"Good Enough is Your Superpower" with Susan Landers, MD

Many thanks to retired neonatologist Susan Landers, MD, for joining me on Episode #173 of “The Art of Medicine with Dr. Andrew Wilner.” I first spoke to Susan on July 9, 2023, on Episode #89 about her book “So Many Babies.” In her first book she reflected on her career, particularly the daily challenge of work/life balance.

Today, we discussed her new book, “Good Enough is Your Superpower: Overcoming Perfectionism for Women by Silencing Your Inner Critic and Setting Boundaries.”

Dr. Landers confessed that for the first 15 years of her career, she suffered as a perfectionist. She was unable to silence her “inner critic” that insisted she was not “good enough.” Rather than take pride in a long and productive day at work, she felt she was shortchanging her children or husband. If she spent more time with her family, she felt dissatisfied with herself at work. 

For a perfectionist, a seemingly simple task such as arranging a child’s birthday party required addressing so many details that it devolved into an exhausting chore. Dr. Landers concluded that the price of perfectionism is loss of rest and recovery.

Dr. Landers eventually discovered effective strategies to silence her inner critic and take pleasure in being “good enough” as a wife, mother, and full-time physician. She provides sage advice to young women to combat perfectionism when facing the dual challenges of a career and family.

We also discussed the concepts of “invisible labor” and “emotional load.” According to Dr. Landers, women tend to do more invisible labor and emotional load than men, which increases their overall workload and stress.

Dr. Landers is planning a book on preventing osteoporosis. Inspired by her mother’s diagnosis and her own, she has thoroughly researched the topic and wants to share her findings with other women.

You can find “Good Enough is Your Superpower” on Amazon here: https://amzn.to/45GTmWy

You can also read Dr. Landers weekly newsletter “MomsMatter” on Substack: 

https://substack.com/@landersmomsmatter?utm_source=global-search

#motherhood, #worklifebalance, #physicans, #dualcareer, #osteoporosis. #perfectionist #perfectionism

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Transcript

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SPEAKER_01 0:09

Welcome to the Art of Medicine, the program that explores the arts, business, and clinical aspects of the practice of medicine. I'm your host, Dr. Andrew Wilner. I've planned a great program for today, but first a word from our sponsor, Locumstory.com. Locumstory.com is a free, unbiased educational resource about locum tenants. It's not an agency. Locumstory answers your questions on their website, podcasts, webinars, videos, and they even have a Locums 101 crash course. Learn about Locums and get insights from real life physicians, PAs, and NPs at LocumStory.com. And now to my guest. I'd like to welcome back Dr. Susan Landers. I first spoke to Susan in July 2023 during episode number 89. And by the way, now we're up to episode 172. And at that time we talked about her book, So Many Babies. Dr. Landers is a neonatologist, and in that first book, she reflected on her career, particularly work-life balance. Today we'll talk about her new book, Good Enough Is Your Superpower: Overcoming Perfectionism for Women by Silencing Your Inner Critic and setting boundaries. And I'm very interested to learn why perfectionism is something we should overcome. So uh welcome, Dr. Susan Landers.

SPEAKER_00 1:47

Oh, thank you, Andrew. It's such a pleasure to see you again and talk to you again. I have to tell you that a lot of women in medicine are perfectionists. I think a lot of high-achieving working women are perfectionists. You're raising your hand. You're a perfectionist too. Maybe some men too. Yeah, maybe some men. I asked my neurosurgeon before my spinal fusion, I said, Are you a perfectionist? And he said yes, and I said, Good. And I had a good result.

SPEAKER_01 2:16

But it has a downside, right?

SPEAKER_00 2:18

It has a Here's the deal about perfectionism in women. We grow up as little girls trying to be good, trying to figure out how we fit in. And whether it's making good grades or having uh a good composure or being a good facilitator and team player, or um, whether it is just not making much noise, we learn to get attention in certain ways. For me, it was making good grades. My sister got attention for being in trouble, and I got attention for making A's. And so perfectionists always tend to strive for the next achievement. They love the achievement, they like the diplomas, they like the certificates, they like the accolades, and there's nothing wrong with that except that when you get that achievement, then it's like you're going, okay, so what's next? What's my next achievement going to be? And for working women who are struggling with a career, half the time a family in a marriage, that's a lot to ask of perfectionists. And what they end up doing, what I ended up doing, was trying to do everything perfectly, which is impossible. No one can do that. And then you feel like you've shortchanged the other aspects of your life. When I was perfect in the NICU, working 10 or 12 hour days, I was not a perfect mom. And I probably wasn't a perfect wife either. And so, um, what perfectionists do then is their inner critic, this Susan, really, you've got to get it together. You're not being a good enough mom. You've got to volunteer at the school, you've got to carve away time to pick up the kids one day a week at least after school. You've got to go out on a date with your husband at least once or twice, once a week or once every two weeks. You're not doing this right. And so our inner critic tells us we're not measuring up. And whether we're not measuring up at work or at home or in our relationships, perfectionists end up telling themselves, I can do better, I can do more. So, what gets lost? Rest and recovery gets lost. Perfectionistic women almost never take time for themselves because when they make their lists, and we're really good at to-do lists, we're at the very bottom of our list. We really are. I mean, if if you're a perfectionist in medicine, you get this sense by okay, today I'm gonna see this, this, and this patient. I'm gonna talk to this, this, and this person. I'm gonna go to this meeting and I'm gonna have lunch with this colleague. And at the end of the day, you look at your list and you go, darn, I missed something. Or I'm really tired. I don't know how I'm so tired. Well, because you made this list that is unbelievably difficult to fulfill, and women do it all the time. You know, I I would go to work worrying about the orthodontist appointment. Did I tell the babysitter to meet me there? Or was I supposed to pick up the kids from school and then she was coming? Or the PTA meeting, what was I going to volunteer for that I could actually do? Or did we send them to school with all the permission slips? And here I was in the middle of a NICU, taking care of sick babies, interacting with parents who were traumatized, and the back of my mind was going, I don't really know about how David's doing in this class, and I need to teach, talk to that teacher. There's this endless dialogue with our inner critics, and my inner critic never said, Susan, you're doing a lot, you're practicing medicine full-time, you're a pretty good mother. Your husband tells you you're a good enough mother. Why don't you give yourself a break? And Andrew, it took me about 15 years to figure that out. I was clearly into my 40s, my mid to late 40s, when I decided that perfectionism was killing me. I just could not do everything on my list. And so I wrote the book, Good Enough is your superpower, because I know other women feel the same way. I know that they're going, I'm not really good enough at this. I'm really good at that, but I'm not good enough at this. And we don't give ourselves a break. We don't. It's just the way women are. We always take on more than we can handle.

SPEAKER_01 7:23

And uh well, as someone with uh XY chromosome, I do have to insist that this is not restricted to women. There's a long test here right next to me, and it never gets done. And I'm thinking right now it's my son's first day today in second grade, and I took him with my wife so that we could meet the teacher, and I'm gonna go pick him up so uh as soon as we're done with this. So there are things, but I would agree that for women, there's no question, there's a whole lot more going on. Um they're they're the cornerstone of the family, regardless of whether the uh even if they try, couples try to be 50-50. I would say somehow, I don't know if it's genetic or environmental, but the women bear the brunt of uh raising the family. That uh is 99% uh true, I'd say, with all families. And it's a lot, I wonder how, you know, I have a resident I worked with last week. She has three young children. It's like, how is that possible? Uh you know, it's like, you know, how is that possible?

SPEAKER_00 8:30

Well, if you're lucky enough to afford a nanny, it's possible. If you have a mother-in-law who's retired and wants to take care of your kids, it's possible. My daughter is a nurse practitioner in the in the pediatric ICU. Her husband works full-time, she works full-time, and their kid, they were in daycare. The kids were in and out of various daycares, and I would sub in when the kids were sick, and then I would get sick. But anyway, that's a whole nother story. And then now, preschool um and first and second grade, now it's kindergarten and fourth, and they're like ecstatic. They're gonna have two kids in the same school on the same schedule because it's really hard to do all that back and forth when you have two and three kids. And it's not just the daycare, it's the pediatrician, it's the pediatric dentist. Yeah, after school sports. After school, it's extracurriculars, it's everything. And so if the mom can't do it, she's got to hire somebody to do it. Now, when my kids were older, I hired a UT student to be chauffeur, part-time babysitter. It worked out really well. Oh, that she loved it. All she did was drive kids around in the afternoon, and then a couple hours later pick them up and bring them back home. So your resident with three kids has helpers. There is no way she could do it if she didn't, and that's okay. And now I do have to admit, most women in our country can't afford a nanny, they can barely afford child care. And most women are patching together coverage with sharing with another mom, having a relative help, working part-time, working from home. God forbid, if I had worked from home with my three kids, I would never have accomplished anything. So you're right, the female of the couple tends to take on the majority of what's now called invisible labor, an emotional load. Like when I went to work thinking about what needed to be done at home, and I'm looking at a baby and I'm thinking, oh, I gotta call David's teacher. That's emotional load. Invisible labor is when I have to clean up something, and my husband doesn't help, even though he helps 20% of the time. I mean, I like that.

SPEAKER_01 11:17

I like that term, emotional load. You know, for pilots, they talk about cognitive load, like when you're landing. There's a lot of things you have to do, and you have to do them right, and you have to do them in a very finite amount of time. There's a right, you don't want any extra things to do. You know, there's no chatting in the cockpit when you're landing the plane. You you focus on what you need to do. But it's very it you need focus, you need energy, you need time. You you have to do that. And to have all that in the back of your mind while you're you know in the intensive care unit trying to take care of others, that's exhausting.

SPEAKER_00 11:50

It is. Uh, my best example of emotional labor for women and men listening is a birthday party. When the men listening talk to their wife about planning a birthday party, they're imagining balloons and cake and maybe favors, and what day and what time. The woman is thinking about the invitations, the RSVPs, the balloons, the cake, the cupcakes, the party favors on Amazon, getting the party favors, reserving the room. The list is like this long to plan a birthday party, which is totally outrageous, but you probably couldn't plan a birthday party for your son to your wife's content.

SPEAKER_01 12:43

Ah, I was gonna say, well, that's probably right. We're looking at it's too well, it's like cleaning the room. It's like I cleaned the bathroom, right? No woman walking in there would say it's clean, but uh nine out of ten guys would say it's clean. There are different standards for sure.

SPEAKER_00 12:59

Right. And that's invisible labor. Mom making the household run tip top, that's invisible labor. Mom working out the schedules, mom talking to the teachers, mom knowing who's going on a field trip, that's all invisible labor. Emotional load, as you said, is that weighted stuff that we take with us to work and we think about because most women don't separate work and childcare. I mean, I suppose if you're in surgery and you're doing an operation, if I was doing a procedure, I wouldn't be thinking about it, but still, it creeps in at the oddest times. Before we started recording, I mentioned to you that women at work love to talk to each other. Yes. It I read a study recently that said, guess what? Working mothers find support in talking to women at work. And I'm going, good grief, that's ridiculous. We've been doing that forever. You go to work, whether you're talking to a colleague, a nurse, a doctor, a secretary, if somebody's chatting about their 12-year-old having trouble, somebody else chimes in, and somebody else comes up and chimes in, and we talk about this and who tried what and what worked and what didn't. And at the end of our conversation, everyone feels a little lighter. It's this amazing thing called social connection that allows women to feel supported. And I don't think we talk about that enough. And working from home does not give people that. You don't get colleague support when you're working from home. I mean, you might on a Zoom meeting, but it's different than going to work in a hospital or an office building or school.

SPEAKER_01 14:56

Let me be very politically incorrect. And so we'll move forward from that. But uh the obvious solution to this, which they had 50 years ago, is women should just stay home and take care of the family.

SPEAKER_00 15:14

Well, you would think that being a trad wife, that's what it is called now, would be appealing to women. But I think now that we've dipped our toe in the pool of independence and financial security and fulfillment, I love my kids, but I would have been a terrible stay-at-home mom. I loved neonatology. I really got a kick out of it. It was fulfilling, it was rewarding, it was challenging, and yes, it was stressful. And I guess I got more joy out of my children, but I wouldn't have given up my medical practice for anything. And I don't think most women want to stay home with their kids and bake cookies.

SPEAKER_01 16:03

Right. So just to be clear, I'm not advocating that. I don't want to see a lot of uh emails, but um I just raised that that was one solution. And um it certainly may not be the best for most women. So, what's your advice, right? Let's cut to the chase here, for a young woman like my resident to not be overwhelmed by perfectionism, you know, so she can save the 15 years it took you to figure it out. Yeah. How what what can she do to be?

SPEAKER_00 16:33

She should buy my book, Good Enough is your superpower, and it will teach her how to say no. No is a complete sentence. If she's like me, she takes on way more work than she needs to. Somebody asks her to give a talk on this, and somebody asks you to present on that, and somebody asks you to contribute to this committee, and it goes on and on and on. And what you do when you're a working woman and you do a good job is you get more work. Yeah, that's and it's true for men too. And so learning to say no, I can't handle that right now. No, that doesn't work for me right now. No, I'll have to think about that. I had a mentor who told me to write no on a yellow sticky note and put it on my computer. I said just the word no, she said, yes, you gotta learn to say no. You do too much. So the first thing is learning to say no. The second thing is setting boundaries. I will go home at 5 p.m. if nobody's dying, if nothing's going on. I will leave work at 5 p.m. and I will be home by 5:30, and I will give my family my undivided attention, provided I learn how to transition from work to home. And so setting boundaries is the next part. Silencing your inner critic is so difficult. You have to listen to her, you have to figure out that she's some whiny little eight-year-old who really wants a lot of attention, and you have to say, Okay, little Susie, you're not helping me. I'm doing the best I can. I need you to be quiet. Women can learn self-compassion, women can learn to silence their inner critic. It's hard because we've been listening to her for so long. Some of it may be our mother, some of it may be our own inner critic. So, what my book does is it teaches people how to use self-compassion, and that's actually been studied, scientifically studied, by a professor at UT Austin called Kristen Neff. She has she has studied women, and I think men too, and has figured out that those who practice self-compassion are happier and less antagonized by lacking something. They say, Okay, I'm doing the best I can. Most people would have trouble with this. All humans make mistakes, it's okay. I'm a human. And you can actually learn self-compassion. So silencing your inner critic, setting boundaries, learning to say no, teaching yourself self-compassion. Uh, what's the other one? Uh setting priorities. That's part of setting boundaries. There are some specific things women can do to give themselves a break. They can learn it. I learned it. I learned other people.

SPEAKER_01 19:52

But no, I think it's very important. And I and I've read, and it may be in your book as well, that one strategy, because you're right, there's a there's a saying, if you need something done, ask somebody who's busy, right?

SPEAKER_00 20:05

It's the do it yourself.

SPEAKER_01 20:07

Right. But to say no, there's a strategy. Someone asks you, Oh, can you give this lecture or do this? Let me check my calendar. So it creates this pause, right? Let me check my calendar. And then you look at the colour.

SPEAKER_00 20:20

I'm not sure if I can handle that right now. And we feel bad when we say no. Right? Oh. But we shouldn't. We really should not feel bad when we say no. And I know for a fact that most women say yes when they're asked to do things. I remember asked being asked to be the room mom for my daughter's fourth grade class. I actually considered doing it. Wow. And I finally said, No, I really can't handle that right now. And a friend of mine who was an ICU doctor, pediatric ICU, not NICU, she took it on and she made it look like science. She came to school with a spreadsheet, and every kid and every mom's name was listed, and all the phone numbers, and all the holidays, and all the birthdays, and everyone was assigned a certain thing, whether it was a school party or a birthday or a field trip, and she handed it out like she was handing out a call schedule. It was great, it was the best thing I've ever seen. And the other mothers didn't really like it that much.

SPEAKER_01 21:29

That's fun. That's funny.

SPEAKER_00 21:31

But it got the job done. And I I told her later, I said, that is really amazing. What you did was really amazing, and nobody else ever did it like that again because it's too hard.

SPEAKER_01 21:44

It's too hard. I think modern life is uh to do the family, and you know, the husband always gets mentioned somewhere near the bottom, but should be a part of the puzzle, right? And then career to do all those things perfectly is. Uh not achievable.

SPEAKER_00 22:01

Right. Speaking of the husband, for those wonderful souls who are still married, you included, I've been married for 42 years. And I'll tell you, during that 15-year period when I was learning how to be good enough, my husband, bless his heart, would say, You're a good enough mom. I would say, I'm not doing a good enough. I would cry, I would whine, I would, oh my God, I'm not good enough. And he would look at me and he would say, You are a good enough mother. You're always here when you're not at work, you're always with them, you're always thinking and planning, and you have their well-being at heart. You it took him telling me that I was a good enough mom for me to truly believe it. And I was a pediatrician and I knew that I was doing a good job intellectually. I knew that I was giving them everything they needed for development and growth. And I still needed to hear him tell me that I was doing a good enough job. And so women are going to have to learn how to tell themselves that or ask their husbands, will you please tell me that every now and then if I look like I'm kind of frustrated? Because it really makes a big difference to have the support of your partner. The support of your partner is huge. You wouldn't have been able to do your practice without the support of your wife.

SPEAKER_01 23:32

No way.

SPEAKER_00 23:33

No way.

SPEAKER_01 23:34

No way. No way. You're absolutely right. Well, let me ask you, you know, I always like to ask my guests about their writing. So now you've retired from the NICU. The kids, I presume, are grown and starting their own families or careers. And so you've got all this free time. Why write? Writing is hard.

SPEAKER_00 23:57

Writing is very hard. I have a I have a newsletter on Substack called Moms Matter. And I started that. I write a short piece once a week. I write because I think I have something valuable to share. I write because I think I have enough experience to help others. And maybe it's a doctor thing. I doubt it. But I don't know. I think just some of us need to put down in writing what we know to be true or our experience that taught us a lesson because others can learn from those stories. My best, my most favorite, favorite stories in my newsletter are stories from the NICU. If I had a parent that was difficult, or if I had a mom of triplets that I worked with for six months, writing about those relationships, help other people to hear that. That's human connection, that's human interaction, that's relationships 101. And I write because I learned a lot, as you did, and I want to share it. My dad's white. You're retired. You really don't. My friends tell me that. And I've actually honestly been thinking about pulling back because I don't need to do it.

SPEAKER_01 25:33

Well, I'm going to counter and say, I think you do. And I know I do. Um way back in high school, I was uh working for the school paper. I was writing back then, and I interviewed a successful novelist who was in town. And it was a big deal for me. I was like 16 and I went to his house, and you know, he was a well-known, you know, novelist. There was uh with dirty passages in his books, you know, it was a big deal. So I asked him, I said, Do you like to write? He goes, No. He says, writing makes me miserable. And I said, I said, Oh, so so why do you write then? And he goes, Well, I'm even more miserable if I'm not writing. And I think, I think, you know, that really rings true to me. That really rings true that there's something kind of essential about the act of writing for those who are born that way, that uh it makes them feel better. I think you were probably like me, I think you were probably born that way. Otherwise you wouldn't do it, right?

SPEAKER_00 26:36

Right. And did do you like to write letters? I used to write letters all the time.

SPEAKER_01 26:40

Oh, I used to love to write letters. In fact, I missed that. I mean, who writes a note? You know?

SPEAKER_00 26:44

Yeah, I do too. And I write cards. And when I send people a card, I always write something in the card. It's not just whatever Hallmark says, it's me saying what I think about them and that I'm sitting down thinking about them or telling them something that's going on in my life. And so again, it's writing is just this special way of sharing our stories.

SPEAKER_01 27:10

Well, to contemporize this, Brett Stevens, who is a columnist from the New York Times, wrote an essay today that I read this morning that you should never use AI for writing. Just don't do it. Don't use it for ideas, don't use it because writing is special. Writing is a process. Writing makes you think, writing helps you articulate it, helps you. Don't skip that step. Even if you don't write well, the point is for you to write, not to get ahead. So I think he wouldn't.

SPEAKER_00 27:47

That's what Anne Lamotte says. She's one of my heroes. You know, she's a fabulous writer, has written gobs of books about writing and other things. And I heard her in a podcast just the other day, and she said, writing is really hard, and your first draft is always a huge, big mess, and that's okay. Just write and keep writing and rewrite and keep rewriting. Uh, so it is good for you, it really is.

SPEAKER_01 28:17

All right. So I think we've covered a little bit about being good enough and the anti, we're gonna form an anti-perfectionist club. Be a lot of members, and I'm so happy that you're still writing. Are you is anything else pending?

SPEAKER_00 28:34

Yes, I'm this is a big bite, and I may fail at this, but I want to write a book about osteoporosis prevention. My mother had very severe osteoporosis, although she lived in 97. She was always had a fracture, was in trouble, or couldn't get around, or you know, and the medicines weren't very good back then. I developed osteopenia at age 52 and osteoporosis at age 64, and now I'm 74, and I had a lot to learn about bone health, and I'm not a dumb person, and I think the average woman, many of us have osteoporosis. Apparently, it's an epidemic right now. I don't think the average woman knows how to take care of her bones, how to increase her bone density, how to maintain bone health, the significance of resistance exercise, the significance of nutrition. And so I'm trying to think about, I have thought about writing a book about how to prevent osteoporosis. My targeted audience is women who are in their 40s and 50s, because that's when you don't think about it. Most women don't think about it until they get the diagnosis of osteopenia in their 60s or later.

SPEAKER_01 30:03

I think it's safe to say that most 40-year-old women are not thinking about osteoporosis. They're thinking about all the things we talked about earlier, right?

SPEAKER_00 30:12

And going through perimenopause, exactly. So that's what I want to do: a book about osteoporosis prevention, because I have that personal story and investment in figuring out how to do it correctly. And I want to share that.

SPEAKER_01 30:32

And this would be a nonfiction, a nonfiction book.

SPEAKER_00 30:36

And I'm no endocrinologist, but there are lots of papers out there telling us how to take care of our bones without medication. Which supplements, what diet, which exercises, what things are bad for your bones? Alcohol, stress, menopause. So as I've been reading more and more, I want to figure out how to make that into a good book.

SPEAKER_01 31:00

That sounds like fun. All right. Well, you let me know when the final draft is done so we can schedule you to talk about osteoporosis.

SPEAKER_00 31:08

Okay.

SPEAKER_01 31:09

Uh anything else, uh Susan, before we close?

SPEAKER_00 31:12

No, that's plenty. That's enough.

unknown 31:15

Okay.

SPEAKER_01 31:16

Well, Dr. Susan Landers, thanks for joining me on the Art of Medicine.

SPEAKER_00 31:22

Thank you, Andrew. It's been fun.

SPEAKER_01 31:24

And now a final thanks to our sponsor, Locumstory.com. Locumstory.com is a free, unbiased educational resource about locum tenants. It's not an agency. Locumstory exists to answer your questions about the how-tos of locums on their website, podcasts, webinars, and videos. They even have a Locums 101 crash course. At LocumStory.com, you can discover if locum tenants make sense for you and your career goals. What makes LocumStory.com unique is that it's a peer-to-peer platform with real physicians sharing their experiences and stories, both the good and bad, about working locum tenants. Hence the name Locum Story. Locumstory.com is a self-service tool that you can explore at your own pace with no pressure or obligation. It's completely free. Thanks again to locumstory.com for sponsoring this episode of The Art of Medicine. I'm Dr. Andrew Wilner. See you next time. This program is hosted, edited, and produced by Andrew Wilner MD, F A C P F A N. Guests receive no financial compensation for their appearance on the art of medicine. Andrew Wilner MD is a professor of neurology at the University of Tennessee Health Science Center in Memphis, Tennessee. Views, thoughts, and opinions expressed on this program belong solely to Dr. Wilner and his guests, and not necessarily to their employers, organizations, other group, or individual. While this program intends to be informative, it is meant for entertainment purposes only. The Art of Medicine does not offer professional, financial, legal, or medical advice. Dr. Wilner and his guests assume no responsibility or liability for any damages, financial or otherwise, that arise in connection with consuming this program's content. Thanks for watching. For more episodes of the Art of Medicine, please follow on YouTube or your favorite podcast player. Please share with your friends and subscribe.andrewwellner.com