Everyday Amazing by Andrew Bracewell

December 21, 2019 Community Healer, CEO Mom- Dr. Shahana Alibhai

Connect with Dr. Shahana Alibhai online in the following places:

www.drshahana.com

Hosted: Andrew Bracewell @everydayamazingpodcast

Produced/Edited: Justin Hawkes @Hawkes21

Full Transcription of this Interview:

Andrew Bracewell: This is the podcast that finds the most elusive people the everyday amazing kind that you know nothing about. I’m hunting these people down and exposing their beauty to the world. I’m Andrew Bracewell, and this is every day. Amazing.

Dr. Shahana Alibhai: It’s okay to feel anxious. It’s okay to feel sad. It’s okay to feel scared. All of this stuff is OK.

Andrew Bracewell: Way. Welcome to the everyday amazing podcast. Today I am in way over my head. Joining me is Dr. Shahana Alibhai. I recently met Dr. Alibhai through a Ted X event where she spoke about emotional literacy and reimagining how we treat youth who suffer with their mental health. As I listen to Dr. Alibhai, I was struck by her sincerity and how non clinical she was as she peeled back the layers of a very complex issue. I knew immediately that I wanted to spend more time with Dr. Alibhai and convinced her to come on the show. I’m ecstatic that she agreed. Dr.. Alibhai. Welcome.

Dr. Shahana Alibhai: Thank you so much for having me.

Andrew Bracewell: Have you ever done this before?

Dr. Shahana Alibhai: First time. Doing a podcast.

Andrew Bracewell: First time. Excited, nervous,

Dr. Shahana Alibhai: actually. Really excited. I don’t need to memorize anything. So It’s a good thing

Andrew Bracewell: that’s true. I get to play doctor today and you get to play patient.

Dr. Shahana Alibhai: I know this’ll be interesting.

Andrew Bracewell: I’m excited. Before we begin, I thought it would be. It would make most sense for me to read your bile from your website in your words, so that everyone could hear your perspective on what it is you’re doing. Does that make sense?

Dr. Shahana Alibhai: Sounds great.

Andrew Bracewell: Here we go. In Dr. Alibhais words, I know the pressures many women face trying to be there for our kids trying to push forward in our careers and at the same time doing it all with a smile. Like many of you, I also have a story. I thought I knew the importance of eating well and moving more. But after completing my residency and family medicine, the stressors of life caught up to me. After the birth of my first son, I found myself deep into what I would later find out was postpartum anxiety, the lesser known counterpart to postpartum depression. Postpartum anxiety can present with panic attacks O. C. D type symptoms and feelings of being constantly keyed up and on edge. With over 10 years of studying nutrition, exercise and medicine. I thought I knew what it took to keep me well, but I fell short. The missing link for me was healthy, thinking I was used to sprinting through life at this pace. Eventually you hit the wall. I’ve come up with the pyramid of optimal health because it’s something I’ve used personally with my patients. By focusing first on our thought patterns are internal dialogue and our state. We can then set ourselves up to make better decisions when it comes to things like eating and exercise. How long ago did you write that?

Dr. Shahana Alibhai: You know, listening to that again I have for gotten. I wrote that. So it’s probably being about two or three years since I wrote that. It’s refreshing to hear again, though

Andrew Bracewell: you touched on something in there called Your Pyramid philosophy, which I really wantto dive into deeper with you. But before we do that, I have a question. How does a person who starts in chiropractic end up in family medicine, then somehow end up in helping youth with their mental health?

Dr. Shahana Alibhai: I think that’s called life in some ways, you know, it’s just so I think, to understand the journey have to understand a little bit about my upbringing. So my parents came to this country as refugees. Basically, they were thrown out of their home in Uganda at 1972 with the exit is so you can imagine when you’re 19 basically there on the first flight to anywhere they could get out of the place. And it happened to be Canada. Thank goodness. But when you’re raised by parents who have that mentality for them, it was find a career that is a safe career, so that would often be nursing or engineering. Or in my dad’s case, it was pharmacy. So for the longest time, they raised my sister and I ah, with the notion that, you know, go into pharmacy. It’s a great career. You have a stable job, you help other people. And that was the goal for me. So I actually wrote it was called the P Cat at the time, did my full application. But the day before I had to submit it. I never did. And the reason for that it was there was something in my heart that told me that this is just not the path for me. I knew it was safe, but what I loved the most was, and it sounds maybe pretty innocent right now, but just exercise. And the reason I loved it is because at the age of 16 I took night classes while I was in grade 11 to become a certified fitness instructor, basically, and I never grew up playing team sports. I never was on a soccer team, and I always really wanted to be good at sports. My parents always stressed individual sports. I was a big tennis player and squash player. I loved that. But you come to an age where you’re just like I want to be involved in people kind of working out together because I never got that when I grew up and I went to my first fitness class. I think I was 15 and I just tripped all over myself doing aerobics. My sister and I were in the back, but they were something about it, of people just working out together, trying to be healthier. Great music is playing, and I was like one day I’m gonna be at the top of that class, teaching everybody, and that’s what I did so long. Story short, I fell in love with group exercise. I fell in love with personal training and then I discovered this thing called kinesiology that you could actually study. And I enrolled myself in what was called human kinetics at the time at UBC. And that’s how I met my now husband, who is a chiropractor. But most people from kinesiology think of one of three things physio Cairo or met, and I thought about all three of them. That chiropractic made the most sense for me because it combined my love of business with my love of health and wellness. And for the first time, it was about keeping people well, not diagnosing people with diseases like I didn’t want that I didn’t want to push medication. The missing link for me was that if you’re going to be, I hope a successful fizzy or chiropractor, you should like treating people with your hands. That should be something that you should enjoy. I didn’t get the memo on that. Basically, I liked everything else. But when I entered choir practice school, my worst class was manual therapy, and I’m thinking well, that I should actually enjoy And so I rerouted. And, um, I applied again to UBC medical school, kind of telling them that I’d made a mistake. Ah, by not accepting their offer the first time. And they luckily let me in the second.

Andrew Bracewell: So how long? How long were you in car Practical Year, Full year for you. And previous to that, though you had been accepted correct into med school. Yeah, ABC turned it down to do the cover

Dr. Shahana Alibhai: price thing. You met your husband. That’s right,

Andrew Bracewell: future husband says. But now you go back.

Dr. Shahana Alibhai: That’s right

Andrew Bracewell: into into the medical field.

Dr. Shahana Alibhai: Exactly. And it was, and I’ll be honest. At that time, I thought about national Catholic. I thought about medicine. But my and I think the date has changed where people is because you have an MD behind your name doesn’t necessarily mean you are trusted. But realize that this was I think we’re talking almost 10 years ago now, right? So things have changed a lot, but I think there was that hope that if I could get through medical school with this love of what I now know as integrative medicine still in my heart, that I would be successful, but I never realized what a kick in the pants medical school would be.

Andrew Bracewell: So let’s unpack. You just made a statement that always jumps out at me. Integrated Medicine Canyon pack without

Dr. Shahana Alibhai: war means. Or so it’s a term that’s actually I was coined by Dr. Andrew Weil, who is the father of integrative medicine. And all that, it really means is blending the best of what we know as conventional medicine with what we think of his complimentary medicine. And the idea is that you take the best of both worlds in a patient centric approach to treat the fur full patient, not to put a Band Aid on the problem.

Andrew Bracewell: So what falls under the banner of complimentary medicine?

Dr. Shahana Alibhai: So complimentary medicine is everything really outside of conventional medicine, so it can span from chiropractic scare, acupuncture, homey apathy, all the counseling mechanisms, biofeedback. There’s all of the other stuff that people are looking. Besides, I want to say it. Prescription medication really played

Andrew Bracewell: and natural path. A cure also fits in with an umbrella

Dr. Shahana Alibhai: under percent naturopathic care in not my sister’s in after path. She was a pharmacist and then went on to study naturopathic medicine, and they get taught everything about everything. I mean, manual manipulations, homey apathy, acupuncture, herbal remedies, nutrition. So it’s a huge curriculum

Andrew Bracewell: you have within your family yourself, an MD, your sister and Andy and your parents who are pharmacists. You have the entire spectrum nearly well, and you have your husband. Callen, who is a counter proctor

Dr. Shahana Alibhai: and my brother in law is owns medical clinics. So it’s It’s funny. So

Andrew Bracewell: what is? We’re approaching the Christmas season. Take us inside family Christmas dinner with all of those opinions around the table on how to treat patients properly. Do

Dr. Shahana Alibhai: you know what this conversation comes? At a time where I think if we take a step back, why did we all go into the health profession? But I mean, my sister and my my husband is because of my sister’s health journey, so that’s what we need to understand. So the conversations are a lot of the time centered around her own experiences as a patient with the health care system and the deficits that she’s felt. So just in a quick stories that at the age of 19 she was diagnosed with ulcerative colitis, a very common condition or a type of inflammatory bowel disease. But hers was extremely aggressive. Within about a year, she had what’s known as toxic Mega Colon, so basically the entire colon could have ruptured. She was taken into, Ah, surgery. Her entire colon room was removed in the age of 19. She had a bag basic, really? So you can imagine what that does to a woman’s psyche to anybody. Psyche. So we live together a TV, see, and she’s my hero. She’s the most amazing person I’ve ever encountered.

Andrew Bracewell: Younger, older than

Dr. Shahana Alibhai: older. We’re only 19 months apart. And now for the last 16 years, basically she’s had multiple surgeries, one of the only patients in BC to have a spinal cord stimulator for abdominal pain. So she actually has a implantable device in her spinal cord for pain. So there’s Bean so many negative sequelae because of all of the surgeries and everything else she’s being through. But it’s because of her journey. She completely realizes. Yes, you need the conventional medicine. Yes, you need emergency and all the rest of it. But there were gaps in her care, and she’s able to be able to fill those gaps with naturopathic medicine.

Andrew Bracewell: Okay, so that spawned the family’s pursuit of health care. Is that is that a fair statement?

Dr. Shahana Alibhai: Completely. And it spawned our our love hate relationship with health care because it’s so different. We all stand on the other side. We all are practitioners in our own way. But just two weeks ago, she was at ST Paul’s emerge. So then we’re on the other side as patients, and you never go in saying My husband’s at this. My sisters of this, you just I’m in pain. I’m a patient, I need your help. But she’s being They’ve been amazing experiences with the health, your industry, and there’s been some not so amazing experiences and me being on the other side. I’ve worked in emerg. I know what their mentality is like, so I can help fill some gaps for her as to why she might be treated that way as well. But, uh, everything goes out the window when you’re a patient and you’re in pain and you need help. And I think for me, this goes back to why I love working at the youth, the Knicks so much not that it’s an emergency But it’s the idea that I can spend time. It’s time that we need more of in our health care system, and it’s nobody’s fault. It’s just the funding mechanism, for better or for worse. But because I have the luxury quote unquote of time when I work with my youth, I feel like I can answer some of those questions that they need answering.

Andrew Bracewell: Okay, you just said Wade perfectly. Thank you for that. But we need to unpack this. So your ah, family practitioner MD yet you’re working at a youth clinic? How is this possible? And how did this come to be and who’s funding this youth clinic?

Dr. Shahana Alibhai: So basically, the clinic was a vision of my mentor, Dr. Elizabeth Watt, and it was started in the very, very grassroots level about 10 years ago now. So when I joined it, we were working out of one room or two rooms at the hospital, basically, and since then we’ve had a number of different moves finally to move into our purpose built building the foundry here in app. It’s for that was approximately a year ago, so the youth clinic is funded in a number of ways Fraser. Health helps fund it. The Ministry of Child and Youth and families Health abundant. But yes, we do have to fight for our finding quite a bit. So the youth clinic functions just is a normal walk in clinic. So we see everything we see source throats, we see even minor traumas. But at the end of the day, what we end up seeing most of is sexual health and mental health. Because, let’s not forget, the youth clinic is for the ages between 12 and 24. So those are the two biggest things that will get them through our doors.

Andrew Bracewell: So just to put things into, let me repeat this back to you, to make sure I’ve got it right. We have a clinic that’s staffed by medical professionals, where youth can just show up, check themselves in, see a doctor. But as it turns out, the majority of the time you’re you end up dealing in the mental health field as often, if not more, than you’re dealing with sore throats, fevers, whatever. Is that a fair statement? Absolutely. This is incredible. And how did how did this clinic come to be?

Dr. Shahana Alibhai: So I think there was a gap, right? If you think about how we we do really well when it comes to pediatrics, because typically the parents take the onus of that to try to arrange those appointments. And then when you turn to be an adult, let’s say after the age of 19 Okay, you can hopefully find your way to a walk in clinic or hope. Well, you have a family doctor. But what about all the rest of it, right? And who We tend to forget that adolescence is the time of supreme transition in so many ways. So I think it came to be was because my mentor, Dr. Elizabeth Watts, saw this this gap in our health care system and saw that there was a need for it and fought, fought hard for funding and for space and for time. And she rallied not just physicians, but nurses and social workers. And now it’s this entity called the Foundry that we’re not just seeing in BC ah, but with us. They’re not too seeing in Abbotsford, but we’re seeing across BC as well, so it’s become a model of how we should be treating our youth

Andrew Bracewell: approximately. How many practitioners are in touch with the foundry.

Dr. Shahana Alibhai: Oh my goodness, it’s hard to say, because we we’re on the first floor of the foundry and we have a rotating, so there’s probably a good 10 to 12 doctors that will come and go throughout and try to pick up shifts throughout the month. Ah, then we have nurse practitioners. Then we have nurses that deal with a lot of contraception and sexual health

Andrew Bracewell: is Sorry, I’m There’s so much good stuff here. I just don’t You’re blowing my brain. Doctors who are quote unquote picking up shifts. Are these doctors just getting involved because this is something they’re interested in? Or how is a doctor saying I’m gonna start spending some time here?

Dr. Shahana Alibhai: Absolutely. That because they’re interested in it because we and Abbotsford have a residency program. So we train. So after you finish your your four years of undergrad four years of medical school, you still have to do two years of family practice, residency or training. And Abbotsford is one of those sites, so these residents have to rotate through the youth clinic, and I was a resident. I rotated through the clinic and there’s I never thought I’d want to work with teenagers. Let’s be honest, like it just was not my I don’t think I could relate. But there was something about working in this environment with the group of passionate people, so we tend to Once the residents graduate, they tend to keep coming back for more. And I was one of those.

Andrew Bracewell: So we’ve got the practitioners we talked about, but then you started talking about the other people in the building and what else is going on? Keep going on that.

Dr. Shahana Alibhai: So, like I said, First floor is just the typical. What you think of is a youth clinic or a walk in clinic. But as he start going on the second floor and third floor, then you’re starting to see programs for youth. So we have walking counseling. So basically a youth can just walk into our building, go up into the second floor and, if available, see a counselor right there and then on the spot so it takes away all of those barriers in terms of ocean like how do I book an appointment tour? Which counts, or should I see? And you know all the stigma around counseling cost. Let’s be exactly, let’s our most important one is cost. So there’s there is what we call the start team, which is the suicide intervention team that is lived up on the second or so the things I can floor there. There’s an adolescent day program for kids that need some extra help during the day. So impact or drug and alcohol abuse counselors are part of our staff. Social workers. So it’s it’s this is this is the root of multi disciplinary care. This is what we need is what our youth need.

Andrew Bracewell: It must be fair to say that you guys are plugged into all of the major players and assets in the city. I would imagine policing department is involved from time to time or you’re communicating with somebody there. You mentioned there’s counseling. There’s medical side. Speak to some of the significant people in the community. Who are you you’re involved with on a regular basis?

Dr. Shahana Alibhai: Yeah, for sure. So it’s the list is so extensive, but if you just kind of hone into the social work realm of things, for example, we have a food bank now on site. So where were directly an affiliation with the Abbotts for food bank. We have kind of an area for used clothes and use products, so there’s a kind of a thrift ing component that’s going on to There’s an exercise component. So innovative fitness is being extremely involved with helping teach our youth the power physical activity. I used to run yoga classes for the youth to like. I could just go on and on. There’s every aspect that you can think of. We try to enmesh ourselves in.

Andrew Bracewell: It’s totally holistic. Completely, completely. How often and in what way are you encountering parents? I imagine there are a huge part of this process or can be, anyway.

Dr. Shahana Alibhai: Parents are when a youth walks in with their parents and allows willingly the parent to sit there in the interview, I can usually breathe a sigh of relief because I know someone is watching over them, and I know that the youth trust them and I say the word willingly very carefully because there have bean many times where I can sense that that dynamic between the youth and the parent isn’t so great, and I often will respectfully ask if the parent can just wait outside so I can speak to the youth one on one, and sometimes it doesn’t come out the first time or the second time. But by the 10th time I can start to maybe understand where the youth is coming from. And often I’ll ask to speak to the parent individually to because let’s not forget, I see the youth for what, 10 23 30 minutes once every week, once every two weeks. These parents are living with these individuals with they’re teenagers. So it’s no easy on them too, right? They have to deal with that day in and day out. So, yes, I listen to the story that the youth present me. But I also have to listen to how the parents are coping. And oftentimes I will recommend How are you coping? How is your mental health? Because dealing with somebody who is struggling with their own mental health can be just as exhausting for the caregiver.

Andrew Bracewell: Okay, you just said something that I want a key in on there. I think most people’s perspective of a patient doctor relationship is we’re dealing with something on acute level, you know, experiencing something. You go see your doctor. You deal with the issue, and then you may never see them for six months. 12 months, 18 months, 24 months. Who knows? But you just made a statement as if you said something to the effect of, you know, I meet a youth, and then I’m gonna see that youth in a week or three weeks or four weeks or six weeks. That sounds totally foreign to my doctor experience. Once you engage with somebody, what does that look like?

Dr. Shahana Alibhai: So it really depends on why they’re engaging with me. So of course I was actually at the clinic. They had no doc yesterday, so I quickly went in to fill in on the end. You know, patient came in with gastroenteritis, like a stomach flu. Easy peasy, right? She would make sure she was hydrated. We figured all what? The root cause, Woz. And you’re gonna be fine. You’re on your weight, and I tell them you come back if X y and Zed, right? That’s very easy. Had another youth. The next patient came in who had been off of his medications and was starting to feel symptoms of suicide. Ality again was starting to feel symptoms of anxiety, depression, all the rest of it. I’m not going to see you in four weeks. I want to see you next week to make sure that everything is going okay.

Andrew Bracewell: And there’s time and money for this.

Dr. Shahana Alibhai: Oh, yes. Oh, yes. Yeah, because the doctors at the youth clinic are paid session Lee. By that, I mean that were paid per hour. So if I see 15 patients in an hour or one patient an hour, I’m not incentivized either way. And to be honest, I don’t care about that. I I care about, you know, giving the time and space to the youth. But the problem now, like anything in health care, is that I would love to spend 1/2 hour or 45 minutes with a patient. But I also have to be respectful that I have a waiting room full of kids who have been waiting for two or three hours.

Andrew Bracewell: This is a significant difference in this clinic versus every other clinic and doctors office correct under present. And how did it come to be that this clinic was set up this way financially? Because this to me, just makes so much logical sense. I understand these issues are complex and, you know, difficult to unwind. But just talk to that and how that impacts patient care.

Dr. Shahana Alibhai: The reason it was is because because what we see most of all, like I said, it’s either is, you know, sexual health or it’s mental health. Let’s put a number on it. Like I would say, about 50% is mental health. Not to say that a regular Family GP would is not dealing with mental health. Yes, they are. But you need the time in space. So to give the youth time in space, the doctor also has to be compensated. So by that I mean, if you are getting paid $35 for a typical office visit and you spend an hour with the patient, you’re not really gonna have a doctor who is? That’s not the sustainable model. No, But then again, the amount that were paid per hour is much less than what a walk in doctor who can see Ah

Andrew Bracewell: 6789 10 patients.

Dr. Shahana Alibhai: Correct, correct. Correct. So you also I think, 10 to find people who yes, you need to be compensated appropriately. But you’re there. The whole notion is not to make money. They’re there because you’re there on purpose. You believe in something, right? That’s the whole reason why When there s o otherwise, could you spend five minutes with a patient who has anxiety? Sure. You just It’s nothing. Take long to write a prescription. It takes a second to sign a prescription. All the rest of it takes time. And that’s why my Ted talk came about because I was signing. And I still do not to say there is a place of his time and place for medication. Absolutely. But when I see the same story played out, over and over and over again, I take a step back going. Okay. What more can we do? What more can I do? What more can our schools do? And that’s how the emotional literacy talk was kind of came to be, right.

Andrew Bracewell: So how much of your time are you devoting to the youth health clinic right now?

Dr. Shahana Alibhai: So right now, because I’m considered my own, have a four month old at home, so I guess I’m technically should still be on maternity. We’re gonna We’re gonna talk about that S o. You know right now, because I if I try to work at least one shift a week, one shift every two weeks, I’d love to be there every day. If I could. It’s just child care. That’s my biggest ah thing. But it’s between right now. I work primarily at the youth clinic and I work at the Breast Health Clinic, and, ironically enough, both our session only paid. So I think I gravitate towards things that I can spend time with. Patients

Andrew Bracewell: will jump to the breast health clinic in a second, but I want to come back Toto. One more salt or question I had. When you’re engaging with these youth and somebody walks in and says My stomach’s hurting or this is hurting or that’s hurting is your radar up for what is possibly a deeper underlying issue as the cause of what’s going on? Or how are you? How are you engaging and and what are you looking for? Even if you’re not being told something or how are you approaching that? Does that make sense?

Dr. Shahana Alibhai: It makes complete sense, so I think this is what is what you learn through medical school. But you. You also either have it or you don’t have it in the sense that when a patient walks in you, there’s this almost a Spidey sense that you understand could look at the patient. You could start to ask questions if they’re in new patient to me, never met them before. I can tell quite quickly. Are you here because you want to address the stomach pain or you here? Because there’s something more on the reason I know that is because if I’m asking them about the stomach pain, I might get very flaky answers like it’s just not fitting. Like, for example, the woman that had for the teenager that had gastroenteritis yesterday or the stomach flu. It was, you know, I was vomiting. I had this. I had that. Okay, it was very black and white. Very strange forward. Where is some cryptic kind of abdominal pain? As I start toe unpeeled the layers, I’m thinking, I asked a very simple question. Just tell me what’s going on in your life right now. I’m new to you. So just tell me, what are your stressors? What are you happy about? Who lives with you at home? and then it’s their facial expression. They might turn away from me. They might really engage with me. They might be a long pause, all of this kind of stuff. And then I’ll use the words. Tell me more, Tell me more, Tell me more. And then they might have broken up with her boyfriend. They might have been sexually assaulted. They might have all of these different things have come up to. Sometimes you can get it all in the first visit. Sometimes you can’t, but you always first have to wear your medical doctor your hat before you wear your psychologist hat. I don’t want to be missing that you have an acute appendicitis because I want to talk about your anxiety like there’s There’s that, too. So I quickly try to rule out all of my red flags in my head, and then, if I’m not sensing anything, I’ll give them a plan. Let’s do X Y and Zed will do some blood. Work will do this, but then I want to talk more about this right and leave the door open and they know where to find me. They can always come back for more right And with that, Like I said, there are red flags with mental health stuff, too. So I need to be careful with that. I’m to be careful. Are you feeling suicidal? Are you feeling that you’re safe? You’re not safe with yourself for others, all of that kind of stuff. So I guess it’s a bit of a juggling act, and that’s what I love about. That’s part of the reason why I love medicine is because no patients ever straight forward, you’re always gonna get surprised. But sometimes that can also be emotionally draining.

Andrew Bracewell: So you and R I aren’t identical in age, but we’re both in our thirties. We’ll leave it at that. We don’t need to get specific. When we were youth number one, there’s no way a resource like this existed. Number to the mental health conversation was not even a conversation, and something that I’ve gone through as an adult is transforming the way I think about mental health. Going from a place where I believed it was fake was made up. It was it was a thing that that weak people used as an excuse to now understanding that not only is it riel But it’s something that needs to be researched, more discussed more. And it’s all around us, and I’m impacted by it in my own life by people around me. How do your youth patients know that you exist is a resource? And what’s the conversation in their mind? Given that they’ve been now raised in a hopefully a better generation than we were raised in? Are they coming in with shame or when the topic of mental health comes up? Is it something that they’re ready to embrace right away? Or are they in denial? Because I can imagine, as a youth, I would have immediately denied I would have said No, this is I’m not weak. There’s no way I have this. This is not a thing. How are they dealing with this issue versus how we would have potentially dealt with it?

Dr. Shahana Alibhai: Absolutely. So, to your first point, how they hear about us, we’re we’re very, um, meshed into the school system, and the counselors at the school know about us so they will often refer. Patients are away, even at the University of the Fraser Valley. There, counselors know about us so as the community resource will got and more well known, Um, and even the family doctors will often refer to our clinic if they find that they need help with a certain patient because, respectfully, they might just not have time to deal with it. To your second point about this change in dynamic with the conversation of mental health. It’s extremely tricky. So let me give you a story. When I was probably about seven or eight, I started noticing what I know now that I had a lot of had some anxiety at that time. I had some O. C. D type tendencies at that time that later translated into restricted eating behavior. All of this stuff was going on in my background. And now I understand it so well that all of these this symptom Atala, jeez, all linked together as a kind of personality type in some ways. But when I told my mom about this, this is now what you know, 25 whatever. Years ago, she just said it’s gonna be okay. Don’t worry, you’re fine. She just tried to normalize everything because she did the best that she possibly could. And her We’ve also haven’t had this conversation now, later on, I kind of said, Well, why didn’t you take me to a place? So there wasn’t a place. There was nothing that existed back then. And in fact, she was so scared of me getting put on some sort of medication that her mind her providing her version of counseling was the best possible option. So I think nowadays, yes, we’re very fortunate that we have these resources, but we have to be careful that the pendulum hasn’t swung the other way. And by that I mean that we start to pathologize or make a disease out of any abnormal emotion. Interesting. So by this, I mean, it’s okay to feel anxious. It’s okay to feel sad. It’s okay to feel scared. All of this stuff is okay. It doesn’t mean that you have depression. It doesn’t mean that you have anxiety because we’ve got to realize that the criteria that you need to meet depression is a checklist. The criteria for anxiety is a checklist. And you might meet that checklist one day and not the other day in trusting to meet to actually have a fully fledged, you know, diagnosis. Yes, you have to have those symptoms for more than two weeks. But I think we’ve become so on board with mental health that by telling everyone it’s okay, you have depression. We also have to be careful that we’re not putting a label on their head. So some this I was listening to actually great podcast the other day, and a professional in this field was saying, It’s OK just to say that I feel stuck right now. I feel stuck and that’s okay. And I often tell that to the youth, too. But we also have to realize that these youth walk in our doors with so much often with so much baggage and such a story that it’s their story that needs unpacking. You need to hear about their upbringing. You have to hear about their lack of a stable home. You have to hear about their encounters with abuse toe. Understand that, of course, you have the feelings that you do, sure, but it doesn’t mean you need to be a victim to those feelings.

Andrew Bracewell: Is it fair to say that in your one of the challenges in assessing a patient who’s a youth versus assessing a patient who’s not, is that there’s hormones that play as well, and bodies are changing. And there’s that whole spectrum that could also be impacting things. Is that a Is that something that is relevant to the conversation?

Dr. Shahana Alibhai: There is absolutely, and I think, more than even just the hormones and body changing is that the brain is not fully developed. Your brain doesn’t get fully developed to the age of 21 by that I mean your actual prefrontal cortex, which is what helps you with executive planning and decision making. That idea that you can assess a situation, think about it rationally and then make a decision. So impulse control for youth is not going to be where it is for an adult at the age of 35 or 40 right? And hence why It’s so much easier to make poorer choices as a youth, whether it be for drugs and alcohol or sex, or all the rest of it, too. So, and there’s also a very normal phase of experimentation, and if you don’t experiment, really, how do you learn? So there’s all of that at play, too, and they’re also trying to find their own identity, right? They’re also trying to figure out where my favorite question like I mentioned, the Ted talk is asking, Well, what do you want to be like? Where do you imagine yourself? And sometimes I’ll get these blank spaces like, Well, what? Like I’m going to be 30 or 41 day because

Andrew Bracewell: they haven’t even stepped outside the space. There is

Dr. Shahana Alibhai: not at all.

Andrew Bracewell: Whatever they’re in is all there is.

Dr. Shahana Alibhai: Clea. They live in that like they’re very present, right, So and realize that the views clinic we see between the ages of 12 to 24 a lot happens between the ages of 12 and 24 right? Right. So I if I see a 13 or 14 year old who has become sexually active and is trying to figure all of that out, that’s a very different conversation than someone who is 1920 2122 right on all of the considerations with regards to that. So, yeah, it’s a complex discussion.

Andrew Bracewell: Well, fascinating. We’ve only scratched the surface there, but I you alluded to something else earlier that I that I do also wantto get to with you. You mentioned you spend time in the breast Health Clinic. Yes. Tell us a little bit about that.

Dr. Shahana Alibhai: I I love it. I love the breast health clinic. So very similar to the youth clinic. Is that it? Once again, it’s healthcare innovation in the sense that we need to change some things. Once again. There was a problem with the way that women were being screened and treated and tree ours with regards to their breast health. Right. So you could imagine the percentage is still that many of the family doctors are male, and sometimes a female patient wouldn’t feel comfortable discussing their breast health complaints with their male physician. Fair enough. We often know as well that regular breast exams are now not standard of practice unless a woman has a complaint of some sort. So there isn’t that chance to have a dialogue with the healthcare practitioner as to what should I be looking for? And what are my concerns in my family history? Enter the breast health clinic. So the Breast Health clinic is situated at the hospital in the first floor. And once again, we’re a team. We’re a team of physicians. Were a team of nurses that go in and basically treat and surgeons, I should say that treat from the time of diagnosis to the time of treatment for breast cancer and everything in between. So I’m one of the four female family physicians trained in breast health at the breast care center, along with two female surgeons and a host of female nurses that work there. And we see everything breast related, from lumps to breast pain to our skin related breast changes to any mammogram recalls. If there is something that’s looking sinister or suspicious, we will arrange the biopsies. I will break the news to the patient as to what is happening, whether it be that they are fine, or whether it be that they actually need more treatment or if they have breast cancer. And on my slate of when I go in every week of 16 17 patients, at least once or twice, I’ll have to walk into the room of a patient I’ve never met before because we’re a rotating

Andrew Bracewell: group of

Dr. Shahana Alibhai: doctors and sit down with them and tell them that they have breast cancer and it is I’ve done it hundreds of times now, and it never how could it ever get easier. How could it ever get easier that you I just had this conversation. I just worked two days ago and were hitting Christmas time soon. And you were telling somebody? It’s actually if I might give my opinion here. It might be somewhat worse to tell a patient that you have a very, very suspicious lump, but we can’t arrange a biopsy for another week or another 10 days. Like, let’s be honest that How do you live with that? Right.

Andrew Bracewell: Okay, you just went into a hole. You just went into a whole another rabbit hole that I wanted. So my first thought, when you say that is, what are you doing for yourself when you’re delivering this kind of news and then you’re going home to your family at the end of the day? I mean, you just dropped a bomb on somebody’s life. It’s not your bomb. You didn’t make the bomb, But you were the one who had to deliver the news. How are you unpacking that in your mind and living with that?

Dr. Shahana Alibhai: I wish I had a good answer. I wish. I wish I was numb to it by now. And I think that would be a bad sign if I was, But I’m not, um, even though it had experience. I’ll be honest when I go home. I see the faces of the women that I have broken the news to. I see the faces of their partners, and that’s what I think about. But the only thing that gives me solace or hope or feeling like I’m making a difference is the way that I break the news to them. If I can make that moment even a little bit easier for them, then that’s what I hang on to. So even though I will tell them they teach, they try to train you a little bit for this, although a lot of it you have to learn by yourself is that you never. You never beat around the bush Never Haman Hall when you go into the room there often sitting in the room for a good 5 10 15 minutes, and this room is covered with breast cancer paraphernalia, so they’re already on it. They’re often with somebody there, and ah, I’ll quickly introduce myself. I’ll quickly tell them, You know, I’ve read through your chart just so that they know that I know what I’m talking about and then I’ll get straight to it. I’ll use the There’s often different schools of thought. Do you use the word cancer, do you not? Well, cancer is cancer. Used the word Be blunt about it in the sense, but then jump right to the point that, yes, you have breast cancer, but you are in the right spot. You were in the spot that you can be treated.

Andrew Bracewell: You’re trying to provide hope exactly immediately.

Dr. Shahana Alibhai: Exactly right away that this is for us as women. This is one and eight of us. Yes, Unfortunately, you are the one, right? But there’s one in eight.

Andrew Bracewell: So we one of eight in Canada,

Dr. Shahana Alibhai: in Canada? Yeah, that’s unbelievable. And it’s the same feeling in my gut that I get with you that why can’t I do more than write a prescription when I see the biopsy report, I always feel Why can’t we do more? How do we prevent this? And of course, there is so much conversation people a lot smarter than I’ll ever be who are doing the appropriate kind of research. But you start to think about lifestyle and genetics and environment and all the rest of it of how, uh why is this such an issue for us, right?

Andrew Bracewell: Yeah, it’s a convoluted conversation, and there isn’t one thing and it could be environment diet habits. I mean, there must be other places in the world that don’t have this rate of breast cancer.

Dr. Shahana Alibhai: And then you start to dig into the whole complex discussion about mammography and the frequency of mammography and us detecting things that we might have not even detected before. And the idea of overdiagnosis There’s There’s so much there to unpack two, which could be a slippery slope because I literally every task force has a different notion as when we should best screen. So there’s not even a good, solid consensus per se if you look across Canada or even different regions in the world as to how often you should be having mammograms and all the rest of it. So we have done our best by saying OK every two years if you don’t have a family history. But at the end of the day, we know that mammograms can also lead you up the garden path in the sense of having a ton of biopsies and testing that actually turned out to be a nothing and in the realm of it caused women a ton of anxiety. So how do you How do you rationalize that? Yes, we’re helping some, but for for a large proportion of them, they’re having all these biopsies, and thankfully they’re okay. But the stress of that time period put a number on that. I don’t know, right.

Andrew Bracewell: It’s fair to say, say yes or no if this is true or not. But this is all in the name of prevention. Yes, which is actually something unique to the medical field. Also true,

Dr. Shahana Alibhai: All such.

Andrew Bracewell: There’s no easy answers there. How are you traversing these issues? So circle back to something we alluded to earlier. Your husband, College chiropractor. Your sister’s a naturopathic doctor. You’re an MD. Your parents are pharmacists. You’ve got the full spectrum in your brain. And I’m sure that sometimes the way you think doesn’t always align with standard MD field or what you’re supposed to think. You know what you’re told to say. How are you navigating that when you’re in these crucible moments and determining what you recommend or what you say to a patient or how you go about best practicing with the people you’re trying to love and care for.

Dr. Shahana Alibhai: I think I feel undereducated. Ill, be honest, even though I do have the full, we have the full realm in our household. The way that I’ve Bean trained as an M. D still makes me feel like I’m at a loss on. The reason for that is because I feel like I’m missing this whole other segment of knowledge that could potentially help patients. But even more than that, coming back to my pyramid is that forget nutrition, Forget exercise. Forget all of these other alternative therapies. If I could focus on one thing keeps coming back to mental health. You just can’t escape that I couldn’t escape it. My patients can escape it. And I think if I could choose more training in any one of those fields, it would be Mawr in, you know, realms like cognitive behavioral therapy counseling. But I also have to realize that I’m I’m not accounts there. That’s not what I’ve been trained to do, but I doesn’t mean that I don’t recognize the importance of it so I think for me in my future I want to do more training and there is a program. Actually, it’s a two year program, but it’s through. It’s through the U. S. For integrative medicine, where family practice physicians can go and get trained in the best of the best of off what we call complementary and alternative medicine. But it’s the evidence based stuff of shrimp. The only problem is that it’s a If I go and do my two years of training, I’ll come back to Canada. And then what? There is no funding for it. There is no I’m not prepared to open a private clinic. Then you start going to the discussion public versus private room, and I don’t That’s a tricky, tricky conversation.

Andrew Bracewell: Yeah, the system is designed to function a particular way, and the system needs to be efficient. But efficiency doesn’t always mean that we’re hitting every patient where they need to be hit. Absolutely, absolutely

Dr. Shahana Alibhai: medicines really good at trying to keep you alive. It’s trying to rule out red flags, sure trying to diagnose diagnosable conditions, but for but I’m not gonna be the only one to say that conventional medicine has gaps. We all know it does. And that’s why people seek out rightfully so other therapies. But the problem becomes is that unlike when you see a physician, you kind of know when you go to a clinic, you know what you’re going to see. You know what you’re gonna get. The doctor’s gonna ask you bunch of questions might do a physical exam. You might leave with a prescription. Okay, for better or for worse, that’s your experience. If you see 10 chiropractors, if you’d see 10 natural pats, you’re often gonna get 10 different experiences and and right there lies the problem.

Andrew Bracewell: In our own household we’ve fallen into, I would say it’s probably accurate for me to say I don’t have a family. I don’t have a doctor. I do have a doctor and that I have a friend who’s a doctor. And when I have something really bad, like I’ve broken something or, you know, it’s very obvious that, you know, I will use my doctor and as this circumstance, my friend, to get the treatment I need. But for the things that aren’t obvious, we have fallen into this habit. Sometimes I think it’s good. Sometimes I think it’s bad of doing the research for ourselves and self diagnosing, because the frustration is that when you go to one particular person in one particular field, you’re not necessarily getting the full scope, and nor is it reasonable or fair to expect that person to be able to give you the full scope. But holistic treatment requires the full scope. Sometimes you have to look at nutrition. You have to look at mental health. You have to look at exercise. You have to be aware of. You know what a physiotherapist can do versus what a coward Proctor can do. And so it’s frustrating. I have found myself frustrated. I know we’ve been frustrated in our health journey and that when you have a conversation with one particular individual, you know you’re only getting advice from one particular perspective. And that isn’t always what’s required.

Dr. Shahana Alibhai: Absolutely, absolutely. And that’s and we come back to that conversation of time right without spending time with somebody. How do you know all the facets of their life? You just don’t write. And I think that’s once again why? Why gravitate to working at the youth clinic? Because even if it’s not me. I hear from the social worker I hear from the counselor. I hear from the nurse, and all of that puts a picture together, right? And it just makes treating them that much easier If I know what’s happening in their life.

Andrew Bracewell: Okay, let’s switch gears, Okay, we crush that way. Did that the best we possibly could. There’s nothing else we could ever say. Exhausted it. You are a mum. Yes, you have a four month old. We’re currently on a nursing break. Yes, you have a two year old and a four year old.

Dr. Shahana Alibhai: Yes. And you have this career? Yes, and you probably have to make dinner from time to time or vacuum or vacuum

Andrew Bracewell: the house or do laundry or whatever. How in the hell does this work?

Dr. Shahana Alibhai: So motherhood is being my greatest gift in my greatest teacher. Everyone who knew me in medical school knew that I talked about one thing on Lee, and it was to be a mum, to be a mom, to be a mom. That’s all I ever wanted. And I wonder if it’s because I had this notion that maternity leave would be like a break My one thought Maybe that’s why I wanted to be a mom. But ah, like we had caught, you did. Alluded to as well, quickly after residency. I finished my residency in six weeks. Afterwards, I was pregnant with you, Sean. My first child. And it was go time. That’s all I wanted. I spent that year researching, and I was gonna be I read basically every book I could get my hands on on motherhood and the best things to buy. But as any rookie mum, of course, no book ever trains you for a child that doesn’t sleep and breastfeeding problem. You mean you didn’t perfectly sleep? Train all your Children? What exactly? Speak given them completely deprived right now, right? Exactly. So And I think for the first time, motherhood was not just an intellectual hit. It was an emotional hit. I’m used to having intellectual hits are okay. You know, you can you can get a B on a paper or you can not do so well on an exam or whatever the case might be. But I’ve never had an emotional hit before. And by that I mean the fact that something this baby was responding to me as if I wasn’t a good enough mother. And it made me feel like what I ever be a good enough mother because I didn’t feel that quote unquote bond that you were supposed to feel. You know, all of that for you. Were you a natural? I like

Andrew Bracewell: some women. You don’t mean some women. They would explain the first a Ziff like it’s like I’ve done this my entire life. It’s like riding a bike. And then I know some women would say the opposite like this was a foreign experience for me. How would you put yourself in that spectrum?

Dr. Shahana Alibhai: You know what it’s like walking through a cloud. Parts were blissful and parts were completely hazy. You know, it felt like I was on Cloud nine, but yet I didn’t know where I was going. If that makes any sense, that’s very good. That that’s exactly the analogies, right? Actually, So and no. And for the first time in my life notebook or my mind couldn’t get me out of it, and I tried and I tried so hard. Ethicists will sound crazy, but between nursing sessions, I actually with schedule meditations I knew. I knew on paper that I needed to do yoga and meditate and do all this stuff for me.

Andrew Bracewell: Were you practicing meditation already for your life?

Dr. Shahana Alibhai: 100%. Yeah. You are a guru. No, but meditation doesn’t work. If you’re trying to do it with for, like a minute between switching breasts and you know it doesn’t work, it takes time

Andrew Bracewell: to get in. Absolutely.

Dr. Shahana Alibhai: Like it doesn’t work to schedule your yoga and get anxious while it’s loading on the last talk like that. Kind of That’s the opposite of what you should be doing. So all of this stuff I laugh about in retrospect. But man, did I hit the wall, man. Did I hit the wall? Because, oh, I can’t even begin to tell you I I was on my knees, figuratively, literally. All the rest of it. I I was at my rock rock rock bottom, and I didn’t hope. Of course, my husband knew what was going on. To some extent, my family knew what was going on to some extent, but once again, very much. It’s okay. It’s going to get better. Postpartum is normal. You just had a baby

Andrew Bracewell: It’s the tools they have in the bag that a very dear friend of mine has explained it to me that way. When talking about you know how are parents have dealt with us, it’s easy to harbour bitterness or to say they screwed up or whatever. But when you realize that they had a hammer and a wrench and that’s all they had, and today we have hammers and wrenches and screwdrivers and way more tools than we had, so we might approach the conversation differently. But they’re just doing what they’ve always known how to do, because that’s the tools I’ve always had

Dr. Shahana Alibhai: and they’re doing it out of love and they’re doing it just I’m sure I’m gonna screw my kids up bad to look high because you do the best that you can. But so sometimes it’s the hardest for family to see what you’re going through, because they just want to see the version that they know of you, not the version that you are now, which was the worst of myself. I’ll share a story which is a little bit of never actually told this to anybody before, but I was driving one day and, ah, I had the split second thought that what if I just drove into the other lane and then it would all be over? And this is the kind of stuff I talked with to the youth. I work with thistles, the kind of stuff I am comfortable talking about. But when I had that thought, and when I realized that you boy, I better take a step back for myself because that kind of thought should not bring me peace. It should bring me fear in some ways that I’ve reached that point right, and that’s what sleep deprivation and emotional burnout and even intellectual burnout will do to you. So I actually reached out to a good friend who’s a nurse at the youth clinic, and I texted her one day and I said, I think I need some help here. And I spoke with my mentor, Dr. What and, ah, my good friend Joanne, who’s the nurse of the youth clinic? And she said, Yeah, this is you need some help here, So I wasn’t comfortable enough to go to my family doctor because she’s a good friend of mine. Um, and this is where ego comes into play. Sure, this is where I wanna be. The super mom. I don’t wanna have any of the stuff going on, so I called. We actually are very fortunate. I think I don’t know if we have it in other provinces, but in BC, We have a confidential physicians help blind or health line. So any physician and their family can call this line and basically access help for anything physical, mental, anything

Andrew Bracewell: for physicians. Only

Dr. Shahana Alibhai: for only physicians and their spouses are pregnant. So I called this and I got put through to an intake worker. And even as they’re doing the intake, I’m thinking, actually, I’m fine. Actually, I’m good. I don’t need help. I’m good. I just made a call like I don’t know what I’m doing for you. Everything’s fine. Everything is blissful. So then, of course the doc calls me and I’m trying to have a very professional conversation. You know, according to the D S M five criteria, I have X, Y and Z because we’re both doctors here, so I’m not sexually Hannah like, just just take it easy. First of all, and second of all, I think you’re gonna need some help and I said, No, I don’t need help. I know what I have. I’ve got postpartum anxiety. Perfect. I’m done. He’s like, No, you’re gonna be Just talk to somebody You might need to consider some medication. And I said absolutely not. Because here I am writing it out for every patient I see, not every but a lot of them. But when my name was at the top of that prescription pad, are you kidding me? I’m too good for that. And that’s rock bottom.

Andrew Bracewell: It’s just fascinating. Like So what do you think is going on in the human brain? This absolutely is not something that only physicians air you you deal with. I mean, I I can say in my own life, I have also dealt with this for some reason. In whatever area that we are deemed to be the professional. There’s this mental block where we cannot suffer with that challenge. And the irony is, is we’re helping people with these things every day. Absolutely, absolutely. And there is I don’t I don’t have an answer for I’m just I’m fascinated by that, and I know that that can’t That can’t be the best of what there is. We’re better than this. We’ve got to get past that.

Dr. Shahana Alibhai: I think part of it, too, is because it’s a self protective mechanism, right? If you feel that if I need to help other people will how can I be down and out? I need to be in a role that I can lift other people up. I didn’t mean to get swept under the current, but we’re all susceptible. We’re all human, right? And then the eagle part comes from the fact that like it or not, mental health still is associated with the weakness. Right there is if you just tried harder. If you just thought CB teeter Cognitive behavioral therapy To your way out of this, do more yoga, do more meditation, eat better, drink more fish, oil, whatever you know, make it go away. And it’s not that easy. And this the other piece, too, is that it doesn’t have to be. We use mental health, but mental health could just be an having a really tough day. I’m having a really tough week. When are we going to start to say that that is OK? Because as a society we never go toe. You ask. How are you doing? I’m doing great. I’m doing perfect. I do. Fine. We’re approaching the Christmas holidays. If you ask somebody, how are you actually doing

Andrew Bracewell: their melting down?

Dr. Shahana Alibhai: Exactly. But do we have to say that you have quote unquote depression needed medication? No. Where is the middle ground? We’ve stopped having riel conversations because all we want to do is present a facade of our life on social media that everything is perfect. And it’s not.

Andrew Bracewell: Don’t go there. Don’t take me to social media. I don’t want to do it. Today started. Let’s rewind, rewind you, you and I. So we got to go for coffee. A few weeks ago, as I was chasing and pursuing you and begging you to come on the show and among other things, I we were chatting. We had a great chat for two hours and you said something that stuck out to me. And I wantto take us back to that moment and just shut up and listen to you talk, if that’s okay. You said something like at some point in time, we, as in you and college, needed to give you a designation and your designation was you were the CEO of your home. And this came in the context of a conversation where we were discussing gender roles and how to make careers work and have people feel validated. And I rolled over. And further context was Is that you’re talking from a perspective where two people have significant careers and yet you have a uterus and three Children, and I was coming out from their perspective where I have three Children. My wife’s career has been to stay home and raised the Children, and I’ve gone out, conquered while she’s done that. And then you just raise this concept of CEO of the home and I went, That’s fascinating. Can you just take off on that?

Dr. Shahana Alibhai: Yes, it’s funny. There’s, ah, actually various important role model Rachel Hollis. She’s written it, really Girl, just wash your face that kind of book. And she had mentioned one of her podcast that when you have something deep within your heart that just keeps speaking to you, don’t ignore it. And that’s exactly what I feel the CEO of the house concept it. So let me tell you more So like you mentioned I have three boys, all boys think, Ah, four year old, a two year old in a four month old. And it was our choice to have, ah, what I would think of as a larger family now. And like you said, for better or for worse, there is a time frame that you have to make these decisions as to when to start your family. And, you know, typically it’s in your late twenties, mid thirties, whatever it happens to be. There’s also a choice that you, as a woman, can make as to whether you want to stay home or whether you want to re enter the workforce. But that’s a very black and white decision. And what often, after spending 10 years or 11 years in the educational system earning this degree, I was spit out with Yes, an M D. But that means nothing. An MD means nothing unless you’re really happy practicing in a regular family practice office, and that for me, I’m That’s not my happiness. That’s not my groove, right? So here I am, a mom here I am, an MD behind my name, but I still don’t know what I want to do. And if that sounds of the ironic enough, yes, I enjoy the youth clinic. And yes, I enjoy breast health. But there’s something in my heart in my soul that I want to create something. I want to be an entrepreneur. I want to create something sustainable. Four women, four mums, especially that they can start to embrace who they are, their sense of time, their identity and give them purpose. And I think a lot of women who start cos kind of start with this sort of notion in mind because they have felt that loss, so they want to give it to others. So once again, I want to go into unchartered territory with this CEO of the House, which by the white, I should say, is a concept that I came up with in the sense that it speaks to the fact that I’m not just a stay at home Mom, Don’t you hate that When somebody asked me that Oh, I cringe. What do you I’m just a stay at home. Mom, don’t say that. Take the just out of there you are doing being at hole. I got to go. I got to goto work for three hours yesterday and I came back invigorated. I was happier. I love my kids so much, but it is hard, hard, hard work. And the reason the CEO of the House idea came up for me is that my husband bought a book. I won’t say the name of the book, but it was with the theme of taking charge of your mornings. Let’s say right, how do you start to utilize the 45? Aye, aye. Ems kind of slot as, ah, time that you can really supercharge yourself. We

Andrew Bracewell: don’t want to say the name of because it’s controversial or you just go

Dr. Shahana Alibhai: Just because I don’t want Thio. I like the concept of the book, but I think it was missing from a God. A female perspective. I

Andrew Bracewell: got it. Yeah. So you want

Dr. Shahana Alibhai: to use what exactly? So you know my ass. It was all, like, charged up about this book that Oh, yeah, it’s likely. Whatever our of power in the morning, I’m gonna meditate. I’m gonna work out, and I’m gonna journal. Oh, this sounds amazing. But I looked and I said, Guess what? I’ve been doing this for four hours four months. All my kids were horrible sleepers, but I’ve been up at 2 a.m. At 3 a.m. At 5 a.m. I’ve been doing this hour of power except I’ve been nursing while I’ve been doing it. Didn’t really mean like, Welcome to the O Club. And it’s so ironic is that we have all of these books for executives and CEOs and entrepreneurs how to unlock the tools and tactics to make yourself the most successful version that you can. But what’s the biggest difference between an entrepreneur, business person, CEO and a mom? What’s the biggest difference?

Andrew Bracewell: I would say the size of the humans you’re talking

Dr. Shahana Alibhai: about the correct, their voices. But it’s This is what I’ve come up with. It’s the ownership of time you ask. Look at yourself. You might have a list of things that you want to do to date.

Andrew Bracewell: Yeah, I scheduled this exactly where I wanted it.

Dr. Shahana Alibhai: Oh, that’s interesting. I have three little munchkins at home. We might wanna have breakfast, but guess what? There is a bill a zillion other things that happen like someone has to go to the bathroom and this and that and there’s a tantrum in, there’s a house to clean up. Nothing that I want to happen at a certain time will ever happen at a certain time. It’s the ultimate ask of responsibility and flexibility. You have to be so flexible as a mom because that time is not your time. It’s someone else’s time. You are serving those other people if you want. If you’re hungry and you want to eat at one o’clock and you have three young kids, ask any mum taco. It’s I find in this intermittent fast increase. Hilarious guy talked another month from a month. She’s like being fasting for all this time because of her mom’s. That’s incredible thing is not new people new. We just do this or you just grab the kids off the set off the kid’s plate, and I want to be careful when I say CEO of the house as a gender specific thing, because a lot of my friends who are females and are out at work, it’s their husbands that stay at home so it doesn’t have to be mad woman. Whoever just know that if you’re staying at home, it’s a lot more than raising kids. It’s conducting everything else behind the scenes, just like we talked about with your wife. You have a beautiful home here who’s actually orchestrated all of this. Who’s putting food in the fridge? Who’s cooking dinner? Who’s keeping it clean? Who’s behind gifts for the teachers?

Andrew Bracewell: Well, anybody who’s in our life yes, knows exactly who that is, and they know it’s not me. I will say this this conversation. So my kids are 12 10 and eight, and I would say my level of awareness of this topic and my sensitivity to it up until I’ll be gracious to myself. Let’s say 56 years ago, that’s being gracious, was very poor. And I’m awakening two the significance of this CEO of the House concept and over the last few years, you know, become more aware, and I believe that I’ve been more appreciative and understanding and just aware of the significant role that my wife has played in all of our lives. But my conversation with you a few weeks back, you really struck a chord, and you put language to it in a way that I’ve never heard language to it before, and I think it’s incredibly valuable. Um, yeah, I I don’t have anything else to say. Other than that, I I I think I would put myself in the camp of I am in the group of people that took some things for granted and have been on a journey, walking myself out of that going. No, Andrew, you got to go out every day and conquer and never think for a second about what was going on in behind you and just coming to the understanding of how significant that is. It’s it’s It’s fascinating

Dr. Shahana Alibhai: if we loop it back to our conversation at the youth clinic as well, a question I often ask the youth is. Tell me about your home, who lives in the home, what his family look like to you. And this is the response they often get. What family? What do you mean? What’s a typical upbringing like? Is it just Mum, Dad, siblings. They can’t relate. They can’t relate because they might have. They might not know their parents. They might be in the foster care system. They might be out on a youth agreement. They might have had such conflict with their parents. Like all of this stuff of what? So what your wife gave your Children? What you have given your Children is stability, and I think sometimes we measure what we give to our kids as quality time. But it’s actually quantity of time. Kids don’t suddenly say that’s really bond right now because I feel like bonding. You just have to be there and hope I absolutely want to bond with you. It’s like fishing. You gotta have the line in the

Andrew Bracewell: water all day and you’ll probably catch a fish. But you can’t just go. Oh, there’s a fish right there through the line and hit it. That line’s gotta be in there for a long, long time in order to get what you’re looking for.

Dr. Shahana Alibhai: But if you’re not there waiting, hoping that you’re gonna catch something, someone else is gonna be there. And you better have someone else that you trust like your spokes, like a good caregiver, whatever the case might be. So I think this is what the CEO of the House of Man or the woman, whoever it happens to be, will grapple with because it’s talk. Kids need time and I because we want everything to be instant. Just my kids are two and four, so going pee and brushing the teeth is the hardest. And changing them is the hardest thing we have to do because you know there’s too many distractions. But sometimes it’s just like waiting for a badge ical bird to appear. You just have to be really quiet and wait, because the more that you force it on them, they can sense your angst and apprehension, and they will just run away from you. Where is my husband has the advantage of really honing in on the quality time. He might not be able to be there for the quantity that he wants to be there. But when he is there, he’s all about having these quality experiences. So sometimes we have these very productive conversations. You mean you mean like fun? Dad, I called Fund out. Yes, exactly. Exactly. Right. And that’s the thing to like. Kids go through transitions. Sometimes they’re gonna be very mummy centric, something that could be very daddy centric. But this is something that all mums, especially I want you to hear, is that give your kids the best of you, not the rest of you give your kids the best of you, not the rest of you. And by that I mean, you do have to learn for your comfort level when it’s okay to say, I need to go. I need to go and take 10 minutes to go for a walk or to exercise or do whatever it takes or lock yourself in the bathroom for two minutes just to breathe. And it’s a luxury in our day and age to have child care like I have help. And I want to be, ah, 100% transparent, that I have child care help at home, and that there is no way that I could even be sitting here with three kids who are not in the school system and have this conversation so even tow have help means that you need to be of a certain economic standing. So all so why should it be that if you have a certain socioeconomic status that you should be able to achieve things that’s not right either? Right? So all the more credit for the moms who were doing it 100% on their own, like they are the CEOs of the House and they deserve that title and that stance and that credit, and by creating this, which I don’t know what it’s gonna look like. A book of podcast modules, things air in the works. But I want to create a community of women that feel as empowered as I do, because right now I am 1st 2nd I’m a doctor, but first I spend 99.9% of my house putting out at home, putting out fires and trying to be the best mom. I can be

Andrew Bracewell: very well said along this line, these lines still, there must be a conflict that only a woman experiences. I realized that we can have men and women play the you know, the stay at home roll the CEO role. But to this point in our evolution anyway, we still only have women giving birth. So can you speak to the conflict of as a woman who wanted to pursue a career? Yet there’s just still at practicality of having to carry a child for nine months, give birth breast feed, I guess. Should you choose that, feed the child in some way and just be present for an infant. That’s a conversation that just a man is not capable or does not need to have in their brain. How does that how does that play out in your mind? And how does that continue to play out in your mind?

Dr. Shahana Alibhai: So I think it goes back to knowing your options. Just be educated. We’re we’re in this society right now. Luckily, a woman does have options, for better or for worse. And by that I mean, if you were choosing a career like I did, that’s going to take you 10 11 12 years to complete. Maybe the best thing that you want to do is freeze your ex. So that way, you know, it’s like having just the safety deposit box. Like, you know, everything is they’re ready to go. And because we’re taking all of this into account by saying that you have a career and you found somebody by the age of late twenties, early thirties, that’s a fluke. If that’s the possibility, right? And we’re also saying that you are in a heterosexual relationship. Maybe you’re not. Maybe you don’t want a partner, maybe, and I’ve had friends who just want to do this by themselves, and that’s okay. But I think you can’t fool yourself into thinking that I could be spit out of this law degree, medicine entrepreneur or whatever the case might be a 35 36 37 hope like that that you were going to get pregnant. Don’t fool yourself into Don’t don’t think that you might be the lucky one. And I think sometimes with social media, with celebrities, we see women at 41 44 50 having babies thinking, Oh, this is easy peasy and we don’t realize that maybe they’re using someone else’s ache. Maybe they’re using IVF. Thes treatments cost a lot of money, right? So this is where I think we have to start having these conversations earlier on with our daughters that never feel like you don’t need to give in to your dreams. Follow your heart, follow your dreams. But if your goal is to conceive it to carry a child, that may be your best bet. Is ex wires at freezing your eggs? What

Andrew Bracewell: happens physiologically your body wants to carry a child from late teens to 30. That that’s what it wants, and therein lies the conflict in the rub.

Dr. Shahana Alibhai: And let’s be honest, too, just because you freeze your eggs And now using Okay, I’m ready to be Ah, Mom. At 41 we often forget to have the conversation about, well, carrying a pregnancy at 41 being a mom at 40 0 Energy having the g having all of that sort of stuff. So you might have your life, your bank books, all in order and feel like, Okay, I have enough money for a child. But what about the energy? What aboutthe supports all of that kind of stuff too? So it I have this and this is the opposite conversation in some ways, but related to the female youth that come in on we discuss birth control because I often tell them I said, although it takes two people, you at the end of the day are gonna be left making a decision. You might love your partner to bits, but let me be honest. This is you. This is your body. I didn’t make it this way. It’s the way that it is. So own it. Now, before you come to me in tears going, what are we gonna do? right. So it is really hard for younger women and any women I should say to make these kind of decisions. But this is life, and that’s what I mean is to be realistic about it. So know your options be realistic.

Andrew Bracewell: So much of what we’ve discussed today was the foundation. I believe for your pyramid philosophy, which we’ve scratched the surface of it actually didn’t really get into it in great depth. And you know, I don’t take too much more your time, but I would like you to just share a little bit about that.

Dr. Shahana Alibhai: So I think this came out once again. All the things for me come out of frustration, but it came out perfect situation because I was trying to figure out without having this full on integrative medicine training. Like I spoke about before. How could I summarize my belief system about not just medicine, but about health in general? So it was after I went through my own struggles with postpartum anxiety and depression that I realized OK, foundation have to be get the mind right. I don’t call it mental health for a reason. I call it healthy thinking it sounds juvenile in some senses, but it really means just getting your mind right or knowing your thought processes, for better or for worse, know what pitfalls you fall into. No, you’re thinking traps on, then The second part of that foundation is connection, because I’ll be honest with you. I also work in a regular family practice office, and I’ll have someone coming in for heartburn. Let’s say that would take it. That’s a 32nd appointment here. Some antacids when your way, you’re done. But if I start asking them will tell me about this and tell me about that. I’ll find out that their child is involved in substances, that they have a dysfunctional marriage, that because of all of that, they tend to cope by eating their eating too late at night. You’re drinking too much. They’re smoking. Well, no wonder you’re having acid reflux, right? So it’s all about that. It’s about the stories and that the word connect deeply for me encompasses the story behind the patient. Who are you connecting with in your life? What is your marriage looking like? Because if you’re coming back home to a dysfunctional marriage, you could be eating all the you know, the best food in the world. But it’s not going to help solve that inner angst that you have, right? You move up the pyramid and you simply I just call it decisions. And I was standing that the reason this came out as I was standing in a Starbucks line and the woman in front of me was trying to decide who’s having this conversation with her friends and, well, what should I eat today? Should I eat the healthier choice at Starbucks, whatever that happens to be. Or should I go for the unhealthy choice? And it made me realize that health is not health. Health is decisions. The decisions that we make every day. Absolutely the decision. When you’re in the grocery, Al as to Are you gonna shop the perimeter or you’re gonna go in between the aisle? Is it making that phone call for pizza? Is it like what are you putting in your kid’s lunch boxes? And no one is perfect. But what do you decide in that moment is going to determine your life, right? Your life is a culmination of all of those small Starbuck decisions. Do you want the extra syrup or not, whatever the case might be, right? That’s what I believe. So stop focusing on what exactly you’re gonna eat or how much exercise you’re gonna get. But just make one good decision for yourself every day. That’s all. I ask one good decision.

Andrew Bracewell: You’re gonna get about 2500 applications for new patients after people listen to this, because what? I mean, I knew this to be true of you. But what comes out of your mouth, the depth to your thoughts and the way you think through you’re practicing how you help people is just It’s so refreshing. And I know that you’re developing to develop a family. I mean, I’m I’m a fan, but your your fan base is gonna grow significantly because of what just came out of your mouth for the last hour and 1/2 of what we’ve done here. So it’s time to wrap things up. You’ve been more than generous with your time. Something I’m really excited to do on the podcast is too. Obviously find people like you, and I think we’ve been a tremendous job with you today in that we’ve truly found someone who’s everyday amazing where not enough people know about you. We’ve shown the light on what you’re doing, and it’s incredible what you’re doing. So thank you for what you’re doing in the community. But now you get the platform for a few minutes and to tell us about someone you know who needs to have that spotlight because they’re amazing. So fire away.

Dr. Shahana Alibhai: Well, thank you so much for the kind words to. So for me, I have to honor my mentor, Dr. Elizabeth Watch. She’s the reason why I’ve become the kind of physician I am today, especially working with the youth. So Dr. Elizabeth watches her name. She founded the Abbotts for Youth Health Center here in Abbotsford. She is the pioneer, the visionary of worked with her for a number of years. And every time I work with her, I’m just blown away by her humility. She is She’s the epitome of service beyond self. She comes to the youth clinic and she does not get paid. She volunteers for time just to be there. She is the ultimate advocate for youth. She cares beyond measure. She has her own health concerns and never once did she let that hold her back. She’s the mum of the youth clinic she’s so carrying. She actually works at the women’s penitentiary here, so she’s used to dealing with incarcerated women. Very, very vulnerable populations. But she was the one of the first ones to teach me in not even such a black and white way, but just to tell me the importance of the story behind the patient. And it’s because of her that even working with incarcerated women, you start to realize that they all have a story they all bought there because of a purpose and a reason. And she treats everyone equally. So I think it’s because of her that we have the foundry here in app. It’s for today, and I can think of no more of an amazing person than her.

Andrew Bracewell: Well, in what year did that that if it was a foundry, found it,

Dr. Shahana Alibhai: found it with 2018 just last year is opened its doors.

Andrew Bracewell: So, Dr. Elizabeth, what? We owe you a significant amount of gratitude. Absolutely. Thank you for impacting Doctor Shahana Alibhai. Thank you, Doctor. What? Shauna? Thank you for giving us your time.

Dr. Shahana Alibhai: My pleasure. I had a blast.

Andrew Bracewell: We’re in your debt, and I hope to see you again very, very soon.

Dr. Shahana Alibhai: Sounds like a plan. Thank you. Happy holidays to

Andrew Bracewell: you too. Okay, I know that she’s a doctor, but can I say that Shahana Alibhai is one of the coolest chicks I know? Is that fair? I think that’s fair Way. Talked about a lot of fascinating things. We spent time talking about her incredible impact at the youth center she shared with us her pyramid philosophy on health, which I think could be transformative for her patients. And it’s clearly been transformative for herself. Way talked about her involvement at the Breast health clinic and all the amazing things that are happening there in the lives of women who are dealing with and struggling with, what is most likely the greatest battle of their lives. And I think what we learned is that Shahana Alibhai is an engaged caregiver in our community, and she is the epitome of everyday amazing, and she’s exactly what I want on this show. But I’m so happy to have been able to share her with. Please be sure to check out the show notes for more information on today’s episode and for Dr. Shahana is website. Thanks for joining us today. Don’t forget to subscribe to the podcast and to check out our website at everyday amazing podcast dot com.

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