on the day after graduation from residency. And then we had a year-long engagement and got married when I was halfway through, almost 3 quarters through my fellowship.

Liza Pulcine: So all in all. By the time I was married we weren't even in a rush to have kids then,  we were in our early thirties, and we both wanted a family. But I thought, Okay, well, I was a very kind of stepwise person, just my own type A personality was like, Okay, I'm gonna establish the career first, finish my residency, finish my fellowship, start on as staff, and then I'll have kids. That was kind of always what I thought about. Now, it may have been different if I had met my partner earlier, and we were married in residency. Maybe that would have been different, but I think it was just the nature of how things evolved.

Radha Sharma: So you had both your children as a staff physician then?

Liza Pulcine: That's correct. Yes. 

Radha Sharma: And so what did maternity leave look like? Because I know, for you know different specialties like family medicine for example, if you have your own practice, you need locum coverage versus if you're in the hospital, it's a little bit different. So can you talk to us a little bit about what your experiences with maternity leave were?

Liza Pulcine: Of course, so I'm lucky to work in an institution where maternity leave is supported. And I say that because I have a lot of colleagues and friends that work in the United States, in Canada and also in Europe, or you could argue that they even have even better social supports and maternity leave. You know at Sick Kids we have a maternity leave policy that you could take, you know, up to 18 months, or as short as you want and that you do have financial support or a maternity top up after a certain amount of working at the hospital. So I believe it was like 3 to 4 months as a staff physician. And so the top up obviously helps financially. So my first maternity leave, I actually took 13 months. And the reason I did that and I think a lot of people are even saying, Oh, 13 months like that's that's a lot for a physicians. And those weren't the people that were my colleagues, it was actually more outside doctors like in the community to say, Oh, that's it's interesting, you know, are you getting bored, or how are you making it work financially? And the reason for that actually was because when me and my husband decided that we wanted to have kids and we were ready we never anticipated the challenges that would bring. So my first son was born via IVF and it took us a long time to conceive, obviously and
we never expected how long it would take to get pregnant, and also the cost of having a child even before they're born. And then my second was conceived naturally and so I always knew with the first that I wanted, I never knew if I could have more than one, because we went through fertility issues and I wanted to make the most of my maternity leave, so I had no qualms about taking as long as I wanted, and 13 months was perfect for me, because at the time of going back to work, the sleep was better, I was ready to return mentally. I wanted the stimulation again, and my son, Charlie, was also ready to move on and, you know, have a new caregiver. But that being said, just going back to the the supports - part of an academic center, I mean, it's really important to know where you work, what kind of maternity or parental leave, I should say adoption leave or family extension leaves the hospital, clinic, or wherever you work has, and part of my one of the reasons I chose to work where I work was also because of knowing that I would have that support, knowing that I wanted to have a family, but I'm lucky, because not everyone is able to necessarily have that support or be in the workplace where that is supported. For example, my husband has no parental leave at his workplace. He's not a physician, but you know, it still feels like, wow, it's 2023 like, not even a few weeks. 

Radha Sharma: It's actually very interesting because when you mentioned that other physicians from different specialties thought that 13 months was a long time when in other arenas or other professions, like 12 months seems to be standard like growing up that's what I thought maternity leave meant. But I think now learning about other people's stories, and seeing how you know even some physicians that have taken I think, like 6 weeks off, or something like that 20 years ago, and that was just the standard. And even then, was something that was kind of stigmatized. But it's great that SickKids has that you know environment. 

Liza Pulcine: Yeah, I definitely felt supported. I didn't feel, with both pregnancies, I didn't feel like I needed to come back earlier. Obviously there is societal pressure. I remember talking to a former division head when my first pregnancy and I had told him, and I was very nervous, and he had questions like, Why are you so nervous? It’s such exciting news. It's your first pregnancy. And he even as like, is it something that I'm doing to make you feel nervous like are you afraid that I'm somehow making you feel like if you leave for 13 months that's frowned upon because he's like that is not at all like what this department’s about or our intention. Looking back, it wasn't anything that the division head had said or done in any way. It was more culturally, like myself as a woman, the feeling like, Oh, my goodness, I'm gonna leave for a year, and my colleagues are gonna have to pick up the slack, and that, I think, is like, almost like ingrained in us, not everybody. And it wasn't anything again that I experienced from colleagues at work.

Radha Sharma: You mentioned that you went through IVF - if you feel comfortable talking about that, what was that time of your life like, what were your support systems like at that time?

Liza Pulcine: For sure. And yes, I definitely feel comfortable talking about it. You know, when I was going through IVF. I found it very hard to find people that are very honest about their journey, or talk about you know, having trouble conceiving and maybe it was the age I was at, or just not knowing the network at the time, and so I promised myself that if IVF worked for us that I would be very open about it, and share openly, as openly as possible, because there's really no shame in it. And everyone starts their family in different ways. Going back to just my personality being a type A person, I assume that when we were ready we would just conceive within a month or 2, and when that didn't happen I felt like, you know, it's like not doing well on an exam or license being like, what do you mean? I'm putting all this effort in it. I'm timing everything perfectly. I didn't realize I was in the sort of denial and lack of maybe information that it takes time to have a family. Sometimes it takes a year, sometimes even more, and then I started talking to my friends, who already had kids. They started to open up and say, Oh, yeah, I know it took us 6 months or a year, we actually did IUI, or another form of treatment. So then it became more understandable that, you know, it's a process. It's a journey, and everyone's journey is different. So when we started, you know, after about 6 months of not being able to conceive. Naturally I had already asked my family doctor to refer me to a fertility clinic again because of working in medicine and just knowing the next steps, and I didn't want to be on a wait list. So we were seen pretty quickly, and at the time there was no specific, you know, reason for why we couldn't conceive, all the tests were normal. So we kind of had unexplained infertility or sub-fertile. All these words had come out - like just not as efficient. And so then there was a question of just continue to, you know. try. And eventually it'll happen versus you can, If you're sick of waiting and why not try and you have the means also? Because IVF is extremely expensive, and then you can also try, you know, starting with cycle monitoring where they kind of monitor when you ovulate and tell you to, you know, have intercourse at that time so that you can potentially get pregnant, or intrauterine insemination, where they just like time it perfectly, give you a trigger shot. But so we kind of did all of that stepwise. And then because of a number of factors, one of which is, I knew I wanted to have more than one kid because of my personality and wanting to have things like happen right away, which I had to learn how to deal with that, and because of COVID - because when we started to plan our family it was 2019, and all of a sudden 2020 rolled around and COVID happened. It was just a whirlwind, and I would say it's probably like the most stressful, lowest point in my life. When I initially kept everything I was, I was ashamed as a woman, even though I'm not at all anymore. But at the time I felt like, you know, I put all this time into my career, and it was never a good time, and now that I want to have a family, I can't and even though I was still in my early thirties or mid thirties, I would question like, you know, everything that I had thought about previously about waiting. And also COVID didn't make that any easier, because there were like no outlets to, you know go talk to a friend over coffee.

Liza Pulcine: But eventually it worked out for us and we actually, we ended up having an ectopic pregnancy the first time around. Unfortunately, so I dealt with pregnancy loss, and that wasn't easy. But when that happened, I think it was kind of our lowest point, and I had shared that openly with my colleagues. I had to take time off work, starting opening up with their families. We actually even didn't tell our families initially, because again, of the stigma of IVF and thinking like, Why do we need help? And when I opened up I realized even now how many of my colleagues, friends, family, have had to have some kind of assistant reproductive methods. I know it's one in 6 of the stats, but it feels like every other person that I know has had some form of either pregnancy, loss, or needing either IVF or IUI, or cycle monitoring. But eventually everybody got to having the children or child they wanted. But the process is still kind of looked down upon. Maybe I think more and more celebrities are sharing it in the media. And so people are becoming more open, which is good to know, because it really shouldn't be that much stigma, and because probably that most of us are thinking about having kids in our thirties instead of our twenties, which is fine, too. But I think we, you know, in medical school nobody told me that if I was going to do a full career and plan to have kids in my thirties, I may. I may need a year or 2 before I have a family. So I had this anticipation of why, just we'll get pregnant right away. It'll be just like anything else in life.

Radha Sharma: Thank you so much for sharing your story. I'm glad that we're doing this podcast and there's websites and resources now, but it's frustrating that that's not incorporated into the curriculum, or that, you know, that openly spoken about. 

Liza Pulcine: Just to add, like what I would say is that you know it may be biology, and just the time it takes and it may be there are personalities that's trying to think like, maybe, you know, we're the type of people that are usually like get A's, and everything in life is like planned out. So when something doesn't go to plan, such as having a child, it's not a process you can truly control. And no matter how hard you try, sometimes it works right away, and sometimes it doesn't. And so I think a lot of the time there's nothing wrong with having assistance. The fact that we are able to ask for a system to find options. And that's what another friend of mine had always said, like you’re so lucky to have options. Because if you were, you know, let's think 20, even 30 years ago, there may have been no options, or have been just so expensive, and it is really expensive that you don't have the means. And the other thing I wanted to add is that you know, I think equity, diversity, inclusion is becoming like a big hot topic, and all of the academic centers and the med school, and and as it should be, and part of EDI, think it's so important that we have financial resources at wherever institution you work with a clinic hospital community that covers some form of, and I call it like family expansion as opposed to maternity, or because, you know, think about our colleagues who are LGBTQ and who may want to have 2 dads or 2 moms, or who may want to adopt a child. And I think that it's so important. And I just think, also colleagues who wanted to start a family, and you know, and their 2 dads. And they for sure are gonna have to go through IVF and surrogacy, and it's just so expensive. And so the other part is that I just think it's so important that we talk about this, and I just learned even that the kids that they expanded their medical benefits to include, like a lifetime payment for family planning so that it's more affordable. A lot of insurance companies just cover the cost of drugs and not the cost of like the actual procedure, and they're both extremely expensive. So you, kinda if you walk the talk, you know, you need to kind of make sure that you support people in both ways.

Liza Pulcine: It's great that we're heading that way and that you're doing this podcast and that's why I really want to be part of it because I think that the more we talk about this, more people here, but this way the more they can plan for themselves and not be like - I was shocked that it could take a year when I learned about it. I don't know why. Someone can think about it, and and not always have to wait.

Liza Pulcine: I had a colleague who had her kids in residency when I was thinking about when to had kids - I was like oh I’ll be a staff. Even when you're staff. It doesn't mean it's a perfect conditions like there's pressure on you, and priorities and promotions and meetings. And so it's never, so when I talk to her, I said, well, how do you know when it's a good time? And she said, Liza, it's never a good time, therefore it's always a good time, and anyone that comes to me for advice about family planning and to residents. I say exactly what she told me, which I think is just - it's never a good time. It's always a good time, so don't delay. If you know you want to have kids and you feel ready don't delay it because you think things will be easier, at the end of residency or fellowship, or a staff. There's always drawbacks and benefits to each phase of training they're in.

Radha Sharma: I know you mentioned. Do you have a husband? How has he been as a support system with raising your kids and just kind of being there with your busy schedule?

Liza Pulcine: He's been great. I think the other part about - and I mean, this is more like marriage advice. When you choose a partner in life, and you commit to being with them. Choose a partner that's going to be supportive of you, especially for women in professional - not necessarily medicine. But any you know profession where you're going to be expected to have you know a lot of pressure on you or not the typical working hours. I think it's important to have a partner that supports you, whether you know husband, wife or any other partner in your life that is able to meet you halfway and like, for example, you know I'm on maternity leave right now. My husband had to go to Calgary for work. You know I have a toddler and a newborn, and we're just struggling right now, making it work. And also, thanks to our wonderful nanny who has helped us so much, and we can afford that because I'm now a staff physician. But you know, at a different point in life when all I had to go away to a conference, and I remember when my son was born - you know he supported me by being able to stay with him and feed him, and let me do my, you know. let me do my part of my career. So I think it's just really important to pick someone that will definitely meet you halfway, and sometimes you're 3 quarters of the way, and they're one quarter depending on the stage. And definitely, babies need their moms a lot in the first few months, but you always find ways to to help each other out both ways.

Radha Sharma: It sounds like he's your partner in crime

Liza Pulcine: Oh, yes, in crime. 

Radha Sharma: How did you go about finding a caregiver? Was that something that you always knew that you wanted to have in your support system?

Liza Pulcine: Yeah. So again, I think having a nanny is a luxury that I can afford, based on where I am in my career. And because she is wonderful, she’s like a second mom to my son, I am able to give it all. When I returned back to work last September, I was just able to work without having the fear or the anxiety of how my son is doing, or is he being taken care of well.
If he's sick like, am I worried that he's somewhere where someone can't take care of it, like all of my anxieties, were alleviated with finding an amazing caregiver for him, and so, therefore I'd be able to perform at work just like I was prior to having children. The reason I chosen a nanny is because of medicine and having my hours, especially with neurovascular neurology, like stroke doesn't happen 9 to 5. It can happen at night on weekends, and I knew I needed to have some flexibility. My husband does have more flexibility than me. That also helps. But I always again knew that I wanted to have more than one, and I just thought that a nanny made more sense if we were going to grow our family. And so the how I found her was actually through word of mouth, part of colleagues through the hospital, but also just posting on Mom physician group for the east end of Toronto. And she reached out to me and a number of Nanny's reached out to me, and when I met her. It was like a first date. I knew immediately I was comfortable with her. My son was comfortable with her. It was great, it was fun, it was natural. She was like part of the family. And so then we were like this, this makes sense, let's do it, and the rest is history, as they say. 

Radha Sharma: And how old is your son now? 

Liza Pulcine: My son is 23 months. He's turning 2 in August, and my youngest son, is going to be a month old tomorrow, 

Radha Sharma: What were some of the unexpected challenges of being a parent that you faced maybe for your first son, and then now as you're navigating having another son?

Liza Pulcine: For sure. I think nothing prepares you for motherhood or parenthood than actual motherhood or parenthood. So everyone and myself, I easily assumed oh, well, I work with children, and I work with sick children, and I see kids all the time, and I did 5 years of residency. I can do sleep deprivation, no problem, no, no, no! It was a rude awakening to understand that when it's your own child, the stakes are just so much higher. And also it's like the anxieties of when parents used to call when we were on a call as a resident, and say, like, my child has a fever, and they had a seizure, and because - usually that's a common call for a pediatric neurologist and all, just like, what do we do? I always question like, why are you calling it's just a fever. As a mom though, when my son had his first fever I just ran to the doctor literally as fast as I could the same day. And I was that crazy mom who's always calling and going. And because you're worried about your child, and that's not very natural. And so now I think I'm probably hopefully a better physician for it in retrospect. Thinking about you know, you are entitled to worry about your kids and I think, there's no problem that's too little or too big. So if you're worried about a fever and a seizure that's very true and genuine, and that concern should be taken seriously. But I guess what didn't prepare me is the fact that I thought that I would have it all covered because of my training, and I definitely did not, and even giving advice to my friends and my sister in law is expecting, and again. The advice is, it's so hard to give advice. It's equal parts challenging and just the most rewarding thing that you've ever experienced in life at the same time. I think anything in life that's hard or challenging also has a lot of rewards with it as well. If it was easy then,  don't know if people would just favor it as much, or have as much reward from it. The other part - sleep deprivation, you know, doing call you get doing call is, you know, you can come home and crash, or you know that you know, in 24 h, 40 h, no matter how bad it is, and how little sleep or no sleep you get, you know you can come home and rest hopefully. If you don't have kids. But I realized that once you have a baby like the sleep you don't sleep until you sleep train, or they, or even with sleep, training, or whatever your way of sleep training like. Then they reach a year and start sleeping better. And so, you know, it's every day 24 h a day. 

Radha Sharma: I know you said the newborn cuddles are great. If you could think of the best thing about being a parent to your kids - I know there's probably a million things - but what's the best thing that you've experienced so far?

Liza Pulcine: I think that sense of slowing down and seeing the world through their eyes, and it sounds very cliche, but I know, since the beginning of you know, I can ever remember. You know I always like in school doing extracurriculars, that it was university, medical school residency, so like my life, was very fast paced, and and the fact that I can just like sit with my son and read and watch him like sleep, and do little like cute smiles. And just that's okay to do in one full day not feel like I have to accomplish nothing today. But actually, I have accomplished a lot. I kept this newborn alive for an extra day. Right so. But I think in our society, or at least North America, we're always taught, like you need to accomplish, that I have a list. I have a to do list and these things, and if I have a day at work where I don't like check stuff off, I feel like it's a terrible day because I have to accomplish things. I think the best part about kids is sitting back and just enjoying life and special moments. I know again, having now had two, that they go by oh, too quickly! And the wonder and and just seeing my toddler now, you know, discovering the moon, and now he loves the moon. He's pointing to the moon, and he's looking for it, and I'm like, I never look at the moon like maybe on a camping trip once a year, but just things like that that makes you slow down and appreciate little things in life. Truly. There's a million more. I could go on for another full podcast. But I'll stop myself there. 

Radha Sharma: That's so beautiful. Thank you for sharing that. If you had a magic wand and could go back and change anything about your journey thus far. Would you go back and why?

Liza Pulcine: Let's say I met my partner 10 years earlier. Would I have had kids earlier? I don't know if I would, because me as a 25 year old versus me as a 35 year old. I'm a different, a different, more mature person, and this was the right time for us to have a family, and would have I also had difficulty conceiving at the time, maybe who knows? Right? We don't really know. Again, it's a bit of a process where you don't have a lot of control, even though you think you do. Age isn’t everything to be fair. I think if there's something I would do and go back in time, is it? Just try not to be so hard on myself. I think women are really hard on themselves for many reasons. Like, you know, now a lot of women are in medicine, but back in the day, you know, women had to work twice as hard to prove themselves and there I think there's still again I don't - this isn't because of where I work or people. I'm surrounded with that work. It's, I think, more in my head. And again, this is probably societal. It's the pressure to, you know - have 2 kids, but also publish articles and do grand rounds and be promoted to, you know, from a associate to full professor at the same timeframes as your male colleagues, or as colleagues that choose not to have a family and to come back and be like spot on and like, you know, everyone says like, oh, like when you come back, do you feel a bit rusty? Yeah, of course you feel a little bit rusty. but then you, as you get back in you. You pick things up. I think it's just the pressure of trying to juggle it all and look perfect doing it.

Liza Pulcine: And no, there's times that for sure, especially going back after my first, where I felt like I was spending way too much time at work, and not enough time with him, and vice versa, where I was like, I can't meet the deadlines and the goals I set for myself before, I just am not able to meet them, and a lot of deadlines are set by humans and by us, and can be renegotiated for the most part right? Very few things like, unless, clinical care is probably the only place where you kind of have to always be on your toes, because you're dealing with humans and patients. But you know, research and education, you can always push the presentation back or submit the publication a few weeks later. It's not going to kill you. So I think that's what I've learned just to take it, just to kind of give yourself grace.

Radha Sharma: Is there any other piece of advice that you have for medical trainees that might be listening to this podcast today?

Liza Pulcine: I also think sometimes things in life happen for reason again. Very cliche, but if like I wouldn't take back the fact that I ended up having to use IVF to conceive my first son. I think it made me more mature. It opened up a whole new world of like, I wouldn't be doing this podcast if I just had babies very quickly and didn't even think about it. I feel like now I'm talking to a lot of colleagues, friends who are going through similar experiences and providing them advice.

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Liza Pulcine: I had. I don't know if you know Brene Brown. She's a famous social worker and psychologist, she does Ted talks and yeah, and she's written millions of books, and when I was going through this difficult time in my life with IVF and COVID combined I refer to her quote which I often give as advice to my friends who are going through similar process, or colleagues, or anyone that reaches out, what you're going through now is a difficult time, but one day you'll be on the other side of it and it'll be someone else's survival guide. It's not perfectly worded sorry, but basically that quote resonates with me because it just says that you know, we all go through challenges and like whether it's family planning or career, or, you know, death of a loved one. But it's like a share human experience, and that someone will reach out to you after you've gone through a challenging experience, and if you can give back, pay it forward by just helping support someone and by sharing your experience, which is why I think you're doing this podcast so I guess my piece of advice for medical students is just to say that sometimes you go through challenges in your life again, whether it's related to family planning or just your career, or you don't get the residency spot you want or the fellowship you want, and you feel like your life is over, and it does feel really raw and and difficult in the moment. But sometimes there's a purpose to one thing, not working out so another, so it can fall into place in a different way. And then in hindsight, you look back and you become the person you are today because of that experience.

Radha Sharma: Liza, we have one final question for you. Are you thriving or surviving right now?

Liza Pulcine: I'm definitely thriving. You've caught me here with Oliver, like all wrapped in me - baby wearing right now for those that can't see. And you know I'm on Mat leave, and just like he's about to be a month and thinking back. Wow! I can't believe he was born a month ago, time flies, but also trying to enjoy every moment. And just grateful that I have this opportunity. Thank you. You're such a wonderful talk show podcast host and it's been a pleasure, really glad that I was able to come on this show/podcast and talk to you, because, I think it's just if it helps one person feel better or just achieve what they want to achieve then all that is really meant to be, grateful for the opportunity. So thank you so much.

Radha Sharma: We just want to give you another thank you on behalf of the team. It was an absolute pleasure chatting with you, and we really do appreciate you taking the time out of your busy schedule as a mom and a physician to talk with me today. This is Liza and Radha, signing off.

Liza Pulcine: Thank you so much.