Driven to Cure: Dr. Beth Rackow’s Story of Purpose, Passion, and Resilience

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Every part of medicine has the highs, the lows, and you have to be able to tolerate the best of days and the worst of days.

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There were times where, if one of my classmates was on vacation, I was working every other day, 36-hour shifts and working 120 hours a week.

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One of the coolest things that has happened a few times is I've had some students either writing essays for college or for medical school about the impact that our relationship has had on them.

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That's something I'm so proud of.

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I have the best job in the world, and it's really what drives me.

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It makes the work worth it.

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Hello and welcome to the Career Journey podcast.

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No Wrong Choices.

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Today's episode features the highly respected physician, dr Beth Rakow of the Columbia University Medical Center in New York City.

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I'm Larry Samuels, I'm Tushar Saxena and I'm Larry Shea.

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We'll be your hosts for what will undoubtedly be a fascinating conversation.

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Before Beth steps in, please be sure to support the show by liking, following and subscribing to it wherever you get your podcasts Now.

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Let's get started Now.

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Joining no Wrong Choices is the highly distinguished OBGYN Dr Beth Rakow.

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You have to say this Dr Rakow works for the Columbia University Medical Center here in New York and is consistently recognized as one of the top doctors in her field by prestigious organizations such as Castle Connelly and New York Magazine.

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She's also an associate professor at Columbia University Medical School and, on top of all of those things, happens to be my wife.

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Dr Rakow, thank you for joining us.

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Thank you so much for having me.

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Okay, Beth.

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So here we go.

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You have all these great accolades, Beth, and yet you married Larry Samuels.

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What is the problem with you?

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Everyone has faults.

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I bet everyone's not perfect, you'd really need me to answer that.

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You have to answer.

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This is the answer portion of the program.

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Well, let's just say that Larry was not intimidated by a strong, career-driven woman and actually that was the type of person he wanted to partner with, and can't say in my experience that those men were very easy to find and we connected, so there.

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That's a great answer.

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Still, you could have done better.

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Anyway, it is the best thing that's happened to me so far.

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I got very lucky too.

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So now that that awkward part of the conversation is over, let's set up the conversation.

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So, Beth, each of our guests, we asked to just give us a bit of background in terms of who you are and what you do, so please set things up for us that way.

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I was thinking about this before this interview and the little snippets of a Twitter profile came to me.

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So I am a wife, a mother of both a little boy and a dog, a physician, a friend.

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I'm an outdoor enthusiast I used to get to do more outdoor adventuring when I was younger A advocate for causes that are important to me.

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Larry is annoyed by the fact that I'm a compulsive recycler.

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Oh, yes, I am.

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What does that mean you?

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Throw stuff out, that's it.

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And, I guess, a reformed slash former athlete.

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And what do you do for a living?

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So by training.

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I'm an obstetrician gynecologist and after I finished my four years of residency, I specialized in a field called reproductive endocrinology and infertility, where we focus on hormone disorders and gynecologic disorders that can affect reproduction, and also treating women and couples and individuals with infertility.

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As part of my training, I also became enamored with this very niche area in OBGYN, where specialists take care of girls and adolescents who have gynecologic issues, Because when a 10 or a 12-year-old girl has a gynecologic issue and calls a regular OBGYN to be seen, most of the time they are not comfortable seeing someone that young and it really is a special level of care to provide children and adolescents who have gynecologic issues.

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So that became part of my niche practice between the endocrinology knowledge and surgical knowledge, and there's a number of people in the country who also have the same skill set that I do.

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So I spend my days in a few different places and every morning I wake up and I have to remember which office I'm going to and what day it is, otherwise I might get very confused.

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I see gynecologic surgery patients which include females and individuals from birth on up who have gynecologic disorders and surgical issues, and I provide surgical services for those individuals who need different types of gynecologic surgery, always with the mindset of protecting their future reproductive potential when possible.

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Then I also spend time at the Columbia University Fertility Center, where I provide the full scope of infertility care for individuals and couples who are trying to conceive.

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That makes up my entire week in terms of some office-based days seeing patients, some procedural days and some surgical days as well.

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So let's go back into the time machine, go back to the beginning.

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Fellow nutmegger, just from doing my research.

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Connecticut is your home, where you grew up.

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What was it like growing up in Connecticut?

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What was your family like and what was the dream originally?

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Well, I grew up with a family of four two parents, a younger sister and then several dogs along the way and we grew up in just east of Hartford in a town called Manchester, connecticut.

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That was sort of a low-key town, a town that emphasized education, sports programs and was a great place to grow up.

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We made tons of friends in the public school system.

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One of the highlights of my youth was playing on a competitive girls soccer team that won the state championship four times and that was a formative part of my childhood.

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It was a huge part of my identity and I think a huge part of what started to make me who I am today was playing competitive sports on a team.

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So did you envision yourself as a younger girl being a professional athlete or going into another field where obviously you would try and feel those competitive juices?

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I think I knew the competitive drive in me was going to lead me elsewhere.

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Because I think I knew my physical limitations at five foot one inch, the number of true sporting options were definitely limited.

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I was never that great at any sport.

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I just loved playing sports and I loved being part of a team.

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Did that competitiveness carry over to your academics?

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Good question.

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I think it definitely did.

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I mean, I was a bookworm as a child, always really curious and loved school, and school came fairly easy and naturally to me for a long time.

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I think I was competitive, yes, with those around me, but I think I was most competitive with myself and I think I had this internal drive to do well and to succeed and that was definitely something that was in athletics as well as in academics.

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What was your favorite subject?

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I like the sciences, like I definitely liked biology, but as we talk about my story today, I'm sometimes a little more scattered than that.

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So I also liked my English classes and I also thought history was cool.

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So, yes, I would say science was one of my favorite classes and biology definitely was inspiring.

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I liked a lot of other things too.

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Was this self-motivation or family-driven?

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What was the genesis of that?

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I think there's a good amount of self-motivation, but I would say I also had parents who were strongly encouraging of my ambitions and were also pushing me in a good way.

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Like my mother used to joke that she kept me so busy with afterschool activities, I didn't have time to get in trouble.

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My parents were supportive and appropriately pushing me to work hard and excel.

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So in high school, who was Beth Rakow?

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So you're playing sports, you're doing well in class.

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When does this person that you've become really start to emerge?

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Are you a leader?

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Who is Beth Rakow during those high school years?

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In high school, some parts of me blossomed.

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I think that's when I started to have more leadership opportunities.

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In fact, I was class president as a freshman and again as a senior, and I think I took on a lot of leadership roles on teams.

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I don't think I was a team captain, but I was often someone other players still looked up to, and I was always a hard worker.

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I also participated in other extracurriculars.

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I wasn't just an athlete, but I was engaged in other community service projects and other things that I also thought were important.

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Yeah, so I mean this starts to make a lot of sense.

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Then right, you have competitive edge with sports, your favorite classes are science, biology, and you want to help people and give back.

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I mean, I'm starting to see doctor.

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It's pretty clear.

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Yeah, Is that how it worked?

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And like, at what age are you seeing that goal and saying this is going to be something I'm going to do for the rest of my life?

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Well, when I was a little girl, I would.

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My father would come home and every single night he would call the patients that he had done procedures on that day.

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He was an endodontist, so he would be doing a lot of office surgical procedures and listen to him.

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Listen to him talk to his patients in his doctor voice, Listen to him call prescriptions into the pharmacist and use all this jargon.

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I was so enamored by what he did.

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What's a doctor voice?

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Give me a doctor voice.

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It just became very, had this cool, calm demeanor and, very matter of fact, it was a different tone than he would take with me and my sister et cetera.

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So that was a very formative sort of part of what encouraged me just to think that what my dad did was so cool.

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And growing up my parents' closest friends one was an internist, one was a dermatologist, one veterinarian, and so there was lots of medicine talk around the table when we'd all get together and I just thought that how they gave back to people and helped people and animals was just the most remarkable career journey.

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And I sort of never looked back.

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It was always in the back of my head that being a physician was something that I wanted to do.

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But I came from a line of dentists.

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So my dad's dad, my paternal grandfather, who I never knew, was also a dentist.

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So I was on track to be the first MD in the family, but still following that family line of medicine and dentistry.

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It seems a good time to ask.

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So let's get it out of the way.

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Whenever I thought about being a doctor, I was too squeamish.

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I was like not happening.

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Blood guts.

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Nope, not happening.

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Did you ever have any of those thoughts, or wasn't even a concern?

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So interestingly, I learned over time that if I was the doer, like when I'm doing things, it doesn't really gross me out or freak me out.

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However, there was a time when I was on an internship in college with an anesthesiologist and I was watching him put in an IV and, oh my gosh, I started to feel lightheaded and dizzy and had a ghost of a cold and leave the room.

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And when people are doing stuff to me I can't really watch.

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I can't either.

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Same thing and you're a doctor.

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I used to think I could I remember when I was younger, someone was taking a mole off my leg and I was like, oh, I want to go into medicine, I can watch this.

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And I totally started to feel lightheaded and dizzy.

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I don't really watch blood draws IVs on me.

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Really the needles freak you out.

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The needles don't freak me out, because I've taken tons of them and had myself tons of shots, but I can't watch someone do these things to me, I just look away.

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It's fine, I got you.

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Yeah, same.

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So let's talk about the next step.

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Where was college?

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So when it came to college, I looked far and wide.

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I knew I didn't want to venture too far from the Northeast and I wanted to get the best education, the best experience, be part of the best like the community.

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That felt right to me.

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I was also a little crazy because I played a very unique sport.

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I played women's ice hockey, which was something I started to pick up and play.

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Is there a sport you haven't played?

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Soccer?

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You play hockey, for God's sake played soccer.

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You played hockey, for god's sake.

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So I had been a figure skater as a kid, and in high school I had this amazing coach who coached me in soccer and groomed me to play ice hockey, and I fell in love with that sport, and so I knew, if I could find a way to play it in college, that would be awesome, because I knew that there would be no hockey for me after college.

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Like I had no crazy aspirations.

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I was limited in terms of places that were schools that I wanted to go to that had a women's college hockey program, so that was the other thing.

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I looked at places that didn't have college hockey, but somehow the opportunity to go to a great school and play hockey was just a double win, and I fell in love with Yale, and so that is where I ended up for college.

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Yale's pretty good too, by the way.

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Chattel's free Yale.

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I had a good experience.

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Talk to us about Yale in New Haven.

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Was it isolated?

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Did you leave campus?

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Because New Haven can be a little crazy, Just knowing the area myself.

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Obviously the best pizza in the Haven.

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Was it isolated?

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Did you leave campus?

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Because New Haven can be a little crazy, Just knowing the area myself obviously the best pizza in the world, but you can say it.

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Besides that New Haven's a little bit shady.

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It is.

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It's a little bit, but Yale I know, and most college campuses you can just stay on campus and get enough of a varied environment that it's not a big deal.

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But did you venture out?

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Were you so busy with your school that you didn't really do much extracurricular stuff?

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What was Yale like?

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Yale is a fairly sizable college and then there's all the graduate schools that are part of it, but they tried to make the community much smaller by having these residential colleges.

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So you are assigned randomly to a residential college.

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I think at the time there were these residential colleges, so you are assigned randomly to a residential college.

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I think at the time there were 12 residential colleges and I was in Trumbull College and it was a way of taking a freshman class that was maybe, I feel, like 1,200 or so and making it no, it had to be more like 2,000.

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And it was more like 200 people in your class were part of this group and it gave you a more of an identity and made a larger place feel a lot smaller and intimate, and that was important.

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The other thing is Yale campus.

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It definitely spreads out.

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There's a bunch of blocks that are all together, but I spent a lot of time on Science Hill and at the rink and those were, you know, a mile off away from campus, so you definitely didn't always feel like you were on campus.

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And then the other thing is, as we talked about community service before you, I did a lot of community service working at soup kitchens, teaching environmental education to kids in classrooms.

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So I definitely felt like I got out and got to know the community to some extent by participating in the tremendous community service offerings that were a great part of my Yale education.

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What are the dynamics for the students?

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Yale education what are the dynamics for the students?

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How competitive is the environment and is there an underlying theme of competitiveness at that level?

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The joke often was at Yale that the hardest thing was to get in and then, once you got in, you could be as intense as you wanted to, but you didn't have to be.

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There was a wide variety of people who were much more driven cutthroat, took the toughest classes, had to be top of the class, and lots of people who just lived life as a Yale student and did what they had to do.

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But a huge part of the experience was the socializing.

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A huge part would be amazing celebrities, international figures, you name it, who would come to campus to lecture, who you had access to.

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There's so much about the experience that didn't just happen in the classroom.

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So I know you had the passion for the outdoor stuff as well.

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You're studying the environment.

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Was it close in terms of choosing environmental work for the rest of your life or being a doctor, which you were so enamored with when you were younger, and were you doing both at the same time?

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Was there a switch that happened?

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Tell me about the actual decision of all right, I'm gonna then put the environmental stuff over here and focus on this.

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I always told people that I had two passions, that one was the environment and one was medicine, and that I also knew that a career in medicine was a much more straightforward route.

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If I wanted to do environmental stuff, I might have done environmental law.

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That was a brief thought.

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Interestingly, my environmental interest and passion led me to work for the National Park Service for two summers.

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I was a park ranger intern at Yosemite National Park, full-on government employee at Acadia National Park.

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I got these fabulous experiences and I would be out there teaching groups of people, leading them on hikes, teach them all about the park, what was unique about it, and that, I think, helped me with public speaking.

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I learned a ton.

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I would go hiking on my days off.

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It was two of the best summer experiences possible as I was submitting my medical school applications, so I knew that that was part of me that was going to get tucked away a little bit once medicine became my career path science instead of medicine and there were people I had to convince why you can have more than one passion in life.

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And then there were people on the interview trail who thought that it was great that I had more than one passion and there were other things that made me interesting so, and there was some convincing that needed to happen.

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Yeah, it sounds like a little inside the podcast here.

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Larry Samuel sends us notes on his lovely wife and last night I'm going through the notes and he's like I think she worked at Yellowstone or maybe Yosemite.

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She's like I don't know, I'm like I'm going to quiz you.

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I'm going to quiz you tomorrow during the podcast, because you need to know I love Acadia.

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Say the name of the town that Acadia National Park is in for me I was wondering if it was going to be Bahaba Give me the main version Cadillac Mountain, a wonderful, wonderful place.

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So it was close.

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There was a lot of convincing that needed to be done for you to actually take the leap and be a doctor, correct?

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Well, I knew I wanted that path.

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I had to convince others that I was dedicated to that path, not every Meaning professors family when I was out interviewing for medical school my personal statement probably talked about another experience.

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I'd had my list of jobs before.

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Et cetera were all environmental-based and just because I hadn't been in a laboratory doing basic science and writing papers on that, my path wasn't the typical medical student trajectory, even though in my heart that was always what I wanted to end up doing.

00:21:00.474 --> 00:21:06.299
I'm curious about your learning process because to be a doctor, obviously vast amount of knowledge needs to be gained.

00:21:06.299 --> 00:21:11.343
People sometimes visualize something photographic memory repetition.

00:21:11.343 --> 00:21:13.611
Were you challenged at Yale?

00:21:13.611 --> 00:21:15.183
What type of a learner were you?

00:21:15.183 --> 00:21:17.362
Did you just have to grind it out or did it come easy?

00:21:17.903 --> 00:21:21.460
I would say in college some classes were easier than others.

00:21:21.460 --> 00:21:22.565
The sciences were tough.

00:21:22.565 --> 00:21:23.690
They definitely were.

00:21:23.690 --> 00:21:24.534
I graduated.

00:21:24.534 --> 00:21:25.916
I don't even remember what my GPA was.

00:21:25.916 --> 00:21:28.644
It was fine but it wasn't anything exceptional.

00:21:28.644 --> 00:21:33.155
But in medical school some of it came easy, but I also worked really hard.

00:21:33.155 --> 00:21:34.277
I took copious notes.

00:21:34.277 --> 00:21:35.357
I studied a lot.

00:21:35.357 --> 00:21:40.121
I was pouring over the information plenty to get it to sink in.

00:21:40.121 --> 00:21:46.565
I recognize that some topics came easier than others, but I put in the time.

00:21:47.005 --> 00:21:48.705
How many medical schools did you apply to?

00:21:48.986 --> 00:21:51.228
I don't remember 10, 15.

00:21:51.788 --> 00:21:53.128
Oh, wow 10 or 15.

00:21:53.128 --> 00:21:54.730
Wow, what is that process?

00:21:54.730 --> 00:21:59.573
Is it a unique application for everyone, where you're spending months putting this stuff together?

00:22:01.575 --> 00:22:02.455
I really don't remember.

00:22:02.455 --> 00:22:12.788
I believe there might have been a common application and then every school had extra information that they would send you extra essays wanting extra information, essays wanting extra information.

00:22:12.788 --> 00:22:14.069
And then you had to take a test.

00:22:14.069 --> 00:22:21.962
This test called the MCATs, this medical test hours and hours where the score mattered, and also letters of recommendation.

00:22:21.962 --> 00:22:24.267
So there was a lot that went into your application.

00:22:24.686 --> 00:22:25.930
Do you remember how many schools you got into?

00:22:25.930 --> 00:22:26.756
One?

00:22:26.756 --> 00:22:29.642
Really yes, 15 applications.

00:22:29.642 --> 00:22:30.763
You got into UConn, correct?

00:22:31.404 --> 00:22:35.117
And I got into UConn off the wait list so I get in Really.

00:22:35.278 --> 00:23:01.715
Yes, I mean it is interesting and it's something I definitely share with students Also people who I know of, who are trying to get into medical school and having a hard time, at least at that time.

00:23:01.715 --> 00:23:06.068
This is what 1996, was geared to let in everyone who was going to excel in the field.

00:23:06.068 --> 00:23:31.633
It was very focused on test scores, it was very focused on research and places where I didn't shine and at UConn the director of admissions thought it was the coolest thing that I was park ranger and when I graduated towards the top of my class and from medical school, I remember saying to him, me and my three anatomy lab partners at least three of us got in off the wait list and we all graduated towards the top of our class.

00:23:34.095 --> 00:23:37.464
I was like you should rethink your admissions criteria, three out of the four of us might not have gotten in.

00:23:44.134 --> 00:23:46.319
I'm just so curious what would you have done if you didn't get into that one school?

00:23:46.319 --> 00:23:47.923
Would you have kept at it, or would you just pivoted?

00:23:47.942 --> 00:23:51.739
But what about all those people who you take care of every single day?

00:23:51.739 --> 00:23:52.981
Where would they be?

00:23:53.442 --> 00:23:57.239
I graduated college and it was actually just a personally really trying time.

00:23:57.239 --> 00:23:59.262
I had not gotten into med school yet.

00:23:59.262 --> 00:24:06.028
I was on the wait list at two places and I was starting the process over.

00:24:06.028 --> 00:24:07.913
Yale was still helping me at the graduate.

00:24:07.913 --> 00:24:09.155
I had a new advisor.

00:24:09.155 --> 00:24:14.182
I was out of college, living at home and starting the application process again.

00:24:14.182 --> 00:24:15.943
College, living at home and starting the application process again.

00:24:15.943 --> 00:24:21.750
And in that moment, all of a sudden, I got this call July 5th and they said you want to come to UConn?

00:24:26.935 --> 00:24:28.182
I was like can I take a year off and then come?

00:24:28.182 --> 00:24:29.429
And they were like now or never.

00:24:29.429 --> 00:24:34.180
What were the emotions during that period of time?

00:24:34.180 --> 00:24:35.044
I mean, you must have been so stressed out.

00:24:35.064 --> 00:24:35.826
I mean, like what were those emotions?

00:24:35.826 --> 00:24:37.173
Right, Because you graduate college and everyone's like what's next?

00:24:37.173 --> 00:24:45.328
And I'm like don't really know yet, but I'm going to work, I'm committed to seeing my dream happen.

00:24:45.934 --> 00:24:46.336
Amazing.

00:24:46.336 --> 00:24:49.923
So going to med school very quickly.

00:24:49.923 --> 00:24:52.888
I just want to get a feel for the day to day.

00:24:52.888 --> 00:24:55.884
What are the demands on a medical school student.

00:24:55.884 --> 00:24:58.980
Are you putting in 12, 14-hour days?

00:24:58.980 --> 00:25:00.304
Are you constantly studying?

00:25:00.304 --> 00:25:01.807
Are you constantly in the lab?

00:25:01.807 --> 00:25:05.142
What are the rigors of medical school in general?

00:25:05.883 --> 00:25:17.537
The first two years are mostly classroom-based, where at my medical school we learned the normal anatomy and physiology year one and then we delved into the abnormal year two.

00:25:17.537 --> 00:25:22.917
And year one is the year that we did gross anatomy, where we literally dissected a cadaver all year long.

00:25:23.398 --> 00:25:25.343
Can I interject for one second, Tushar?

00:25:25.343 --> 00:25:29.077
Does abnormal make you think of a movie Abnormal?

00:25:29.077 --> 00:25:32.664
Of course it does Frankenstein.

00:25:32.664 --> 00:25:33.626
Sorry, I had to get that in.

00:25:33.626 --> 00:25:34.449
Please continue.

00:25:35.015 --> 00:25:49.768
And so those first two years are mostly classroom-based, but we would get some experience, starting to learn clinical skills and the physical exam and talking to patients, because we would certain afternoons go off and work shadow physicians and start to get some experience.

00:25:49.768 --> 00:26:03.009
And then third and fourth years is when you're doing all your rotations and going to like pediatrics and psychiatry and internal medicine and surgery and OBGYN and getting these multi-week rotations through each field.

00:26:03.009 --> 00:26:07.755
Your classroom time, I think, if I remember correctly, was very structured.

00:26:07.755 --> 00:26:17.259
You had class nine to three, nine to four, whatever you had, labs et cetera, but then you would spend your evening studying, socializing too.

00:26:17.259 --> 00:26:23.522
It was also a very social time, but you would study because you'd have tests, practical exams et cetera.

00:26:24.064 --> 00:26:26.945
But when you went on to rotations, that's when life was crazy.

00:26:26.945 --> 00:26:36.373
That's when we were up at four and five in the morning at the hospital because the medical students had a round before the residents, before the attending physicians, and the hours were just insane.

00:26:36.373 --> 00:26:42.846
No one was paying attention to how many hours we worked and you would also take call alongside residents, et cetera.

00:26:42.846 --> 00:26:47.547
So it could be, depending on the rotation you were on, it could be really, really difficult.

00:26:48.115 --> 00:26:51.906
So you're a triple threat in terms of your own concentrations.

00:26:51.906 --> 00:26:54.924
You're a surgeon, obgyn, rei, I believe.

00:26:54.924 --> 00:26:59.103
How did that factor into medical school for you?

00:26:59.103 --> 00:27:03.279
At what point did you say, okay, I want to be an OB or no, I want to be a surgeon, I want to go into this aspect of my medical career.

00:27:03.279 --> 00:27:05.465
How did that play into medical school for you?

00:27:06.115 --> 00:27:09.846
I remember going through all my rotations and really enjoying every single one.

00:27:09.846 --> 00:27:15.346
I even liked psychiatry, which is good because I feel like I'm a part-time psychiatrist in my day job.

00:27:15.694 --> 00:27:16.719
And your night job, too Nice.

00:27:19.434 --> 00:27:24.205
You get all these experiences and I began to realize that I liked continuity of care.

00:27:24.205 --> 00:27:29.166
I liked taking care of someone throughout a chunk of time in their life.

00:27:29.166 --> 00:27:34.640
I didn't like seeing a patient in the ER and then not knowing what happened when my shift was over.

00:27:34.640 --> 00:27:36.682
Like seeing a patient in the ER and then not knowing what happened when my shift was over.

00:27:36.682 --> 00:27:40.506
I didn't like being the surgeon who fixed something and then sent the patient on their way.

00:27:40.506 --> 00:27:42.847
So I realized I like continuity of care.

00:27:42.847 --> 00:27:52.683
I realized I was really inspired by women's health and I realized that I liked the surgical aspect of medicine and that I liked fixing things.

00:27:52.743 --> 00:28:27.601
And I had some really awesome experiences with some surgeons where I was at some really small hospitals doing a surgery rotation where it was the surgeon and it was me and I was the other body scrubbed in and they were letting me start to learn breast biopsies, appendectomies, all this stuff skin closures for plastic surgery, operations and I learned so much and I fell absolutely in love with the surgical part of a career and I realized that there's only a few specialties that allow you both continuity of care and surgery.

00:28:27.601 --> 00:28:37.064
Now my classmates had pegged me as an OBGYN from year one and everyone's like you're going into OB, we know it, and I was like come, let me experience everything else.

00:28:37.064 --> 00:28:38.526
But they were right.

00:28:39.468 --> 00:28:41.457
As you're telling that you're stressing me out.

00:28:41.457 --> 00:28:50.165
So I have to ask the stress question, because I couldn't imagine doing what you do and studying like that and the hours that you were keeping at that point in time.

00:28:50.165 --> 00:28:52.577
So at that point, did it stress you out?

00:28:52.577 --> 00:28:53.759
Because you sound excited about it.

00:28:53.759 --> 00:29:02.006
You sound like the challenge was gripping and exciting and passionate about it, whereas for me my heart starts racing and I'm like I can't do this.

00:29:02.006 --> 00:29:03.861
So thank goodness for people like you.

00:29:03.861 --> 00:29:06.122
But were you stressed back then?

00:29:06.122 --> 00:29:11.126
And if so, and if so now, how do you handle that stress?

00:29:11.126 --> 00:29:13.282
Was sports a part of it in college?

00:29:13.282 --> 00:29:16.297
And now you have to handle that very differently.

00:29:16.717 --> 00:29:26.946
The way I handled the stress in medical school and residency was working hard helped me just feel better, like I had more command of the information I needed to know.

00:29:27.414 --> 00:29:28.176
Preparation yeah.

00:29:28.738 --> 00:29:38.800
I also played on a local soccer team throughout medical school and then a separate team when I was in residency, keeping up just some athletics.

00:29:38.800 --> 00:29:41.887
I was a runner way back then, so I would run for exercise.

00:29:41.887 --> 00:29:45.320
That was very important for my mental health.

00:29:45.320 --> 00:29:55.636
And then also connections with people who weren't in medicine, because it is also so easy to just pigeonhole yourself and only talk medicine all the time.

00:29:55.636 --> 00:30:02.940
In fact, when I was in residency I lived with my sister, who was a law student at the time, and I loved it when her friends would come over and we wouldn't talk about medicine.

00:30:03.701 --> 00:30:13.344
So, beth, the times when students hit the rotation portion of their medical school career, when you all have to head into the hospital, as you said, the first couple of years of med school it's all about classroom work.

00:30:13.344 --> 00:30:21.498
Does it become more like boot camp when you officially hit the hospital and then, obviously, you're working hours upon hours upon hours on end?

00:30:21.498 --> 00:30:23.963
Is that really where you separate the wheat from the chaff?

00:30:24.546 --> 00:30:27.861
Yes, I think the intensity of the rotations?

00:30:27.861 --> 00:30:29.263
Absolutely.

00:30:29.263 --> 00:30:30.465
You're part of a team.

00:30:30.465 --> 00:30:32.611
Med students can only do oh so much.

00:30:32.611 --> 00:30:42.982
But you're there to help, to run errands, to take care of the most mindless of tasks and just to soak it all in and learn.

00:30:42.982 --> 00:30:54.381
But it can be a grueling experience based on what's expected of you, the number of hours, and I will say medical school is much kinder and friendly now when I see how our medical students are treated.

00:30:54.842 --> 00:30:57.737
The kids always have it easier now than we did back then.

00:30:57.737 --> 00:31:00.265
True, how hands-on was it at that point?

00:31:00.265 --> 00:31:03.545
I mean, obviously you said you do a lot of scut work, you're following around residents, etc.

00:31:03.545 --> 00:31:05.200
But how hands-on was it?

00:31:05.954 --> 00:31:10.835
It really depended on your team and on, like your senior resident and who took you under their wing.

00:31:10.835 --> 00:31:18.207
And I think if you were interested, motivated and worked hard, people were always willing to give you more experiences and worked hard.

00:31:18.207 --> 00:31:21.792
People were always willing to give you more experiences.

00:31:21.792 --> 00:31:28.342
If you were annoying, whiny and didn't want to work that hard, of course people weren't that invested in your education.

00:31:28.342 --> 00:31:31.669
So that's a very simplistic view, but I think you found ways to gain more skills.

00:31:32.215 --> 00:31:39.243
I didn't really know how to place an IV and by the time I was a fourth-year medical student I was like shoot, someone's got to teach me how to do this.

00:31:39.243 --> 00:32:01.638
So I was on my ER rotation and I made friends with a bunch of the nurses and I got them to teach me, because they're the ones who are so good at it, and they would find all the people in the ER who needed IVs, who had these big veins, and they would pull me into the room and make me place IVs and to this day, I'm actually very good at it.

00:32:01.638 --> 00:32:04.487
But you had to seek out opportunities and so, like anything in life, experiences are what you make of them.

00:32:05.295 --> 00:32:07.804
So focusing things a little bit.

00:32:07.804 --> 00:32:11.278
We've gone through college, we've gone through medical school.

00:32:11.278 --> 00:32:20.671
If I remember correctly, you did your residency at the University of Pennsylvania in Philadelphia, so you've chosen to be an OBGYN.

00:32:20.671 --> 00:32:28.387
How do you start to focus and really begin to become the Dr Beth Rakow that we know today?

00:32:28.387 --> 00:32:32.083
How do you make those choices, those decisions, how do you sharpen that lens?

00:32:33.046 --> 00:32:49.480
So again, it's the breadth of experience you get on all your rotations as a resident, which are now all focused in the field that you plan to have your career in, where you spend time learning obstetrics both in the office as well as on the labor floor.

00:32:49.480 --> 00:33:01.670
You learn gynecology, both in the office and in surgery and you learn from all the subspecialties that are part of our field and start to realize what resonates with you.

00:33:01.670 --> 00:33:07.288
Again, I had mentors that helped sort of shape who I am and the career that I wanted.

00:33:07.288 --> 00:33:12.067
But I realized that I liked some of the younger population in OBGYN.

00:33:12.067 --> 00:33:15.424
I still liked continuity of care and I still liked surgery.

00:33:15.424 --> 00:33:26.848
I was really enamored by the field of reproductive endocrinology and infertility and again, mentorship played a huge role in making me the person that I am today.

00:33:27.375 --> 00:33:31.046
By my second year of residency I hadn't really thought that that was what I was going to do.

00:33:31.046 --> 00:33:37.240
I thought I was going to be a high-risk obstetrician and that's what most people thought I was going to do, just based on what it seemed like I liked.

00:33:37.240 --> 00:33:46.642
But this was a huge right turn to a very different field which is more based in medicine and endocrinology, but also surgery and infertility care.

00:33:46.642 --> 00:34:14.657
I was fortunate that one of the people who I'm still close with today also focused part of her practice on the care of kids and adolescents who have gynecologic issues, specifically problems many of which aren't issues that a general obstetrician gynecologist are comfortable taking care of, and so I also knew that this was a niche field that I wanted to be part of my practice.

00:34:15.039 --> 00:34:18.927
Before making this decision, how many babies did you deliver?

00:34:18.927 --> 00:34:23.681
Oh, my goodness, goodness I know the answer that I'm asking this question I think it's well over a thousand.

00:34:24.123 --> 00:34:26.978
I couldn't let that slip on a thousand kids.

00:34:26.978 --> 00:34:28.945
You brought in a lot, yeah, lots of.

00:34:28.965 --> 00:34:29.306
I mean.

00:34:29.306 --> 00:34:33.114
I also trained before what is now the 80 hour work week.

00:34:33.114 --> 00:34:40.978
So nowadays, residents have their work hours carefully monitored and they can only work 80 hours in a week.

00:34:40.978 --> 00:34:46.001
They can only work so many hours consecutively without 24 hours off.

00:34:46.001 --> 00:34:49.681
As I said, kinder gentler definitely better.

00:34:49.681 --> 00:34:54.824
They learn so much better when they're not one eye open all the time Working.

00:34:54.824 --> 00:35:07.528
Before that, there were times where, if one of my classmates was on vacation, I was working every other day, 36-hour shifts and working 120 hours a week 36 hours.

00:35:07.548 --> 00:35:13.791
Yeah, because you'd show up in the morning, you'd work till the next evening, you'd go home and sleep and you'd come back the next day and do it again.

00:35:13.791 --> 00:35:15.411
It was a tough way to learn.

00:35:15.411 --> 00:35:18.733
I mean, lectures were hard to keep your eyes open during.

00:35:18.733 --> 00:35:26.338
We drank tons of coffee there is something to be said for a sick patient coming into the hospital and you took care of them for 36 hours.

00:35:26.338 --> 00:35:35.344
You learned so much and these days there's more handoffs and shift work, but it is a better lifestyle and a better way of learning.

00:35:35.344 --> 00:35:38.349
So that was definitely a rough patch.

00:35:38.795 --> 00:35:41.297
What do you love about the job and what do you hate about the job?

00:35:42.018 --> 00:35:43.563
Well, what I love about my job?

00:35:43.563 --> 00:35:46.076
I love the connection that I make with patients.

00:35:46.076 --> 00:35:56.465
I love helping people, especially when some of the things I do and offer are things that either others haven't been able to fix or haven't been able to figure out.

00:35:56.465 --> 00:36:03.326
The figuring out, the problem solving and then improving the quality of someone's life I mean that just is one of the coolest things.

00:36:03.326 --> 00:36:05.338
What do I not like about it?

00:36:05.338 --> 00:36:07.083
My husband will know this.

00:36:07.083 --> 00:36:08.626
I'm tortured by medical records.

00:36:08.626 --> 00:36:15.547
I'm tortured by notes and keeping up with constant communication from patients.

00:36:15.547 --> 00:36:18.382
One of my practices, patients email us.

00:36:18.382 --> 00:36:23.001
My other practice, patients send portal messages and it is nonstop.

00:36:23.001 --> 00:36:26.548
That, I think, is hard because you feel such a responsibility.

00:36:26.548 --> 00:36:34.909
I think some of it is hard to delegate to somebody else, and I think AI is coming to help with this.

00:36:34.909 --> 00:36:43.648
Larry, they're talking about it, Very exciting, but hoping that there's going to be other ways to help write some of these notes and provide documentation.

00:36:43.648 --> 00:36:47.463
That isn't me sitting on the couch catching up on notes at night.

00:36:47.943 --> 00:36:51.376
Speaking of responsibility, how do you handle mistakes?

00:36:51.376 --> 00:36:56.085
I mean, we all make them and she's got malpractice insurance.

00:36:56.106 --> 00:36:57.588
you moron, Stop it.

00:36:59.599 --> 00:37:00.523
But it's so funny.

00:37:00.523 --> 00:37:06.271
I have so many questions related to that because we all talk about like I don't feel like myself today.

00:37:06.271 --> 00:37:07.235
I don't feel 100%.

00:37:07.235 --> 00:37:10.719
You can't have a bad day Like your bad days.

00:37:10.719 --> 00:37:13.326
There are dire consequences.

00:37:13.326 --> 00:37:17.264
There are bad things that happen and I was joking with these guys before.

00:37:17.264 --> 00:37:22.302
If I have a bad day, like a game doesn't get on the air on serious Oops, that's a bad day for me.

00:37:22.302 --> 00:37:23.827
But there are lives at stake.

00:37:23.827 --> 00:37:25.679
So how do you handle mistakes?

00:37:25.679 --> 00:37:28.186
Do you feel that pressure and that stress?

00:37:28.835 --> 00:37:30.298
Yes, there is pressure and stress.

00:37:30.298 --> 00:37:42.730
I mean to be a surgeon and take on that responsibility, but I think you know the things that I do is I'm very detail-oriented in terms of the evaluation, the testing, the counseling all that goes into taking care of a patient.

00:37:42.730 --> 00:37:48.967
I work with amazing colleagues and there's always people around that I can bounce ideas and things off of.

00:37:48.967 --> 00:38:01.503
I have colleagues outside of my specialty who I know I could turn to for help if I need help during a surgery or if I need my patient to see someone else and get another opinion or have something else looked into.

00:38:01.503 --> 00:38:14.518
So I think that there's something about the community and the people who surround you that helps you through sort of the stress of the grind of the day-to-day job.

00:38:15.059 --> 00:38:16.643
In terms of handling mistakes.

00:38:16.643 --> 00:38:22.885
I mean, I think we know that in medicine, outcomes cannot be guaranteed and it's one of the hardest things.

00:38:22.885 --> 00:38:24.998
It's something that I talk to patients about all the time.

00:38:24.998 --> 00:38:29.518
I mean, there's days I come home and I just say like gosh, I'm just so tired of getting bad news.

00:38:29.518 --> 00:38:38.403
And a lot of these things aren't mistakes, but they are just things that we have no control over, things we can't fix.

00:38:38.403 --> 00:38:54.748
But there have, of course, along the way, been things that haven't gone the way they're supposed to, and I think acknowledging it to patients and explaining what happened and finding ways to make it right, I think being open and honest to the best that we can, is important.

00:38:55.155 --> 00:38:58.047
How do you stay current with procedures, with new practices that are out there, with new teachings that are out there?

00:38:58.047 --> 00:39:00.958
How do you stay current with procedures, with new practices that are out there, with new teachings that are out there?

00:39:00.958 --> 00:39:01.820
How do you stay current?

00:39:02.681 --> 00:39:04.005
So a lot of different ways.

00:39:04.005 --> 00:39:20.266
We have continuing medical education and I have to do X number of credits per year of either going to meetings and saying that I sat through this number of lectures reading articles, and there's a certain number of articles I have to read every year to maintain as maintenance of certification.

00:39:20.266 --> 00:39:25.280
So there's a number of different ways, both locally, within the two divisions that I work within.

00:39:25.280 --> 00:39:36.601
Like we always have either people coming to talk to us or have people presenting papers and things that we're talking about in terms of current research, going to national meetings, talking to colleagues, listservs.

00:39:36.601 --> 00:39:39.989
There's so many different ways to work to stay current.

00:39:40.534 --> 00:39:41.858
How do you prepare for surgery?

00:39:41.858 --> 00:39:46.416
Everyone has a routine or something to get your frame of mind right.

00:39:46.416 --> 00:39:47.918
Do you meditate?

00:39:47.918 --> 00:39:48.639
Do you?

00:39:48.800 --> 00:39:49.702
play loud music.

00:39:49.702 --> 00:39:52.507
Everyone has a different thing.

00:39:52.507 --> 00:39:54.559
I think that they do.

00:39:54.619 --> 00:39:56.407
I don't know what I would do, but I want.

00:39:56.407 --> 00:40:01.269
If I'm laying on the table, I want to make sure that my doctor is focused and ready with it.

00:40:01.269 --> 00:40:01.813
What's your routine?

00:40:01.833 --> 00:40:02.114
It's so funny.

00:40:02.114 --> 00:40:06.871
I definitely get my game face on, but there is coffee in the morning.

00:40:07.432 --> 00:40:08.014
It's got to be there.

00:40:08.014 --> 00:40:10.161
And the game face, by the way, starts the second.

00:40:10.161 --> 00:40:10.905
She gets out of bed.

00:40:11.375 --> 00:40:19.221
She's focused from the very second her feet hit the floor yeah because I'm usually running late and so I need to be late in there.

00:40:19.320 --> 00:40:29.989
So there's coffee, there's putting my scrubs on, putting on my OR hat, talking to the patient, signing consent forms, and that's starting down my process of focus.

00:40:29.989 --> 00:40:37.824
I mean, the night before I usually have reviewed the patient's chart and reviewed my plan for surgery, so I have all that information fresh in my head.

00:40:37.824 --> 00:40:45.047
And then in the operating room, I'm talking to the team who's with us today about what we're doing for each procedure.

00:40:45.047 --> 00:40:59.081
We even have a timeout procedure that's required by the institution, but we're talking about through a list of what's the case, what are our concerns, what are safety things we need to think about, unique issues for this patient that need to be on our minds.

00:40:59.141 --> 00:41:00.985
What's everyone's name and role in the room?

00:41:00.985 --> 00:41:15.335
We all make sure that we know each other and then, once we get going, we turn on music and I like music in the background and my husband does not like pop music, so I have pop music in the background and who knows what it might be.

00:41:15.335 --> 00:41:21.085
There was one year where it was a lot of Ed Sheeran, justin Bieber, there's like anything under the sun anyways.

00:41:21.867 --> 00:41:26.480
I would not want you to be my surgeon if you're listening to Bieber, not a chance it's not loud.

00:41:26.579 --> 00:41:37.001
I just need to actually not be in my head too much and I need to have a little something, because I can't have the room be quiet, but I also don't want to hear everyone else's side conversations.

00:41:37.362 --> 00:41:41.873
Right, what is the timeout procedure like and how many people are in the room?

00:41:41.873 --> 00:41:42.054
Roughly.

00:41:42.094 --> 00:41:46.527
So usually in the room we have an anesthesiologist, me the surgeon.

00:41:46.527 --> 00:41:49.043
I usually have someone training with me, usually a fellow.

00:41:49.043 --> 00:41:52.864
There is a scrub tech who's handing us instruments and a circulating nurse.

00:41:52.864 --> 00:41:58.481
That's the minimum, and sometimes there's a few other duplicates of other people who are in the room.

00:41:58.481 --> 00:42:16.085
Sometimes I have a medical student or a resident with me as well, and the timeout is actually a very serious moment where everyone is supposed to stop what they're doing, announce that we're doing a timeout, no music on and everyone's paying attention and not fiddling with something or still organizing or setting up.

00:42:16.927 --> 00:42:17.407
I run it.

00:42:17.407 --> 00:42:26.637
So the surgeon is supposed to talk through who the patient is, their medical record, what the procedure is, and then we talk about do they need antibiotics?

00:42:26.637 --> 00:42:28.141
How are we preventing blood clots?

00:42:28.141 --> 00:42:29.726
What are our safety concerns?

00:42:29.726 --> 00:42:42.385
Do we need blood products ordered All these different things that we go through and make sure that everyone is protected with the appropriate personal protective equipment, everyone has eye protection on and that everyone's in agreement that we've gone through everything we need to go through.

00:42:42.385 --> 00:42:55.300
So it is a step by step, institutionally required process and the first thing is, at least for the first case of the day, we all introduce ourselves and state what our roles are, so everyone remembers each other's names.

00:42:55.882 --> 00:42:56.043
Right.

00:42:56.043 --> 00:43:01.126
Can you think of a case that you're particularly proud of?

00:43:01.126 --> 00:43:05.228
Is there a surgery that you've done that you're very proud of?

00:43:05.228 --> 00:43:07.436
That really was a signature moment for you.

00:43:07.775 --> 00:43:19.751
But there's definitely been a few cases of some adolescents who have congenital or from birth variations of how their reproductive tract formed and these can cause pain.

00:43:19.751 --> 00:43:59.760
They can have block problems, with either abnormalities of the vagina or of the uterus that require a detailed surgery and someone who knows what they're dealing with, and there've been times where patients have either been mismanaged elsewhere or just no one's been able to figure out what's going on, and the opportunity to see and treat these individuals and fix what needs to be fixed and help them get their life back and help empower this young person to go ahead and have a normal, healthy reproductive life and talk about what this means for future fertility, et cetera like that is such a special and unique experience.

00:43:59.760 --> 00:44:08.284
There's this one young woman who I saw after several other gynecologic consultations to figure out why she never got her first period.

00:44:08.284 --> 00:44:19.677
We figured out pretty quickly that she had a very unique gynecologic disorder that was gonna require surgery to fix because there was something abnormal about her vagina and menstrual blood couldn't come out.

00:44:19.677 --> 00:44:58.123
To take care of her required me to assemble a team of surgeons to help fix the problem in an emergent, time-sensitive way, and she's been under my care for probably the past 12 years, so she's actually one of my longest patients since I'm at my current job in New York City, and it's just been so remarkable to watch her grow up and see how she navigates this condition and how it can influence her current reproductive and sexual life, as well as her ability for future reproduction, and she's just dealt with it with such grace and positivity.

00:44:58.844 --> 00:45:03.161
It's tough to be a young woman growing up who is different than their peers.

00:45:03.161 --> 00:45:03.842
In some ways.

00:45:03.842 --> 00:45:26.987
This person has an interest in going into the medical field, and one of the things that really was a special moment that we shared is she told me that the essay that she wrote to help her navigate the waters of starting medical school or physician's assistant school or something, is that she wrote about our relationship.

00:45:26.987 --> 00:45:42.280
That's just so special to me just to think that in this field, where I take care of these young women and I'm the first gynecologist that they really interact with that you can really have such a marked impact on someone's life.

00:45:42.882 --> 00:45:44.987
And with all these hats, you also teach.

00:45:44.987 --> 00:45:47.494
So, talk to us a little bit.

00:45:47.494 --> 00:45:51.105
I mean, I don't know where you find the time to teach, but talk to us about how that came about.

00:45:51.105 --> 00:45:53.500
Do you love it and who are you teaching?

00:45:54.121 --> 00:46:03.603
I do two different forms of teaching and some of the teaching I do is a dedicated PowerPoint lecture or case-based lecture where I'm teaching.

00:46:04.626 --> 00:46:22.690
Occasionally medical students, more commonly our residents and fellows, and sometimes other groups or divisions at the hospital, ask me to come speak on a certain topic, so that I very much like is a more didactic but often interactive conversation on a specific topic.

00:46:23.775 --> 00:46:42.643
The other type of teaching and this is what I do more of all the time is patient-facing teaching where often when I'm in my office seeing 25 to 30 patients, I have often a resident working with me who's seeing my patients alongside me, and sometimes they'll go into a room to take a patient's history, come out and talk to me.

00:46:42.643 --> 00:46:44.737
We'll talk about the patient, we go back in together.

00:46:44.737 --> 00:46:52.681
So there's in the moment teaching which I so enjoy because I think that's for me that was one of the ways that I learned best.

00:46:52.681 --> 00:47:01.657
There's some great, always nuance and clinical pearls and things that just resonate when you've seen it and dealt with it hands-on.

00:47:01.657 --> 00:47:12.688
So that is the other type of teaching that sort of happens in stride, both in the office as well as the days that I'm in surgery where I may have residents with me during those days.

00:47:13.496 --> 00:47:18.206
And I can see the pride and the joy and the satisfaction that you get from that all the time.

00:47:18.206 --> 00:47:20.041
Your kids, they're your kids.

00:47:20.041 --> 00:47:29.769
Something else that we do want to explore is something that you have been fighting for a period of time.

00:47:29.769 --> 00:47:50.541
We recently had a guest on named Sadia Zapp, who works for the Breast Cancer Research Foundation, and it was a very unique conversation for us to have, because this is a young woman who happens to work for the company or for the association that exists to fight the disease she is fighting.

00:47:50.541 --> 00:47:53.487
It was such a moving discussion.

00:47:53.487 --> 00:48:22.956
Similarly, you have also been struggling with cancer and fighting cancer for quite some time now, and I can't imagine as a physician, as a doctor, knowing what you know and living the life that you do, how somebody can do that and how you manage to push through, from a time perspective, an energy perspective, a scenario of knowing too much.

00:48:22.956 --> 00:48:28.806
Can you talk to us a little bit about your fight and your struggle?

00:48:30.228 --> 00:48:30.528
Sure.

00:48:30.528 --> 00:48:39.668
So it's been hard to believe almost nine years since my cancer diagnosis.

00:48:40.416 --> 00:48:41.458
Wow, I didn't realize that long.

00:48:41.458 --> 00:48:43.324
I mean I was saying it was a while, but nine years.

00:48:43.324 --> 00:48:44.315
Wow.

00:48:45.217 --> 00:48:47.661
Yeah, Going on nine years in February 2025.

00:48:47.661 --> 00:48:58.523
Wow, and it knocked me off my feet and was never what I expected as a newlywed.

00:48:58.523 --> 00:48:59.585
It's been a journey.

00:48:59.585 --> 00:49:09.215
It's been eye-opening in lots of ways, challenging, had a lot of hairstyles along the way thanks to chemotherapy.

00:49:10.876 --> 00:49:12.137
You were a blonde when I met you.

00:49:12.137 --> 00:49:17.000
I has been eye-opening, to say the least, and experience people who I really wish treated me the way I think I treat other people.

00:49:42.496 --> 00:49:43.980
I've had to advocate for myself.

00:49:43.980 --> 00:49:47.978
I've had to get multiple second opinions to try to understand what to do.

00:49:47.978 --> 00:49:54.684
I mean, the cancer I'm dealing with is very rare, so rare that there's not a playing field out there.

00:49:54.684 --> 00:50:03.744
If this was a more common cancer, playing field out there, if this was a more common cancer, there would be a path and you do A and then you do B and then you do C.

00:50:03.744 --> 00:50:09.179
Well, I passed all those things a long time ago and I'm doing great, as great as you can do.

00:50:09.398 --> 00:50:14.248
But my physician jokes that I live in a data-free zone.

00:50:14.248 --> 00:50:20.291
There is no medical study that says what we should do next.

00:50:20.291 --> 00:50:28.018
And I've been a guinea pig and I've tried lots of innovative things and I'm fortunate that I've often responded to lots of innovative things that I've tried.

00:50:28.018 --> 00:50:33.108
But I've also worked fairly full time throughout this.

00:50:33.108 --> 00:50:42.641
Whether that makes me crazy or not, it has been the best distraction, because I can't sit at home and think about the fact that I have cancer.

00:50:42.641 --> 00:50:53.230
I would rather be the doctor than the patient and it's just been grounding for me, just to normalize life as best as I can.00:50:53.230 --> 00:51:14.581


So that's been part of my mind, that I have a tremendous team around me and I recognize that as a physician, I probably have been able to advocate for myself in ways that other patients have been able to, and I have this amazing team and other opinions that provide input to my care, so I'm really fortunate.00:51:15.375 --> 00:51:16.400


You just touched on it there.00:51:16.400 --> 00:51:24.202


The idea of is it a blessing or a curse that you know so much about the human body as a physician do you grapple with.00:51:24.202 --> 00:51:25.505


That Is ignorance, bliss.00:51:25.505 --> 00:51:31.246


Do you wish you knew less a little bit about your condition or about what's happening with your body?00:51:31.586 --> 00:51:32.389


That's a good question.00:51:32.389 --> 00:51:52.923


One of the treatments that have been offered to me from day one of my diagnosis was radiation, and I'd seen some of the terrible side effects of radiation how it can harm the intestines and the bladder and the skin and I was deathly afraid of it and I never would consider it as an initial treatment.00:51:52.923 --> 00:51:58.864


Because of that and my team knew that for the longest time, it was something I was never willing to consider.00:51:58.864 --> 00:52:22.007


I'd gone through two huge surgeries, I've gone through multiple rounds of chemotherapy, but recently, this past March, it came up again as we'd been talking about it for the six months prior, like maybe my next best thing, and I got wrapped my head around it and finally realized that I was going to take the plunge and they were able to provide that service in a way that made me comfortable.00:52:22.007 --> 00:52:31.585


So that's probably a great example of I knew too much and I also might not have known the right things, but again my team couldn't tell me that this was guaranteed to make a difference.00:52:32.128 --> 00:52:36.561


Turns out seems to have provided some benefit, which is great, but I was really.00:52:36.561 --> 00:52:37.242


I was scared.00:52:37.242 --> 00:52:38.646


I didn't know what to expect.00:52:38.646 --> 00:52:40.931


Provided some benefit, which is great, but I was really, I was scared.00:52:40.931 --> 00:52:41.733


I didn't know what to expect.00:52:41.733 --> 00:52:50.985


So I think that's one of the situations where you know a little too much and I had to engage my team and multiple opinions to get my head around it.00:52:50.985 --> 00:52:52.128


It took a while.00:52:52.594 --> 00:52:54.563


There's a certain amount of service to what you're doing, right?00:52:54.563 --> 00:53:00.626


I mean, your whole life has essentially been about service, whether it be service to your community, now, obviously, service to your patients.00:53:00.626 --> 00:53:12.081


As a doctor In this sense, since your cancer is so rare and unknown, do you take a certain amount of solace in the idea that you know the treatments that are happening to you?00:53:12.081 --> 00:53:21.262


There's service in that, because obviously this will teach others who may eventually have the similar type of cancer that you have that there is a roadmap.00:53:21.735 --> 00:53:23.663


That's a really great point, tushar.00:53:23.663 --> 00:53:30.648


So I recognize that things that have happened to me may benefit others.00:53:30.648 --> 00:53:35.547


Interestingly, when I was meeting with my oncologist a few weeks ago and I said what's new?00:53:35.547 --> 00:53:38.798


Because I hadn't asked him that in a while, and he's well, we're looking at new things.00:53:38.798 --> 00:53:45.445


In fact, your humor is part of that study, which is weird to think that they still have like pieces of me that they're studying.00:53:46.710 --> 00:53:56.016


One of the coolest experiences that I had, and Larry was part of, is my initial treatment for this cancer was I was part of a clinical trial.00:53:56.016 --> 00:54:04.750


There was this new drug out there that was specific to my condition, that I met the criteria to be part of this trial.00:54:04.750 --> 00:54:09.523


So it wasn't available to the public yet, but it was what was called a phase three trial.00:54:09.523 --> 00:54:10.405


It's already been tested.00:54:10.405 --> 00:54:16.878


They know the right dose and now they're trying to figure out its true effects on a tumor and the thought was it might be able to shrink this tumor.00:54:16.878 --> 00:54:21.056


So they said that the side effects seemed to be low.00:54:21.056 --> 00:54:22.501


Did I want to give it a try?00:54:22.501 --> 00:54:26.356


And my team seemed to say that this was not crazy.00:54:26.356 --> 00:54:52.894


I could try it for a few months, get scanned again and lo and behold, I tried it, I tolerated it really well and my tumor shrunk Fast forward, maybe a year or two later, as this drug is finally about to come onto market, and I was invited to the company's headquarters in Boston to speak to the team who had created the drug and was working on the drug to tell them my story, because I was kind of patient number one.00:54:53.014 --> 00:54:58.025


I was one of the first patients to use this as an initial treatment for my cancer.00:54:58.025 --> 00:55:00.295


I get emotional just thinking about it.00:55:00.295 --> 00:55:20.215


I mean it was such an emotional day just to meet the researchers who had thought about this drug, created this drug, done the trials on this drug, and speak to them and share with them why their work was so important, because they needed to see what they were doing was making such a big difference.00:55:21.137 --> 00:55:29.157


And having been there with you, there literally wasn't a dry eye in the room, not one dry eye.00:55:29.217 --> 00:55:32.965


I talked about my life, growing up and wanting to be a physician.00:55:32.965 --> 00:55:35.086


The one joke I didn't tell you guys is.00:55:35.086 --> 00:55:37.585


Everyone always asked me like why didn't go into dentistry?00:55:37.585 --> 00:55:38.719


And I was like I didn't tell you guys is.00:55:38.719 --> 00:55:40.125


Everyone always asked me like why didn't go into dentistry?00:55:40.125 --> 00:55:47.422


And I was like, well, I didn't like the fact that my dad worked in a deep dark hole and I said, man, I'd be in a college, but a bum Q Ripshot.00:55:47.503 --> 00:55:55.867


Yeah, I told them that story and I was just like sharing my story and how what they did had been hopefully life-saving for me.00:55:56.027 --> 00:56:08.666


And in fact, I had my surgery and I ended up going back on the drug for another two years or so and subsequently, Larry and I went out to the company that was actually producing the pills and met that team and that was really, really cool.00:56:08.666 --> 00:56:22.117


And at that point, as I shared with that company where my life and where I'd been and how they'd been so instrumental in treating my cancer, we also shared with them that we were pregnant, which is really cool.00:56:22.117 --> 00:56:23.981


At the time we were 18 weeks pregnant.00:56:23.981 --> 00:56:38.168


I couldn't carry, just based on all that I'd been through, and so we had a surrogate and again, it was just, I think, really inspiring for those people to see the good in what they did.00:56:38.168 --> 00:56:45.318


So I don't think a typical patient would have had these experiences.00:56:45.318 --> 00:56:53.945


I think, being a physician and the doctors who have been part of my care since day one were the ones running the clinical trials I mean, they got me access to these two engagements.00:56:53.945 --> 00:56:56.664


Those were really really cool experiences.00:56:57.315 --> 00:56:59.963


I will simply say that Wonder Woman ain't got nothing on you.00:56:59.963 --> 00:57:02.822


You are the real Wonder Woman out there.00:57:02.822 --> 00:57:04.039


My God, it's ridiculous.00:57:04.039 --> 00:57:09.485


Yeah, yeah, and Sam, you need to kiss this woman's feet every day.00:57:09.485 --> 00:57:11.460


She should have done better.00:57:11.460 --> 00:57:12.523


She can do better.00:57:12.523 --> 00:57:18.681


Beth, what's it like to be, I guess, now what six, seven years running now One of the top doctors in New York?00:57:18.681 --> 00:57:26.539


The country, the country pardon me, Considering what you are going through as well to maintain that level of excellence.00:57:28.184 --> 00:57:29.447


I don't have a tissue, I have a mask.00:57:29.447 --> 00:57:33.119


Perfect.00:57:33.159 --> 00:57:35.844


For those listening on radio or on audio.00:57:35.844 --> 00:57:39.289


Beth is wiping her eyes with a surgical mask right now.00:57:39.815 --> 00:57:40.998


Improvisation at its best.00:57:40.998 --> 00:57:42.202


What was your question?00:57:43.083 --> 00:57:44.047


What's it like to be awesome?00:57:46.275 --> 00:57:50.614


Well, I was going to say, it all depends on how much stake you put in those surveys.00:57:50.614 --> 00:57:57.949


I mean, some of those surveys do have some merit because it's doctors nominating other doctors.00:57:57.949 --> 00:58:02.719


Merit because it's doctors nominating other doctors.00:58:02.719 --> 00:58:17.139


I get some of these I think are not exactly as meritorious as impressive some of these accolades, but it is cool that I've been recipient of some of these awards and I'm far from the only one of my colleagues who has been your journey is remarkable.00:58:17.701 --> 00:58:25.757


I do want to inform you, though, that the way you feel about the people who helped you, I'm sure your patients feel about you, so that's a fact.00:58:25.757 --> 00:58:39.976


While you're going through this, this career journey, your struggle with cancer, et cetera, I mean, do you take time to consider your legacy and how much you're helping people and the impact that you're making in the world?00:58:39.976 --> 00:58:41.880


I mean, it's remarkable.00:58:42.641 --> 00:58:46.608


I definitely hear it from some patients.00:58:46.608 --> 00:58:55.244


I hear it from some of my adolescent patients who, as they're moving on to an adult provider, there are hugs and we reminisce about how long I've known them.00:58:55.244 --> 00:59:02.186


I hear it from my patients from my fertility practice who I've helped get pregnant and helped them build their family in a special way.00:59:02.186 --> 00:59:16.248


One of the coolest things that has happened a few times is I've had some students either writing essays for college or for medical school about the impact that our relationship has had on them.00:59:17.335 --> 00:59:18.822


That's something I'm so proud of.00:59:18.822 --> 00:59:26.143


When I step back from the grind of oh my God, I'm 20 notes in the hole and I don't know when I'm gonna get this done.00:59:26.143 --> 00:59:41.481


But when I step back from the grind of long days and catching up and all the nitty gritty like the not so glamorous parts of being a physician I have the best job in the world and it's really what drives me.00:59:41.481 --> 00:59:44.447


It makes the work worth it.00:59:44.447 --> 00:59:58.643


I've always been proud of the care I provide and the job that I have, and I'm very honored to interact with people at such an important time in their lives and to make it an impact.00:59:58.643 --> 00:59:59.824


That's how I want to be remembered.01:00:00.324 --> 01:00:03.429


For anyone else out there who wants to have the best job in the world, like you.01:00:03.429 --> 01:00:05.851


What is that piece of advice you want to give?01:00:05.851 --> 01:00:11.155


Is there one piece of advice or multiple pieces of advice you want to give to someone who wants to have the best job in the world?01:00:12.860 --> 01:00:19.563


I will say, like one of my friends has always said, that I'm the happiest doctor he knows, and that just is.01:00:19.563 --> 01:00:20.384


That is me.01:00:20.384 --> 01:00:22.507


There's highs and lows of being a physician.01:00:22.507 --> 01:00:27.458


For sure, that's a very ancient saying be happy in your work.01:00:27.458 --> 01:00:48.762


My pointers for others are you're going to have to work hard for this career, but to avoid tunnel vision and avoid pigeonholing yourself and allow yourself to experience other things and allow yourself to have more than one passion in life, because I think it enhances your life and the career person that you're going to become.01:00:48.762 --> 01:01:13.568


I think mentorship is key, because that has clearly been critical for me every step along the way, and I think it's important to understand the good, the bad, the ugly of what you're getting into, because every part of medicine has the highs, the lows, and you have to be able to tolerate the best of days and the worst of days.01:01:31.202 --> 01:02:01.077


And I think working through that thought process is really important and I do want to bring up that it's always a great satisfaction for me when I see the parents, in particular, of your patients, and I see the way that they look at you and I can see that the difference that you're making in their families lives, and it's truly one of the most remarkable things that I've ever seen.01:02:01.077 --> 01:02:10.804


So you know, with that, beth, I think this is a good place to say thank you for coming with us today on this journey and sharing all of this with us and really being so open and honest in telling your story.01:02:11.204 --> 01:02:12.206


Thank you for having me.01:02:12.206 --> 01:02:13.838


It's been a great experience.01:02:13.838 --> 01:02:19.088


I admire so much what you guys do on this podcast and I'm just honored to be part of it.01:02:20.076 --> 01:02:25.407


So that was Dr Beth Rakow, obviously a story that I'm quite familiar with.01:02:25.407 --> 01:02:28.864


So, guys, why don't you give me your thoughts?01:02:28.864 --> 01:02:30.501


Tushar, please lead us in.01:02:30.934 --> 01:02:35.063


Sam, I've said it before about your wife and I'll say it again she's an absolute superhero.01:02:35.063 --> 01:02:41.228


Beth's path to become one of the best doctors in her field is unconventional.01:02:41.228 --> 01:02:45.804


Right, she was pulled off the wait list for going to medical school.01:02:45.804 --> 01:02:50.081


She was rejected from a lot of medical schools and she didn't let that get her down.01:02:50.081 --> 01:02:54.443


She had a singular focus because in many ways it was because of her upbringing.01:02:54.443 --> 01:03:00.563


Right, she wanted to go into the family business of being a health caregiver, her father being a doctor, being a dentist.01:03:00.943 --> 01:03:03.429


She's just amazing when you hear her story.01:03:03.429 --> 01:03:08.135


It's unconventional in the fact that you know she did take time off to work in the Forest Service.01:03:08.135 --> 01:03:09.762


She would have been successful at whatever she did.01:03:09.762 --> 01:03:11.416


She could have gone into law, as she had mentioned.01:03:11.416 --> 01:03:19.190


I mean, obviously she would have been successful in whatever job, whatever career she chose, because she's so driven and focused.01:03:19.190 --> 01:03:28.887


But I'd say, at the end of the day, it's not so much that but it's her ability to overcome and her singular focus which has allowed that.01:03:30.257 --> 01:03:33.106


It got very heavy and very intense when we started talking about cancer.01:03:33.106 --> 01:03:36.706


This is obviously a subject that we have known for years.01:03:36.706 --> 01:03:42.952


We don't talk about it a great deal For her to have gone what she is going through mean it's not she's not done with it yet.01:03:42.952 --> 01:03:49.213


What she's going through and to come out on the other side stronger, it's just amazing.01:03:49.213 --> 01:03:52.099


I mean, she's such a wonderful wife, wonderful woman, wonderful mother.01:03:52.099 --> 01:03:55.586


I am in awe of her at all times.01:03:55.586 --> 01:03:57.117


I mean, you hit the jackpot, sam.01:03:57.117 --> 01:04:02.003


That part is for sure, and I'll say it again she is an absolute superhero.01:04:02.003 --> 01:04:02.625


What do you think, shay?01:04:02.996 --> 01:04:07.043


I love that you used the word superhero because I literally wrote that in my notes.01:04:07.043 --> 01:04:10.074


You know, I think most doctors are superheroes.01:04:10.074 --> 01:04:14.264


But then you hear Beth's story and it just takes it to a whole nother level.01:04:14.264 --> 01:04:16.282


I mean really impressive.01:04:16.282 --> 01:04:25.556


Wonder Woman's got nothing on her.01:04:25.556 --> 01:04:25.918


Super impressive.01:04:25.918 --> 01:04:27.862


I was also taken with the role that athletics played in her life.01:04:27.862 --> 01:04:34.400


Early on she said she loves to be on a team, she's competitive, she's driven, and this really kind of set her up for her career journey and a life of winning.01:04:34.400 --> 01:04:41.159


Basically so super impressive, the way that played such a vital part of her life.01:04:41.159 --> 01:04:45.728


You know and we did talk about this as well T I'm squeamish, you know.01:04:45.728 --> 01:04:57.324


So this is, this is not a job for everybody, but, um, you know, I couldn't imagine the level of joy that she must get, changing people's lives every single day.01:04:57.324 --> 01:05:03.523


You know the amount of dedication and service and she wants to help people and it's just so admirable.01:05:03.523 --> 01:05:07.599


And we can't thank her enough for sharing her story because it's a remarkable one.01:05:08.041 --> 01:05:15.021


You know, larry, you use the perfect word to sum up what Beth does, and that word was joy.01:05:15.021 --> 01:05:32.949


You know, beth is a person who tackles each day with such desire I don't know if ambition is the right word Passion and just this incredible attitude that makes the work that she does feel like something beyond work.01:05:32.949 --> 01:05:38.244


You know, people have jobs and careers, et cetera, et cetera, but what Beth does is something completely different.01:05:38.244 --> 01:05:45.548


You know, this is a person who puts in 12-hour days without even blinking and it doesn't feel like work to her.01:05:45.548 --> 01:05:49.186


This is passion, a calling and beyond.01:05:49.186 --> 01:05:53.494


So what I see her do day in and day out is just truly remarkable.01:05:53.936 --> 01:06:07.369


And then, in terms of her health stuff, you know she's been fighting cancer for close to 10 years and she has shown and demonstrated a strength that I didn't really know existed within people.01:06:07.369 --> 01:06:14.168


I mean, she's been through surgery and chemo and all these other things and she's never allowed it to get her down.01:06:14.168 --> 01:06:24.603


She's gone to chemo on Friday and she's gone back to work on Monday and I ask how she is and the response is I'm fine, I'm good, and she just keeps going.01:06:24.603 --> 01:06:26.909


It's truly, truly incredible.01:06:26.909 --> 01:06:53.396


So you know, for any young doctor out there, hopefully, this conversation has shown you a little bit in terms of what it takes to get to that next level and you can pull some great advice and some great nuggets out of this and beyond that, just from, you know, a human interest aspect, or just from a human standpoint, beth should be, you know, truly an inspiration to anyone out there who has a battle in front of them that they need to get through.01:06:53.396 --> 01:07:02.050


Well, know that you can do it, and a lot of it depends upon your attitude and your perseverance and your perspective on things.01:07:02.050 --> 01:07:09.809


And what Beth has shown me day in and day out over this past you know however many years has truly blown my mind.01:07:09.934 --> 01:07:15.847


So, you know, with that, beth, I've been asking you for a long time to break down and join the show.01:07:15.847 --> 01:07:17.802


You finally did it today.01:07:17.802 --> 01:07:21.615


I thank you so much for agreeing to come on with us.01:07:21.615 --> 01:07:24.483


Your story is certainly remarkable.01:07:24.483 --> 01:07:26.971


We also thank you for joining us.01:07:26.971 --> 01:07:35.922


If this episode made you think of someone who could be a great guest, please send us a note through the contact page of our website at norongchoicescom.01:07:35.922 --> 01:07:43.420


While you're there, please check out our blog for a deeper look into each of our guests and episodes, as mentioned at the start.01:07:43.420 --> 01:07:48.782


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On behalf of Larry Shea Tushar Saxena and me, larry Samuels, thank you again for joining us.01:08:05.668 --> 01:08:10.264


We'll be back next week with another inspiring episode of no Wrong Choices.