Thriving or Surviving with Dr. Heather Shapiro

“I guess people looking at me from the outside must have thought that I had to make a decision or a compromise between a career and a family, but I always knew that I was going to do both.” - Dr. Heather Shapiro

In this episode, we chat with Dr. Heather Shapiro, an Obstetrics and Gynecologist and Reproductive Endocrinology and Infertility (REI) specialist. We learn about Dr. Shapiro’s leadership roles, her perspectives on the change in work culture over the years, and the best parts of being a mother and grandmother. 

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Contact Information

Dr. Heather Shapiro, M.D.
Email: Heather.shapiro@sinaihealthsystem.ca

Dr. Heather Shapiro is an obstetrician gynecologist by training. She also completed a clinical fellowship in reproductive endocrinology and infertility. Dr. Heather Shapiro focuses on reproductive endocrinology and infertility at Mount Sinai Hospital, and currently holds the position of Vice-Chair Education at the Department of Obstetrics & Gynaecology, University of Toronto. She is also an Associate Professor at the University of Toronto. She is interested in the laboratory education of embryologists.

Transcript

Radha Sharma: Welcome to season 1 episode 18 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 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 this process themselves while planning parenthood, parenting, and all the support along the way.

Radha Sharma: In this episode we have Dr. Heather Shapiro. We are so thrilled to have you on our podcast today. And again, thank you on behalf of the entire team for taking the time to really share your story here.

Heather Shapiro: Oh, thank you for having me, and you know how passionate I am about your project, and how proud I am of all the work that you've done. So, anything I can do to help, it's my pleasure.

Radha Sharma: We appreciate that a lot. I'm going to start with the first question today. Can you tell us a little bit about the day in the life of Heather Shapiro, what does that look like?

Heather Shapiro: Oh, you know the day in my life it probably varies by decade. So you know, for all those people who are wondering if there's a light at the end of the tunnel. I'm here to tell you that there is a great light at the end of the tunnel. So I'm an obstetrician gynecologist by training, a subspecialty in reproductive endocrinology and infertility, which is to say, I'm an IVF doc. I spent a lot of my career on clinical care, but also I had an academic position. I was the Residency Program director, and then Vice Chair of Education for the Department of Obstetrics and Gynecology at the University of Toronto. But today most of my educational administrative work is around the masters of clinical embryology program in the school of graduate studies. So that keeps me busy a couple of days a week doing all sorts of really interesting educational stuff. On my clinical side, I'm still a practicing gynecologist, but I'm not seeing patients every day, probably more like 3 days a week, and of the time that I see patients, most of it is a sort of consultation, and then some of it is the IVF procedures.

Radha Sharma: It sounds like there's a lot that goes on in the day in the life.

Heather Shapiro: I have lots of time to do lots of things these days, lots of things. 

Radha Sharma: That's amazing. Can you walk us through how long that took, how long was your training? Where did you attend school?

Heather Shapiro: Sure. Absolutely, I did my undergrad at U of T. I did my medical school at McMaster. I did my residency at U of T. I did a one year sort of fellowship in Switzerland, when my husband was also doing a fellowship there. Then I came back and did a more formal 2 year fellowship in REI at U of T. And then I started on staff at what was then called Toronto General Hospital, Toronto General merged with Mount Sinai  in the obstetrics department. So I've been at Mount Sinai kind of ever since. I did a lot of my training at man Sinai as a resident, and I think it was really, born into me, that was my home. That's where so many of my personal experiences happened as a professional and and personally, so it feels like home to me, and it was very nice to come back.

Radha Sharma: Well, that's so nice to hear.

Radha Sharma: As you know, the goal of the podcast and you know, as an extension of the website that we've created is talking about family planning within a medical career. What inspired you to sort of start a family? What was your motivation?

Heather Shapiro: You know, I knew you were gonna ask me that question, and I should have a better answer. I don't think I ever thought about having a family. I just assumed I was gonna have a family. There wasn't a lot of thought that went into it. I guess people looking at me from the outside must have thought that I had to make a decision or a compromise between a career and a family, but I always knew that I was going to do both.

Radha Sharma: I love that. What did family planning sort of look like for you? When did you have children?

Heather Shapiro: So I hate to sound like one of those old people, but you know, when I was a resident there was no post call day off. There was no one in four call, there was one in three call, and you worked the next day. So I didn't think I was capable, as I used to say, I was barely capable of tying up my own shoes in the morning. I didn't think I was in any state to take care of a child. So I had my first child when I finished my residency.

Radha Sharma: And how many children do you have?

Heather Shapiro: I have 4 children.

Radha Sharma: So it sounds like you had your children after training then. Did you have any of your children during fellowship or? 

Heather Shapiro: I had my first child at the end of my residency, so she was a newborn when I did my first fellowship, and then I had my second child when I was in my second fellowship, and then the last 2, when I was on staff.

Radha Sharma: Amazing. And were there any challenges that you experienced being, I guess, a staff position or a fellow and navigating parenthood while also balancing a career in medicine.

Heather Shapiro: I think the choice of words is really important. When you say challenge, it makes me feel like you're asking, was there an obstacle that I had to overcome to get to a specific goal and that's not how I phrased it. I framed it, as every day is full of decisions to make. Every day is always full of trade offs, you know, clinical reasoning. You're making trade offs. You're making probability decisions. And so this was, these were the cards that I was dealt, and then I had to figure out how to make it work. But honestly, I didn't feel that challenge was the word to describe it, it was my path. I kind of just went with the flow, maybe a better way to look at it. 

Radha Sharma: More of a go with the flow. 

Heather Shapiro: Yeah.

Radha Sharma: What were your biggest support systems at that time?

Heather Shapiro: Yeah. So I think there's 2 parts. I could not do this podcast without a shout out to my husband, who is an incredible husband and an incredible father and an incredible role model to other physicians. He's a surgeon. And he made it very clear to everyone in his orbit that he had important responsibilities at home as well. There was not a clear role model who looked like me married with children when I was a trainee. You know again, believe it or not, when I was a trainee, the majority of obstetricians were men.

Radha Sharma: How was the culture like at that time?

Heather Shapiro: I think that there was an understanding that there were jobs to be done at the hospital. and as long as those jobs were done whatever you did in your spare time was your business. But I think that's slightly different than today, where I think that leadership would say, we understand we have to look at both of those simultaneously.

Radha Sharma: I know we’ve been talking about some of the supports you’ve had during your journey, but I’m curious, did you have any colleagues or friends that you could lean on for support?

Heather Shapiro: You know, I can't say that I consulted in people or asked for help in those manners, but I will tell you that, as I said, I go with the flow, and I don't really plan so one of my professional partners, Dr. Ellen Greenblatt, and I should have worked together for many, many years and we, without planning both, found ourselves pregnant at the same time. So that makes it a little bit challenging for us, covering each other on maternity leaves. But it did make for a very nice environment, because we were both working and pumping at lunch and trying to balance things at the same time. So that was very nice. It saved a lot of explaining. People knew exactly what I was talking about.

Radha Sharma: Especially if there's 2 of you in the same room, doing the same thing.

Heather Shapiro: Yes, yes. I think that it was helpful for me to always try to look for the learning opportunities or the benefits in any situations that I was in. So there were lots of times when I looked for ways being a working parent as being beneficial for my children, and I have lots of examples of that. I think inadvertently, perhaps,I taught my children a lot of resilience. They learned how to be a little more independent than some of their friends at an earlier age. And I’m pretty sure that they would say they thank me for that now. I would also say, you know, on the flip side, in my educational role I met lots of trainees. I saw some of the things that they struggled with, and I was able to sort of take that with me and think, you know, how? How can I help my children? How can I support them? So, it was very much a 2 way street in a lot of ways.

Radha Sharma: So, with your perspectives as a grandmother now, a mother of adult children. How have their perspectives on your career path changed over time - maybe from when they were younger to now?

Heather Shapiro:  Well, I will say this, that I have 2 children that have followed my husband and I in our careers. so we take that as a sign that they thought we did okay, because they're clearly willing to do the same thing to their kids. But you know, I think what's really important is not only your children's perception, but also your perception and your ideal of what is the the kind of perfect parent and I think that you know, for example, there are a lot of cultures where the definition of a devoted parent is one who leaves their children, travels halfway around the world makes money and sends money back. And we forget that when we say, I'm gonna go to work for 8 h or 12 h or 24 h that there's a different definition of what makes a good parent and we shouldn't tie ourselves to the definition of a previous generation or a previous culture or location, and we have to make our own definitions.

Radha Sharma: I love that. It's like rebranding the idea of what a good parent is, because that seems like something so special and innate to your own relationship with your children. So I love the way that you phrased that. 

Heather Shapiro: Yeah, so don't let somebody else define what your definition of a good parent is. Yes, that would be to me, a very important message I would want to send to people.
 
Radha Sharma: I'm glad our listeners can have that piece of knowledge, and I hope they take that with them. What's been the best thing about being a parent, or now I guess a grandparent?

Heather Shapiro: Oh, well, I mean you know everything. I think what I would say is that many people would say there are things about parenting that they don't like, and I think it's to remember that there are things that are not part of being a parent. So like doing laundry is not parenting even grocery shopping is not parenting, you know, today we have, you know, Amazon and Uber and everything else. But those are all really important things. So,  we're always making little trade offs, and important to remember that trading off doing those things doesn't have to be trading off your identity as a parent.

Heather Shapiro: And so I say that by way of saying that I spent lots of quality time with my children. I spent lots of time away from my children at work, but I didn't spend time away from them when I wasn't working, so I make sure that when I was with them I hope that they felt this way that I was focused and devoted to them because I was able, from my position of privilege, because, frankly, you know, we're really well paid as doctors, really well paid, that I could delegate that stuff that I didn't think was crucial to parenting. The basic premise that I worked with was how much support do I need? And so when my kids were young, when I was taking call, I knew that I could not manage with a 9 to 5 kind of support arrangement. So, for example, daycare was never going to be an option. I always knew that I needed more than that, and frankly, I needed really more than one person, because, while I might have been willing to work 12 and 14 h and 6 and 7 days a week, I wanted the people looking after my children to be energetic and enthusiastic. So I had lots of help. I sometimes had people on the weekend, sometimes I had regular people at night, because if I was gonna be on call or my husband's gonna be on call. That wasn't the time to start calling around for a local teenager to babysit. I needed to have that kind of infrastructure and I would say that one of the bonuses of that arrangement that I did find that was different between me and maybe some families who didn't have that was, it was a lot easier for my husband and I to go away on vacation because we had built in overnight support. We had people who knew our children. Other people would often say it was hard for them to get away. You know they couldn't, you know their parents were maybe elderly. They couldn't be responsible for looking after their children for long periods of time. They didn't have ways of getting their kids to school or after school activities if they were late, because they had always done all of that. So that was one thing that we benefited from.

Radha Sharma: It sounds like having that extra help in your corner really made a huge difference for you. I’m wondering, could you talk to us  a little bit more about your experiences with having a nanny, maybe if coworkers or other friends that you know had those experiences as well - I think it would be interesting for our listeners to get a taste of what your life story was like?

Heather Shapiro: So I mean, I guess, an answer to your question: other people that I knew that had a more similar lifestyle, or maybe not in medicine. There may be people in law or business that have a similar kind. But I was very lucky. I will tell you that when my 30 something year old son was 3 months old, we hired a woman to work part time for us on the weekends and she still comes once a week. We definitely had some people who were absolutely part of the family, people that I could trust implicitly. I will also say that I had a nanny, who came to us when she was 19 from the former Czechoslovakia. I think her last job was running the budget department of the President's office at U of T, so having somebody like that really made my life a lot easier because she is a really really smart, organized woman. And she made sure that I was always pointed in the right direction, and that my kids had a good value system. 

Radha Sharma: Many of our listeners may be medical learners themselves, either students, or residents. Do you have any advice for them, you know, individuals who may be thinking about family planning or just any general words of wisdom they might find helpful?

Heather Shapiro:  It's not very helpful. But I would say, don't be afraid. You may say I'm not the kind of person who's a trailblazer, who's a pioneer. I don't want to be the first person to do this, and I imagine all the problems I'm going to have if I try to do something different. But don't be afraid, because you'd be very surprised how much support there is out there, how much support you'll find. And you know, even if there isn't quite as much support as you want, it will all be worth it in the end. So my bias is that I work in the fertility field. So I only see people who are devastated about not being able to have a family and while we can do lots of things, the one thing we can't do is turn back time. And so my advice to everybody is, try to get pregnant as soon as you can. There is never going to be a perfect time and don't wait for it. Residency is a great time to have a baby. I know some residency program members might not feel that way, but I think it's changing, and I do think it's a really good time.

Radha Sharma: I know earlier we said, you can't actually go back in time. However, if you did have this magic wand and could change anything about your journey, would you and why? Or if not why? 

Heather Shapiro:  You know, of course there's a thousand things that I could have done better. Absolutely. I'm sure there’s lots of things I could have done better as a parent, for sure there's many more challenges that I didn't meet professionally, papers published, you know, career goals, that sort of thing. But is there anything that I beat myself up about every day, I got to say no, I gotta say I feel like I'm really lucky and very blessed. I think you know more lucky than good would be what I would say. 

Radha Sharma: And Heather, in the name of the podcast my last question for you is, are you thriving or surviving?

Heather Shapiro: Oh I’m thriving. Everybody should be thriving absolutely. There is a way for everyone, absolutely.

Radha Sharma: There's a light at the end of the tunnel, as you said earlier today. 

Heather Shapiro: And there's like a lot of peepholes along the way you have to, I think that if I had to give people a message it really is a bit cliche, but it's about the journey. Don't think about where you want to go. There are too many twists and turns to prepare for all of that. I think it's the same advice we give people, whether it's about studying for a course or being a parent, you know, one step at a time. Don't sweat the small stuff, you know, think about the bigger picture, but really live in the moment because you never know how things are going to turn out.

Radha Sharma: I think I'm personally gonna take those messages with me as well, of not being afraid and then not sweating the small stuff ‘cause I think it's easy to kind of overlook them as a medical student, especially so hopefully, that resonates with our viewers, or our listeners today.

Heather Shapiro: Yeah, I think you know, as a student, you're used to having exams. You're used to having marks. You're used to having things being formulated. You have points in time. It's hard to get away from all of that. It's hard to live with uncertainty. I think that makes your life a lot easier if you can just accept that, you can't always figure out how things are gonna go. I think that would be my advice to people.
Radha Sharma: Thank you for sharing that Heather.

Heather Shapiro: My pleasure. 

Radha Sharma: We just want to give you another thank you. It was an absolute pleasure talking to you and hearing about your journey and your career. You can find our guest's contact information in the notes from today's show. This is Radha and Heather signing off.

Heather Shapiro: Thank you.