Breaking Point: Divorce, Codependency, and Choosing Yourself as a Woman in Medicine

Podcast Introduction and Valentine's Day Setup 0:00

Welcome to Heartline, Changemaking in Healthcare. I'm your host, Dr. Andrea Austin, a board-certified emergency physician, physician development coach, and educator. After years on the front lines, I've learned that real change in healthcare starts within. Each episode invites you to explore the inner work that unlocks clarity and bold leadership, because healing systems through changemaking begins with following our heartlines. Hi, fellow changemakers. Happy Valentine's Day week. I know this week can be awesome if you're in a relationship or it can be really tough if maybe you're in a breakup or not in a relationship right now.

And I've been all of those things. And this week, I'm going to read a couple of chapters from my book. I've had some coaching clients that have come to me while they're going through a divorce. And so I want to read that chapter because I think it has a lot of insights about how a really tough time in your life can be a period of growth. And then I also want to read the chapter on partnering well, which is super short, because I think the most important thing about our personal lives and honestly also our professional lives is who we choose to share it with.

And while I'm going to read the first chapter about the divorce where I quite frankly miss the mark, I have a really great husband now.

Chapter Four: Divorce and Self-Discovery 1:24

Enjoy these chapters. If you enjoy the book, you can pick it up on Audible. And regardless of what your love life is like right now, just love yourself. That is the most important thing to have that self-compassion and to really be your own best friend this Valentine's Day and every day of the year. So with that, let's jump in. Chapter four, breaking point, navigating divorce and self-discovery. Through an incredibly shitty period of your life, You're allowed to have joy in the middle, beginning, and during whatever part.

and that was a quote from Heartland podcast of February of 2023. 50% of Americans will get divorced at some point in their lives. This process can be filled with pain, uncertainty, and the unraveling of dreams. My journey through divorce began during medical school, and it made me reflect on the unique challenges that women physicians face regarding relationships, marriage, and the complexities of life while doctoring. While I'm not a relationship expert, I feel there is much to learn from my experiences trying to partner as a woman becoming a doctor.

The time pressures we face and the culture of perfectionism can take a heavy toll on finding and being a good partner. As we start this chapter together, I want to be honest about my shortcomings and the lessons I learned from my divorce. While my divorce was undeniably painful, there are also moments of unexpected happiness and fun. Despite the turmoil, I was surrounded by supportive friends and engaged in activities that brought me joy. It was a reminder that there's always a flicker of light amidst the darkness.

These moments of pleasure were a lifeline, keeping me afloat during the storm. It's a realization that I wish I'd remembered during other challenging times like on deployment or the COVID-19 pandemic. Now let me take you back to the beginning of my marriage. I got married at the young age of 22. In hindsight, I realized how little I knew about myself and what I needed from a partner. As a driven undergraduate and medical student, I focused primarily on checking off boxes of academic success. Side note, I like to call this the achievement treadmill.

Signs that you're on the achievement treadmill are that you look for external sources of validation, frequently feel like you're not in control of how fast or the incline, and you're exhausted. Whether by design or inadvertently, many things in medical education and later medical industrial complex are incentivized to keep doctors on the achievement treadmill. Back to 22 year old Andrea, there was little time for self-reflection and exploration of my desires and aspirations. Marriage for me became just another item on the checklist, a natural progression after completing undergrad and entering medical school.

My first husband, whose name I've changed here, Matteo, was a Swiss foreign exchange student whom I met when I was 15 and profoundly affected me. He was introduced by a friend serving as his host family. His olive skin, jet black hair, thick hair, and soccer player physique were irresistible. He was intoxicatingly handsome and he had a magnetic pull on me. Our year of dating was intense and filled with new experiences and emotions I had never encountered. However, the foundation of our relationship was built on codependency.

When you're into dating, Matteo fell into a deep depression. Looking back, his depression likely reactivated some of the dynamics around my mother's episode of depression. I knew that depression was not his fault and that it was a neurochemical imbalance. I felt like our relationship crumbled around the same time. But leaving him felt cold and I feared I would make his depression worse, even trigger suicide. This led to the development of a codependent dynamic in which I felt like I was responsible for his well-being.

I stepped into the caretaker role and out of the girlfriend role. Instead of a give and take, a dynamic emerged of me being the fixer, planner, and problem solver for everything that developed. The hyper-functioning that I honed during my childhood was on overdrive with the struggle to balance being a great girlfriend, working, and studying. Not only would I be an A student, but I'd be everything to everyone in the dorm, as an RA, and with my free time, I'd be encouraging Matteo. Being mired in everyone else's lives kept me from pursuing self-discovery.

Aside from my friend Jen, there wasn't anyone checking in on me. Not that I blamed them, my external armor of I have it all together was ironclad. I needed more self-exploration and introspection to prepare to be a partner. The academic demands and the necessary volunteering or work experience to go into medical school take up a lot of time. Only later when I found myself deeper into the relationship did I realize the magnitude of what I had committed to and the lack of solid foundation we had built.

I also didn't know how to be with Mateo without being codependent. Codependency is defined as an emotional and behavioral condition that affects an individual's ability to have a healthy, mutually satisfying relationship. It is also known as relationship addiction because people with codependency form or maintain relationships that are one-sided, emotionally destructive, and or abusive. For me, the mutually satisfying part was lacking. Sure, there were some exhilarating moments, especially in the first year and later on trips to Europe, but overall it was a net negative for me.

It was not just a hard season, but a slog that I felt required to stick out, likely activated by the depressive episode Mateo experienced early on and relapses throughout a relationship. Many people, especially women, are drawn to medicine because of its inherent caretaking aspect. We thrive on taking care of others. I encourage aspiring and current doctors to consider whether their caretaking tendencies cross over into codependency in their relationships. As our marriage began to fall apart, it became increasingly apparent that I had unintentionally enabled codependency that showed up as me trying to pick up the pieces and shield him from failure.

I forgot that while I was an aspiring doctor, I could not heal a person's internal wounds. To have the courage and clarity to leave, I had to confront the damage I inflicted that led to the end of the marriage. I realized more factors influenced my decisions. Growing up in the Midwest, it was a cultural norm to get married around 22. Many examples from my friends and family groups supported this pattern, and with couples who had been together since their early 20s, were genuinely happy. For some, this dynamic worked out well.

From my observations, a key for these couples is the ability to grow together. No one is the same person after meeting their partner. Life experiences change everyone. Adding to the complexities, being a woman in medicine comes with inherent expectations and pressures. We receive overt and subtle messages to be pleasing and accommodating. These societal messages can influence our behavior, and in my case, they played a significant role in my decision to stay in the relationship, even when it got to be emotionally and physically abusive.

If you are contemplating a career in medicine, particularly young women, pause and reflect on whether you genuinely have the time and space to get to know yourself. Understanding what you need and want in a partner is vital before starting a lifelong commitment. Building a solid foundation of self-awareness is critical to navigating the complexities of relationship while pursuing a career in medicine. The decision to get divorced was both slow and fast. Shortly after getting married at 22, I received an email That was the proverbial straw.

We are both supposed to graduate college simultaneously. My husband didn't walk and sat in the audience with my parents at the graduation ceremony. Considering his shy and nonconforming nature, I thought little of it then. However, about a month after our wedding, his father sent an email containing my ex-husband's college transcripts. It revealed that he had been cheating and failed all the courses in his last semester and had not graduated. I read the email while surrounded by coworkers at my summer research job.

The shock, surprise, and heartbreak hit me all at once. I recall that young 22-year-old version of herself excited about starting medical school and working hard as a research assistant. As I absorbed the information, my heart raced and pounded with surprise and profound disappointment. My colleagues beside me saw no external reaction as we worked that day. I wanted no one to know that something was amiss. This was typical for me in those years. My perfectionism kept me from sharing anything that could dent the image that I didn't have my life together.

The situation shows an unhealthy form of compartmentalization. I stayed at work all day, numb and detached and brooding over how to react when I got home. Later, I'll discuss strategies to be more aware of when you're compartmentalizing and question if it is necessary or simply more of an avoidance strategy. We'll also discuss how to move through emotions after necessary periods of compartmentalization in a healthier way. So after receiving the email that day, I went home, I stormed through the front door and fueled by anger and disappointment.

I couldn't hold my anger back anymore. I confronted my ex-husband about what I had learned. I looked him in the eye and I said, I received an email from your father today. I know that you failed your last semester and didn't graduate. It's not okay, especially since you lied to me. The air was thick with the ferocity of my words. I demanded answers, desperately seeking an explanation for failing his classes and lying. The response came, it doesn't matter anyway. You're going to be a doctor. He quipped back at me.

In that instant, as his words hung in the air, a realization washed over me. His response was profoundly disappointing, but looking back, it was at least honest. Yet, I wouldn't process the meaning behind his words. Instead, I went into hyper-functioning overdrive and employed my favorite persona, the fixer. I began brainstorming ways he could go back to college and some work he could do while he was in school. He was indifferent to my long wandering list of potential solutions. The argument began to fade, not because anything was resolved.

It was more of exhaustion of tears and circular conversations with the knowledge I had to be up in a few hours. As I lay in bed that night looking at the ceiling, I knew the marriage was over. My thoughts took on a repetitive, shame-inducing chorus. How could I end a marriage after two months? I thought about the celebrity couples that get divorced after a few months and how I judged them. is immature and stupid. Getting a divorce after a few months of marriage didn't seem all that unreasonable, unfortunate, but not unmanageable now.

Hey friends, Andrea here. There are moments in a doctor's life that mark you forever, and for me, they often involve travel. It's where I connect with awe and wonder that help me see my life and my career differently. The Heart of Medicine in Uluru, Australia, July 29-31, 2026, is a retreat that is an immersive, soul-level experience at one of the world's most sacred landscapes. It's a space to breathe again, to reconnect with your purpose, to hear your own voice without the noise of the busy clinical environments we all work in.

We'll gather a small group of clinicians for thought-provoking sessions, storytelling, cultural learning, and genuine rest. Spots are very limited. If your heart has been asking for something more, this is your invitation. Learn more and register at coachingfordoctors.net.au or you can email me at andrea at andreaaustinmd.com. Some may be wondering why it upset me that he didn't graduate college. Simply graduating college is not necessarily correlated with intelligence or work ethic. But I was learning what I want and need in a partner.

I like to read and talk about politics, culture, and art. And I want to do it with a person I share my life with. I also had many family members struggle with unemployment, limited by their lack of education. While I didn't have the complete clarity on my wants and desires, I knew I wanted a partner who shared my intellectual curiosity. I yearned for a partner that I could connect with deeply on a philosophical level, something I later called brain sex with my now husband. I hope this intellectual connection would extend long past the more superficial aspects of physical attraction.

While plenty of intellectually curious people don't attend college, it was a shorthand for me, especially when I hadn't been exposed to people with varied life experiences. In addition, I wanted a partner. What stung so much was that I would be the breadwinner for all of us under every circumstance. I don't mind making more than my partner. I mind when we're not in a partnership. I couldn't articulate it, but in my bones, I knew I needed someone who could take care of himself, take the lead, plan ahead, and frankly be self-sufficient, as I knew I'd work many long hours.

I knew I didn't want a grown child. I was outgrowing this codependency phase of my life. I desired a genuine partnership built on trust, support, and shared values. At that moment, I knew it was time to walk away and seek a future where I could find the love and companionship I longed for. However, I lacked the courage and knowledge to move forward. Our marriage stayed in a suspended state of dysfunction for about another year. One of my other go-to strategies when life is hard and I don't know how to proceed is to read books.

I also spend time alone, walking, and journaling. Medical school started a few weeks after the disclosure and the pace of medical school left no space for me to think about how to extract myself from this failed marriage. Nearly every waking thought was focused on studying and there was a deep uneasiness that I wasn't good enough to be there. I only got into one medical school. I applied to seven schools, a smaller number than many. I was overly concerned about the cost of the applications. Only getting into one school activated an intense level of imposter syndrome.

And when medical school began, I was all in. I put my marriage on pause and bottled up my emotions deep down inside of me. It wasn't all bad either. Becoming a doctor was my dream and the complexities of the human body and the science behind it genuinely enamored me. Medical school became my refuge where I found comfort in pursuing knowledge and the companionship of my brilliant classmates. While many people reminisce that their high school or college years were their best, medical school was the best time of my life until that point.

Despite the marriage difficulties and the suffocating imposter syndrome, I found a real sense of purpose and deep friendship in medical school. Fortunately, there was a summer off between the first and second year and involved a few weeks away from Mateo. Foremost, the summer between first and second year medical school is the last summer break we experience as medical students. Yet, my summer break was interrupted by my military service obligation. Right after my medical school acceptance, I signed up to join the Navy.

I was attracted to the idea of serving my country and honestly that they would pay for my medical school. Also, I had a deep desire to leave Iowa. While I knew very little bit about the military, I knew there was no Navy in Iowa. While most of my classmates went on vacations, I went off to officer development school in Newport, Rhode Island. The days were filled with nonstop activity beginning at the crack of dawn and continuing until late in the evening. Amidst the chaos surrounded by my fellow newly minted Navy officers, I still found an internal process the last year in collapse of my marriage.

Quiet strength was growing inside of me and I was sure I was going to figure it out. I was so ashamed that my marriage was ending.

Closing Thoughts and Outro 17:08

Again, listening to my inner voice, I knew I needed to confide in someone. I had not shared what was going on with any friends or my parents. I knew it was a risk to share what was happening, and I felt the safest person was a friend from my medical school class, Miranda. Miranda was slightly older than the rest of us because she hadn't pursued medical school right after undergraduate studies. Originally from New York City, her life experiences differed from mine in most of the people from Iowa, where most of our med school class originated.

I was captivated by her background, her writing pursuits, and the incredible things she had done. She was mature, engaging, and hilarious too. Being around her, I sensed that she was a safe person to confide in, someone who could understand even if she hadn't experienced a mistake of the same magnitude. Until this conversation with Miranda, everyone I talked to about my relationship thought it was an incredible fairy tale. Marrying my high school sweetheart, a foreign exchange student, and going on European adventures together, people found it so romantic.

Miranda provided a different perspective. She didn't find my story romantic and said divorce was a reasonable option. The validation was like a salve on my soul. I started to feel more whole and like I could trust myself to navigate the situation. Going through a divorce was undoubtedly challenging, but I found comfort in the moments of raw vulnerability with people like Miranda and others who showed tremendous kindness and compassion. My friends from that period saw how broken I was and how much pain I was in, and they loved me anyway.

Once it was out that the divorce was happening, we planned a party. As I walked down the hall of our medical school on the night of the party, I saw June, one of my classmates. She looked tired, and although that was not so unusual, I could sense something more profound in her face. I invited her to the divorce party and later learned she was going through a painful breakup. That year I learned the power of vulnerability. My friends later told me that in the first year of medical school, I was uptight and not that fun to be around.

Removing the veil of perfectionism, I began to make deep friendships and had many fun experiences I still cherish to today. Along with medical school, the Navy played a significant role in helping me channel the fighter inside of me. One of the most memorable experiences of officer development school was the USS Buttercup ship simulation. This Navy ship simulator lives indoors, but within minutes of being aboard and traversing the compartments adjoining the watertight doors. It's easy to forget that it's a simulator inside of a building.

The exercise begins with the ship slowly filling with water. We had to work as a team to save the ship. We patched holes and ran pumps to drain the water. Though safety monitors were present, the experience felt uncomfortably realistic. The water levels rose, reaching our necks, and shorter individuals even had to trend water at some times. Through these Navy adventures, I discovered an inner strength I never knew I had. As Glennon Doyle beautifully says, we can do hard things. Each challenge I faced in the simulation and drills from jumping off the high diving board into the dark pool, firefighting, or working to save a ship with water up to my neck revealed the depth of my resilience and capability.

I could feel the energy and determination to navigate the turbulent waters of divorcing while returning to the second year of medical school. As doctors, our grit can be a strength and a weakness. Grit can keep us in harmful situations. We may fall into the sunk cost fallacy in which we are reluctant to let go or abandon something or someone because of how much time we've invested in it. I had been with Mateo for six years, which weighed on me. How could I let go of a relationship that I'd had for this long?

It is hard to acknowledge that something you've been working on, whether marriage or a job, is not working. The first step is to stop digging a deeper hole. What helped me let go of this marriage was to step out of my perfectionism. A part of me worried what other people would think about the end of my marriage. I finally realized this was my life, my story, and nobody knew the inside of my marriage. It didn't matter what others thought about divorcing a mere year into my marriage. I was suffering and living with toxic codependency.

While my ex may have been doing his best, I also knew he couldn't grow into the partner I needed. it wasn't my job to stay and fix him. As I began rearranging my condo, for one, I felt my heart sink. Would I love again? Or was my career the love of my life? A small splinter of clarity began to emerge. I knew I'd be better off alone than in a relationship that didn't light me up for the rest of my days. I boldly chose myself and my career and my future happiness. I started to hear my inner voice and trust her a little bit more.

I'm actually going to leave it there and save the partnering well chapter, which is incredibly short as a special Valentine's Day extra bonus. So check back on Valentine's Day for that. And if I can be of any assistance to you as you're navigating your changemaking journey on a personal or systems level, reach out to me at my website, andreaaustinmd.com. And don't forget to keep following your heartline. Thank you for listening to Heartline, Changemaking, and Healthcare. If this episode sparked something for you, I'd love for you to share it with a friend or colleague who's walking their own changemaker path.

If you're interested in coaching, consulting, or speaking engagements, you can find me at andreaaustinmd.com or connect with me on LinkedIn and Instagram. I work with individuals and organizations who are ready to build meaningful, sustainable change without losing themselves in the process. The views expressed on this podcast are my own and do not reflect those of any organization I work for or with. This podcast is for education and entertainment purposes only and is not intended as professional advice, including but not limited to medical or psychological guidance.

Until next time, keep following your heartline.