Episode 483: Fibroids, Endometriosis, and Financial Loss: The Real Cost of Untreated Womb Conditions w/ Dr. Kemi Doll

Dr. Kemi Doll 0:02

Absenteeism is when you are just gone, right? So, like, absent from work, presenteeism is when you actually are present, but you are functioning so much lower than you normally would be, because of some other condition going on. That's what happens with women who have heavy menstrual bleeding, heavy menstrual bleeding, meaning they're bleeding too much, they're iron deficient or anemic. So, presenteeism is actually a much bigger problem. It's actually impacting the quality of how you're showing up and how you're making decisions. So, I'm very passionate about this, because one in three black women, one in three black women with heavy periods is clinically anemic.

Speaker 1 0:43

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Intro 0:45

Welcome to the Journey to Launch podcast with your host, Jamila Souffrant. As a money expert who walks her talk, she helps brave journeyers like you get out of debt, save, invest, and build real wealth. Join her on the journey to launch to financial freedom in

Speaker 2 1:03

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Jamila Souffrant 1:11

If you want the episode show notes for this episode, go to Journey to launch.com or click the description of wherever you're listening to this episode. In the show notes, you'll get the transcribed version of the conversation, the links that we mentioned, and so much more. Also, whether you are an OG journeyer or brand new to the podcast, I've created a free Jumpstart guide to help you on your financial freedom journey. It includes the top episodes to listen to, stages to go through to reach financial freedom resources, and so much more, you can go to Journey to launch.com/jumpstart to get your guide right now. Okay, let's hop into the episode. Hey Jamila, welcome to the Journey to Launch podcast. I have on today Dr. Kemi Dahl, she's a physician, surgeon, researcher, advocate, and coach working at the intersection of health, justice, reproductive equity, and personal empowerment. She is a professor at the University of Washington Schools of Medicine and Public Health, a double board certified gynecologist, oncologist, and OB-GYN, and the founding director of the Gynecologic Research and Cancer Equity Center, she also has a podcast, Your Unapologetic Career, and she has a new book that is out, A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing. Welcome to the podcast.

Dr. Kemi Doll 2:38

Thank you so much for having me. I'm excited to chat with you.

Jamila Souffrant 2:41

Yeah, I'm so.. I'm really excited to dive into your work and how important what you talk about is, and we'll get into that. But I always like to start with the journey of the person I'm talking to, and so I'd love to hear, because I'm reading your bio and I'm like, how, like, where do you have all the time? You know, I know becoming a doctor is not easy, but then you're doing all this other work, so I love to take it back to kind of the beginning, and like, how we'll eventually get into how you got into this work, but like, how did you, or envision your life would be, and how did you start this process to become the doctor you are?

Dr. Kemi Doll 3:16

Oh my gosh, this was definitely not what I envisioned when I was thinking about becoming a doctor, I would definitely say that. So I was definitely the little kid that was like, I want to be a doctor when I grow up. I mean, not really knowing what that meant, but that was that was my thing. And I had a fairly tumultuous time getting there, in terms of just having some family struggles, which I write about in the book, and getting to undergrad, and I really struggled, because one, my family home situation was very volatile, and two, it's just like a big adjustment for me to come from public schools in Atlanta, and I went to Duke undergrad, and I was in their school of engineering, which was like very rigorous. I got a great education for sure, but I also like reached some lows of the lows, so when I came out of undergrad, I was not 100% certain that I was going to be able to get into medical school and like be a doctor, I don't know, like it might in the way that I saw things, you know, I had been on, I'd basically gotten kicked out of school academically because I had done so poorly that they were like, yeah, you gotta go, so I had to, like, reapply, gain, regain admission, and then try to rehab my GPA. I still wanted to graduate as an engineering student, like, it was rough. So, when I was coming out, I just didn't have that confidence that I had had for so long of being academically successful. Regardless, to jump over that journey, I ended up doing a pipeline program. I ended up getting into Columbia and Ivy League medical school. I went to medical school, and it was in medical school that I realized I really liked taking care of women patients, and I really liked all of the kind of ways that our lives intersect with our health, and especially our reproductive health. Excuse me. So that's what got me into OB-GYN.

Jamila Souffrant 5:00

Okay, I have to just go back a bit, because I am amazed at just your ability, your resilience in what seems to be the trying times of getting through school, and like you said, you got into Duke, so you must - I'm just assuming that you are academically really sound to be able to get in, and so, and I'm asking this as a parent myself, my kids are pretty young, but I, I'm thinking back to my, you know, my college days, and thinking about them, and just people maybe listening when you were struggling, like, what allowed you to keep persisting, or to go back, because some people, you know, that's their stopping point, and they take a break,

Dr. Kemi Doll 5:38

yeah, that's the end of the road, yeah,

Jamila Souffrant 5:39

right, so for you, what was that? What encouraged you to keep going and to try again and do something else?

Dr. Kemi Doll 5:45

Sadly, trauma, I think. So, you know, I didn't grow up in a house where there was a lot of warmth and nurturing. There was high expectations, for sure, but there wasn't a lot of warmth and nurturing, and, and by the time I had this, this academic failure. I couldn't even actually go home anymore. By that point, I was kind of like banned from my own house, and my father was very abusive. There was just a lot going on, but I had just felt like I was on my own, like I was the only one looking out for me. I probably felt that way since I was like 12 or 13 years old. So, when it happened, for better or for worse, I was used to being on my own, and I remember feeling like I just have to try my best for this dream I still have, and then if I completely fall on my face, and if it's totally the end, then I'll pivot, but like what I have to do is just take the next best step in front of me, and like that's like all I can do to stay alive, is kind of how. So, there was this like resilience born of extreme like hyper dependence, but also this sense that I've always had, which is that I would so much rather just try my absolute hardest and be told no, right? Like, you have to close the door in my face, I'm not going to take myself out of the count, so that was really my mode, and I mean, I had to rehab that later, because there's, there's like a negativity, right?

Jamila Souffrant 7:11

Right, it can work against you, like there's, yeah,

Dr. Kemi Doll 7:13

the overworking, like there's a whole side of that that doesn't, that is not great in terms of your health, but it did get me through that really rough time, and I was just only focused on like the very next step in front of me. Like, I remember all I wanted to do when I was kicked out was to get back in, like that was the only thing that mattered. And then once I got in, all I wanted to do was graduate, like I will graduate, I will. So there was this sense of that's how my momentum was carrying me, and it took a long time before I was able to slow down and say, like, okay, but what is this life like? What, what are we doing here? But that's to answer your question. I mean, I don't want my kids to have this lesson, to be honest. I'm like, I believe that it's that it can be born of other things, like I see people who are actually very well supported, and their resilience comes from this sense of like I'm gonna be okay because like my communities got me, my family's got me, so like I'm gonna recover and bounce back because I'm held well, and I think that's possible too,

Jamila Souffrant 8:11

right? Right. Thank you for sharing that. I'm very powerful. So now I just have to ask, just because you know we, I talk about money and personal finance a lot, and so you just mentioned some Ivy League schools, and going, girl, be a doctor, so now I have to know about, like, you know, the, like, the loans, and, or, and maybe we'll get to this further down, but what does that look like financially?

Dr. Kemi Doll 8:33

Yeah, so when I went to undergrad, I had a lot of loans, I had some need-based aid, and then I had loans and and then one of the ways that my father retaliated against me, actually he stopped paying the portion of my tuition that my, my family was responsible for, so I kind of went like I had all three, I had need-based loans, I had a family contribution, and then I had work study and some grants from the school, so when that happened, I had to take out more loans in order to cover that portion, and then I think I was like a lot of young people then. I feel young people now are different, but then it was just like you just kept adding to the loan, so like when I get to Columbia, and at that time I think it was like 52,000 or $53,000 a year. Now it's, I mean, it's totally different, but, like, that was still insanely expensive, so it was just more loans, more loans, more loans. So I feel like I probably graduated with, like, a little under $200,000 in debt, something like that. And then, you know, what, Jamila, the next thing that you do as a medical graduate is you go become a resident for years, where you make nothing, you make pennies.

Jamila Souffrant 9:44

Yeah,

Dr. Kemi Doll 9:44

so then I was on the whole deferment, income-based deferment, forever, because I'm a resident, I can barely make any payments, and I took out more loans to be able to move from New York to Chicago, where I did my residency, so I'm just like piling on debt, so. So I mean, when I came out, it was, I was, I had so much, so much in loans. So now, do you want to know what happened out of that?

Jamila Souffrant 10:08

Yeah, well, that, and how long it took you to complete, from, I guess, when you grow, how long did it take you to get your undergrad, and then from there to complete, because I know, like, becoming a doctor is work, it takes time, like, how long that takes.

Dr. Kemi Doll 10:19

So, four years undergrad, and then medical school was four years, so that's eight years, and then OB-GYN residency was four years, so that's 12 years, and then gynecologic oncology fellowship was four years, so that's 16 years.

Jamila Souffrant 10:35

Wow, wait, and you could have stopped after the first resident, like the first, what was your first specialty?

Dr. Kemi Doll 10:43

My resin, my OB-GYN residency. Yeah, I could have stopped at that point, got my board certification, and then practiced OB-GYN, but in residency I realized how much I really, really enjoyed the cancer side of things. It was very rare, actually. I didn't even know that field existed, that the gynecologic cancers is actually a field within OB-GYN, and it's not in traditional oncology. So, I really loved that, as like a very holistic approach to dealing with that, those diseases. So, I decided in residency I'm going to keep going, and I'm going to get a subspecialty certification.

Jamila Souffrant 11:16

Wow, just now curious, for the doctors out there, people who are interested and in the process, so could you have specialized without doing the first four years residency?

Dr. Kemi Doll 11:25

No, no, girl, no, you have to do it. So, there's, there's all these like, there's kind of like the base specialties, where it's like, if you're going to do, I don't know, if you're going to be in the nephrologist for the kidneys or a cardiologist, you have to do internal medicine first. Got it. If you're going to be a pediatric gastroenterologist, you have to do peds first, so that's how the years add up, is because you have to get the base, and then if you want to sub-specialize, then you continue going. And then, when I was in fellowship, I actually decided again that I really wanted to do research. I was really, I like, was very interested in learning more about the scientific process and being able to do research to help my community, so then I went to grad school again, and I did a two years full-time master's degree at the UNC School of Public Health, and so I just, you know, more school, but then I was done,

Jamila Souffrant 12:12

right? Well, and like you said, during that time, lots of loans to support yourself,

Dr. Kemi Doll 12:16

yes,

Jamila Souffrant 12:17

and working, but not making probably as much as your capacity, what you couldn't make once you've completed everything.

Dr. Kemi Doll 12:23

No, as a resident, you're making like minimum wage,

Jamila Souffrant 12:25

right? Wow. Okay, so you now have gone through all the schooling, and it seems like your passion, like you really, like you've drilled down and discovered what you love to do within like the work.

Dr. Kemi Doll 12:38

Yes, which

Jamila Souffrant 12:39

I find that so many people don't know, right? I feel like even now, for myself, I'm like, what do I love doing? Like, other than this, what is there, you know? So, you know, I always love seeing when people are following their path, and then it leads to seems to be fulfillment, and then helping others, and hopefully financial success.

Dr. Kemi Doll 12:56

Yes, yeah, I was really driven by what I loved, and I would actually probably say all the way from the beginning, right? I was like, I really, this is where I see myself, this is how I want, this is what intrigues me. I like biology, I like science, I like helping people. So that was pushing me forward. And then once I was in, and I was in training, and I was seeing what was happening with black women, and I was seeing how empty the research was, for lack of a better word, like there was some research, but ultimately it's almost like the only conclusion was that black women are just broken, you know? Like, what are we going to do? It just is what it is. And so that decision, right, wanted to keep going to say, "Okay, I want to.. I want to do gynecologic oncology. That was calling me. I really appreciated it. I also felt I remember being in OB-Join residency and failing, like I really love obstetrics. I actually loved it a lot, but four years was enough. I remember feeling that way, like, you know, I.. it's like I'm enjoying this, but I see there's more for me somewhere else. So all of my decisions were driven by what is.. what is like lighting me up, because my eye.. my energy flows in that direction. So I know I will continue to have energy for this thing if I'm moving towards what lights me up, and it didn't always make sense for other people, but it did make sense for me. Yeah,

Jamila Souffrant 14:09

right. I can imagine. And then also, too, the belief that you could change and make an impact. I think so many people think and have hopes of, they see something that's wrong and they want to do something about it, but they don't think that they can, right, or it's not going to make a big difference, but then you pursue this, and then you are making a difference, which we'll talk about.

Dr. Kemi Doll 14:28

Yes, and also, I mean, the other thing is, like, making a difference often takes time. I think that's the other piece, is like I'm driven by wanting to make a difference, right, but we just talked about 16 years of training to get to the point where I'm now just entering into the arena, like I'm just entering into the game now, and saying, okay, now I'm done, now I'm going to start practicing, now I'm going to start doing studies myself, I'm going to start examining what's going on, like, and then that's just that beginning, right, it's another decade plus. Us before I'm talking, like, oh, we have done this, we have made this impact, we've changed the guidelines, we've changed these things. So I do think that sometimes that can get lost in the sauce of, like, when people say, I don't feel like I can make an impact. Sometimes I want to say, well, what is the impact you want to make, and how long do you think that's how long has the problem been going on? That's why I like to think about how long I mean, because if the problem has been going on, or the area you want to impact, or the absence of whatever you want to create has been there for years, decades, centuries, like we have to be a little bit more humble about how much, how long it's going to take to then have an impact, right? That's not going to come overnight, you're gonna have to build towards it,

Jamila Souffrant 15:42

right. And so I mean that that parallels and tracks for us, so everything, most things in life, like outside of all like the fast pace and instant gratification that we have now as a society. I think it goes back with finances too, and money, and when trying to tell people about investing and not looking for the quick wins, and like steady wins the race, and in 1520 years you'll be so glad you started

Dr. Kemi Doll 16:07

slow and steady. Yes. Oh my gosh, 100% And so I don't know if this relates, but you have to tell me, is that the idea of the compounding interest, I think about as the compounding impact too, and the thing about, and this is where you have to tell me if I'm wrong or right. The thing about, I think, another arena where people can go off is that they try to start too many different things in too many different arenas that aren't actually building on on each other. So, like in my world in research, I try to tell people, listen, figure out what your lane is, be patient, and build and build, because every piece of science that you create will build on the last, but if you're trying to do something over here, something over there, something over there, it's a lot of energy, but nothing is moving like it's not building on itself, you're not getting the benefit of the prior work that you put in. So, I think about that too, is like focus is important in that, in that compounding effect, is that true in finance? I,

Jamila Souffrant 17:05

yes, I believe so. No, it's really true, because oftentimes you can spread yourself thin, trying to accomplish too many goals. Yeah, and that keeps you stagnant from moving forward, because the little bit in each bucket doesn't, you know, work as well as figuring out and taking care of, let's say, one debt first, and or one goal first, to give you the momentum to push forward.

Dr. Kemi Doll 17:27

Yeah, exactly, exactly. That's so interesting. Yeah.

Jamila Souffrant 17:30

Okay, so let's talk a bit about now, like the work that you're doing, the research, and how it's all connected, because when I first was introduced to you, I really love the idea of you talking about just how the workplace, how you know, we expect like part of I talk about financial freedom and independence is you need money, you need to earn money to do that, and most times people start within a company structure or in a career, even as an entrepreneur, right? If you do that, you have to show up and work,

Dr. Kemi Doll 18:01

yes,

Jamila Souffrant 18:01

and nope, we make money, and so part of your kind of pitch was what happens when our bodies are not allowing us to, and that holds us back, or that doesn't allow us to earn as much as our counterparts, or men that that don't have the reproductive organs we have that cause maybe some of these things, so I want you to kind of talk about that, and then we can dive deeper.

Dr. Kemi Doll 18:23

Yes, okay, I want to talk about that, but can I go back and tell you about what happened with the loan? Oh, yeah, yeah, because I feel like we, we didn't finish that story. People were like, that's a lot of loans, and it's not like I didn't just finish and make a lot of money and pay them off, that's not how it worked. So, so I just wanted to say, because I think it does have to do with what we're talking about, with like what keeps you going, and how do you have momentum, is that the other thing is like there's a way that you can be creative about having whatever is driving you serve multiple functions, so for example, I am a research girl, you know, I knew I want to do science, etc, so I find out that there's actually something called the NIH loan repayment program, and the way that it works is that essentially you have to propose science, you have to talk about what you're going to do, what you want to work on, and instead of giving you money to do your science, you have to find and get grants to do your science separately, but when you apply to this program and they, you have good ideas, they start to repay your loans while you're doing that science. So, I applied for a loan repayment grant in that final four year stretch. That's when I first became eligible for it, and it paid off at that time $35,000 of loans a year. Wow, yeah, but you could renew, you had to keep applying, like they didn't play games, like you had to renew and keep showing them that I am doing the science, I'm publishing papers, etc. and that was what took care of the majority of my debt. So, like, as I'm doing the science I care about, and as I'm writing grants to get money to do the science, I was also getting this loan repayment benefit. It, and it came with some restrictions, but, like, the restrictions were worth it to pay off those loans. So I just wanted to, like, make that clear, since we started down that lane.

Jamila Souffrant 20:08

Thank you for, like, circling back to that, because it also shows, and there's, like, so many resources out there, like, I mean, not all of it could be applicable to, like, you know,

Dr. Kemi Doll 20:17

everybody, everyone,

Jamila Souffrant 20:19

right? But I just find that there's so many. I call this what I talk about in my book, your journey to financial freedom, like clicking on the hyperlinks in your life. And so the one of the things that came up as you were talking was, okay, how did you find out about that repayment program? Like, let's just say you just never did or never applied, then you'd be stuck with the loans, and I talk about hyperlinks, meaning you hear things, you, whether that's through someone, or you find something, or you see a just a breadcrumb about something that's interesting, and you research, and you look into it, and then you do it, and those little things really put you ahead of where you could have been without trying. So, I just find that, like, great as a resource.

Dr. Kemi Doll 20:56

Yes, absolutely. And you know, you've got, you have to also, there's like an egoless part of it where you have to just be you have to be willing to be a student learner again, so like one of the things that happened to me was when I got to buy fellowship that last four years there was actually no funding for me to get my graduate degree and there was no funding for me to do my research there like you can do it but you got to find your own money it was the need to find the money that was allowed that allowed me to say, okay, what are all the possibilities? So I'm going around, you know, here I am, have 12 years under my belt, I'm still not afraid to be a learner, like I don't know anything about this. How do I find this money? So people are sending me, okay, this you could apply for this grant or this program or this, this, that's how I got my tuition paid for. So it was through those conversations that I found out about this loan repayment program, which actually at the time wasn't helpful, because they're like, well, this would repay your loans, but that doesn't actually suit your first need, but I remembered it, so as soon as I was funded to do my research, I like locked into gear and applied to that next. I do think, like, in this age of like the kids avoiding cringe culture, and all there's like this way that people want to already know, you know, they want to have, and it's like, no, you've got to like put yourself out there and ask,

Jamila Souffrant 22:09

right? Be curious, look around, ask questions, yes,

Dr. Kemi Doll 22:13

yes, like be annoying, right? Like, tell me, I would go to people, be like, tell me, how did you get to where you are, like, how did you get that thing, and it's about the next step. I know we're gonna get to my book, I get it, but like I'm just saying, like I feel because we're in this mode, and you like sometimes when we want to ask for help, I feel like sometimes we want to ask people who are like 10 steps ahead, and I don't think those are the right people to ask all the time. Sometimes it's like you need to ask the person who just did what you're trying to do, like two years ago they were where you are now, and so that person who can give you like the nitty gritty. Like in January, I did this, and so sometimes medical students, like, will ask me, like, what do I do, and I'm like, baby, I was in medical school decades ago. Like, my, I promise you, my advice is old, like, you have got to go and find somebody who got into medical school last month, because they are gonna know, like, what's happening right now. Okay. Thank you for letting me go on that rant. No,

Jamila Souffrant 23:08

I love it. And again, I always, you know, since my obviously my kids are a big part of my why, and I think, you know, I think about them, and I'm like, I tell them all the time, be curious, can you, you know, ask questions, like, you know, don't just sit around and let things happen to you in the classroom or around you, like, and so it's one of the things I know that helped me succeed in life. Yes, and make the career change I made and the money I've made, I'm just like, I mean, there's a lot of things I want to instill in them, but I'm like, I just want you to be a problem solver, and just because someone says no, or you don't know the answer, doesn't mean you sit on your hands, and like you're done. No, you figure it out. You figure a way,

Dr. Kemi Doll 23:44

exactly. That's actually your best asset, is like your ability to problem solve, figure it out, be creative. That's like one of the best things that you can know about yourself, or hone about yourself. Anyway, let's talk about the womb in the workplace. So, yeah,

Jamila Souffrant 23:56

yeah,

Dr. Kemi Doll 23:58

so through all this figuring out, right, through all the stuff that we're working towards, my background is in gynecology. My research is around actually black women and uterine cancer, which happens to us later in life, in like the 60s, usually. However, what my research showed me is like this other issue that's going on, definitely with black women, though this impacts pretty much everybody with the uterus as well, which is like this insane differential that we have in terms of what we have to live through and suffer through and work through and pretend everything is normal, and so one of the things, there are several conditions that really create this double standard, is what I think about it, and that's heavy menstrual bleeding, like having really, really heavy periods that often cause anemia, endometriosis, that is like an extremely painful condition that generally starts in the pelvis, but can spread other places, and then, as well as fibroids, that could create all types of problems in the body, and the problem with these things is that both us, I think, both as women, but also as gynecologists. Kind of have this paradigm that's like we will do something about it when it becomes so severe you can't work or so severe you can't do your daily activities, etc. which is a problem because I think as women we are very socialized to do it anyway. We teach little girls that when a little girl has her period, what she learns is how to keep it a secret. She learns how to go to school, nobody knows, play on the playground. She learns how to basically walk through life, so nobody knows what's going on, and we hold on to it. So, what happens is that we have women in the workplace who are bleeding so much that they're iron deficient and that they're anemic and their main concern is keeping that under wraps, not recognizing that your fatigue is because you don't have enough oxygen in your blood, girl, and that does have effects on how we perform. There are a lot of statistics out there. I mean, there's something.. I mean, we think probably women with endometriosis, especially who are undertreated, are missing probably about between like 60 to 65 days of work a year, which is a lot. Also, if you don't feel comfortable telling people why, you have your coworkers being like, what is going on with her, why is she always gone? Right, I have a period too, I'm still here. Women with heavy bleeding and anemia tend not to miss work, but they tend.. there's this.. have you heard of presenteeism? I had not heard of this.

Jamila Souffrant 26:24

No, no, let's.. what is it?

Dr. Kemi Doll 26:25

Yes. Okay, so absenteeism is when you are just gone, right? So, like, absent from work, so it's very easy to measure, because it's like, okay, girl did not show up to work today. Presenteeism is when you actually are present, but you are functioning so much lower than you normally would be, because of some other condition going on. That's what happens with women who have heavy menstrual bleeding, clinically heavy menstrual bleeding, meaning they're bleeding too much, they're iron deficient or anemic, so they have cognitive decline, they have difficulty with attention, they have difficulty with detail following detail and mood instability, and it's not because they're women, it's not, it's because literally they're missing this iron and eventually red blood cells, and that creates that problem. So, presenteeism is actually a much bigger problem, and one, because we're just dealing with it, we're going to work, but two, it's actually impacting the quality of how you're showing up and how you're making decisions. So, I'm very passionate about this, because one in three black women, one in three black women with heavy periods is clinically anemic.

Jamila Souffrant 27:36

Wow,

Dr. Kemi Doll 27:36

so just think about how much you know, like, of yourself as being just left on the table because we've been normalizing this idea that we just pushed through,

Jamila Souffrant 27:46

and then obviously then it presents as you may be looking lazy or inconsistent, and just all these negative stereotypes that will come up that will impact your work.

Dr. Kemi Doll 27:57

Yes, slow,

Jamila Souffrant 27:59

right, like in high, I guess, salary or careers, where there's just like this, I guess, bigger profile of who the woman is, and kind of, yeah, speaks to maybe the education level. There's like so many also like these minimum wage jobs where it's even like the margin for missing work, yes, and not doing well. It's like, and like, is the financial lifeline for the woman, and then it impacts everything even more.

Dr. Kemi Doll 28:24

Oh my gosh, 100% It's like you're on a dime in terms of that job, right? Like, you have no wiggle room, especially when the demand is so high now, right? It's like you lose your job, somebody else will replace you tomorrow, which is crazy. And at the same time, like women, in particular, black women in particular, we are even more vulnerable in this setting because we are one kind of taught to and used to normalizing and neglecting these severe symptoms, and then sometimes when we go to the physician, when we actually go to the doctor, when you do get that Saturday appointment, or God forbid you take off work to go, your symptoms can be, can be dismissed, and you can be dismissed, and you're walking away without anything to help. So, that's a, that's another big reason I wrote this book, because I'm like, I need to call attention to these problems, but I like, have to give you tools, so that you, you can feel better, do better, and be better, because right now, my field is not really where we need to be in terms of treating black women well,

Jamila Souffrant 29:23

right. And then also to think about, like, the chronic, like, if you chronically even have been dealing and just bearing through for like decades of your life, right, or years, then it becomes part of who you think you are, like, you don't even know maybe that that is not like you, like,

Dr. Kemi Doll 29:39

correct,

Jamila Souffrant 29:40

it's not about being productive for work, you know, but just who you are yourself, like you may not even know your true self and your energy level.

Dr. Kemi Doll 29:48

Yes, it has so many layers. Yeah, because you are now.. I'm just.. this happened to me. Like, I used to think that I was just like a punk. I'm like, "Oh, I just don't have a high pain tolerance. Like, I was just like, because we. Just crazy, it was like this double stamp, so I didn't get diagnosed with my own endometriosis until I was on the table having a C-section for my first child in my mid 30s after I already had finished ob-gyn training. Why would that be? I knew about the diagnosis, I knew all the criteria, I knew it was primarily like it usually presented with pain, etc. etc. I just never thought that my periods were painful enough to qualify, so I, I had internalized this idea that, well, they're not that bad. I mean, I can still work, right? Even though, like, when I think about the stories and the things I used to do in order to function, it's like they were extreme. There were times I had to, like, crawl up the stairs, but I couldn't walk up the stairs, I was in so much pain, but it literally never occurred to me that they were painful enough that they would qualify for a diagnosis, because I had just been taught that this was normal, and I had been, I had normalized it myself for so long, and so it was just, I just figured I have normal periods like everybody else, but I'm just weak, I just can't handle them, so that was like an identity thing. I took care of a woman in training who came in for like a routine pap, and I was just asking her about her periods, and I was like, this sounds really heavy, like they sound too heavy. So we got a blood level, Jamila, her blood level was four. This test called hemoglobin, that is like critically anemic, that is like sirens, alert, alert. Like, if she was in the hospital, I would have got a page from the lab. Like, we have a critical lab value. This woman needs a blood transfusion right now. This is an emergency. She walked into clinic for a pap smear, and I remember when I called her, I was like, "Girl, you got to come back, like you are very mimic. She laughed at me. She was like, "We just have strong periods in my family, and also I have to go to work. I can't miss work. She worked as she was a grocery stalker, like she stalked groceries in the grocery store. So this is a physically demanding job, and she's doing it at like barely livable oxygen levels. If she got into a car accident, she'd be dead on the scene. She'd have no window of time for the ambulance to come. She gets one more bad period. She's in the ER, financial issues, you know, bills, etc. So I really hear you when you talk about like that, that threshold that we can live on, that is, I call it the hidden crisis, because it's just like all underneath, right? It's underneath the silencing, and it's underneath all that we're taught to say is normal, but that we live with, and who knows. I remember thinking, if this woman had a full tank of blood, she would be an Olympian. Like, we have no idea what she's capable of.

Jamila Souffrant 32:30

Wow, right? That, and that's that's really powerful. You're bearing through it, and maybe you're listening now, and you're like, you know, I don't know. And maybe we could talk about symptoms or things people can look out for in themselves, and then talk about solutions or ways to, like, help, but yeah, you're like bearing through it, and you don't even realize, like, your potential and what is possible, because you're just, you've been living at this energy low, just functioning, yeah, even though you're high functioning, you're making it work, but it's like without much gas, without much fuel. So, imagine if you had that.

Dr. Kemi Doll 33:03

Yes, imagine. Yes, we have to. I say it like we have to reset what normal is. A lot of us, just because you've lived with it, doesn't mean it's normal from a medical sense. And what frustrates me is, we have so many options of treatment. We have so many things we can offer you. People are very scared, like they don't need to be scared. There's all sorts of hormonal and non-hormonal things we can do, but you're never going to access it if you're at home thinking this is just how things are. So, yeah, I think that reset is is really important.

Jamila Souffrant 33:37

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Dr. Kemi Doll 35:13

so let's start with heavy periods. So actually, the clinical definition is just like you bleed more than you want to, like it's a real subjective, like your bleeding impacts your quality of life in some way. Again, this is why it's a terrible definition, because if you're, if your threshold is like, I mean, I'm alive, you're never gonna go in. But there was, there have been several studies where they said, okay, well, what if we look, what if we track bleeding really, really carefully in like 1000s of women, and then we look to see, like, who's anemic, who's iron deficient, and so what they did was they were able to pull out and say, okay, these are like the set of characteristics of women that basically we're going to call normal flow, because these women bleed every month, but they're not anemic, they're not, you know, oxygen, like they're fine, like they're they're not having any quality of life issues, they're good. So that's what I want to share with you. So number one is you don't have to ever change your pad or tampon more frequently than every three hours because of flow. Number two, over the course of your period, you don't use more than 21 pads or tampons. Number three, you can use like your regular overnight pad without worrying about saturating your mattress or bleeding through your clothes. Number four, you can pass clots that can be okay, but they're never larger than a quarter, about an inch. These are signs of a normal flow. So, if I'm saying this and you're like, "Girl, what are you talking about? Like, this is not me at all helpful, you should also not have more than two days of heavy bleeding in a period, you know. Most periods are seven days, they're not longer than seven days, and only two of those days are heavy. So, if your periods are 10 days and you're bleeding heavy for five, that's way too much, way too much. So, those are the, those are some of the like guard rails that you can say, wait a minute, I feel like things might be on the heavier side for me when we talk about pain with periods, periods can be painful, that they can be uncomfortable in that your uterus is contracting to get the blood out, so that's like that's okay, that should be able to be taken care of with like over the counter Tylenol, maybe occasionally you have to take some ibuprofen here and there, and that's it. And basically, you can do the activities that you had planned to do anyway. If your period is so bad that, despite the fact that you're taking like ibuprofen around the clock, you got your heating pad on, you're still on the couch, because even if you wanted to, you really couldn't do the things that you need to do. That is too, that's too painful. That's not necessary. Women who have really, really struggle with GI symptoms around their period, to the point where, like, sometimes they have to, like, be in the house, or you know, they have a lot of pain with bowel movements. That's a classic sign of endometriosis. And for anybody listening, if you're, like, very first few periods, like when you were a little little girl, your very first few were really painful, like you were just knocked out, you were throwing up stuff like that, classic sign of endometriosis, all reasons why we can improve your pain. I just want to throw that out there, because again, I don't know about you, but when I'm in a group of women and I say that, they're like, well, at least two or three, at least, are like, well, okay, that's me, and I'm like, okay, so we can, we can be better with, with whatever you want to be doing. My goal is just that you can do it easier, and that you don't have this sense that this like monthly cycle thing that we go through is like something that is supposed to take you down and out, that's not true,

Jamila Souffrant 38:41

right? So, it sounds like one of the first steps is recognizing if that's a problem for you, and if you do recognize that it's a problem for you or someone that you love, and know it's like, what then next, especially if you feel like it impacts your work.

Dr. Kemi Doll 38:55

Yes, yes, okay. So, a few things. So, I just want to acknowledge, I do think some workplaces are starting to be better about, like, menstrual leave policies, and whatever, whatever. I feel like when we think about culture, race, power, racism, etc. I think some people are going to have more easy access to be like, "I'm on menstrual leave, y'all, goodbye, than others. And I don't, I don't know that relying on that is the right way to go, especially if somebody actually needs clinical help, like medical help, not just being on leave. So, number one is a journal of your symptoms. So, like, you need to start tracking what's actually happening to you as a gynecologist. The number of times women come in and I'm trying to understand what's going on, and we can barely remember. They're like, "Well, I mean, I guess I kind of been bleeding a lot, and it's kind of annoying. It's all of this kind of like vague stuff, that's another reason why it's hard for you to get help. So we really need to start tracking symptoms, and I try to encourage people just for three months, for three cycles, just actually track what's going on with you, so you have your baseline. If your baseline is abnormal, then you already have the data and. You don't have to spend half your visit trying to explain to your gynecologist what's going on, is there? If everything is normal, you have now a record of normal, so if something changes, you don't have to wonder, you're like, "Oh no, this is not what was happening last January, let me go in right now. So that's number one. Number two is to seek out and go ahead and make that appointment with the gynecologist, and I know we don't have a great reputation all the time, which is why I wrote the book. Like, the book is filled with stories of people not really being treated well, actually, because I wanted to be honest about this. Is what happens a lot of times when black women come in. However, when you're armed with information, when you actually know what's going on, and you understand like the kinds of questions we're going to ask, and why it really demystifies how we figure out what your diagnosis is, and how we treat you. So, I guess one thing is going to be like to get my book, because you will be super informed about how to go in. And then the third thing is, don't go by yourself, don't go by yourself. It's very vulnerable, it's very vulnerable to seek gynecologic care. There's all these stereotypes that are running around. Everybody thinks that everything that's happening to them is related to some person they should have never messed around with. I have 72 year old women coming in, like, I know it was Larry, and I'm like, it was not Larry, you know? I'm saying, like, this doesn't have anything to do with what happened to you when you were 42 like, but like that. But my point is that we make a lot of meaning about what's happening down there, right, and we make a lot of assumptions. It's this stress, or I ate this wrong, or whatever. So, there can be a lot of self-blame and judgment, and I need for us to divest from that by being more open with at least one girlfriend, who I call a womb sister, who can come with you and be like, girl, I don't care what you say in this room, but like, I'm here to back you up, I'm here to listen, I'm here to hold, like, you know, to hold you accountable to whatever the plan is going to be, and also just somebody there, so you're not alone. When I have to get undressed and I'm in the stirrups, all I think about is getting the hell out of there, you know, and even to the point at which I might not actually be fully clear about all the things I need, because I want to go so bad, so I really don't think we should go alone.

Jamila Souffrant 42:09

I love those tips, and because it's so important to open up, and I think for so many people, like being vulnerable, even like when you talked about looking into resources, being vulnerable to, like, say, 'Oh, I need help, I don't understand this thing, and it's okay, because they're, you know, most people want to help, or will help if they can. And so I just think it's such a.. it's hard. I know it's hard, especially, you know, depending how you grow up or your culture, but it's okay to be vulnerable and to ask questions, and it just will put you just in a better place and have more support and have this what you need

Dr. Kemi Doll 42:45

100% and ultimately like when you shift your norm this has to I'm sure this resonates in your world too it's like a lifelong impact like when you decide at some point oh I'm not doing this anymore or I'm not I think actually black women are very good about this. Like, once we're like, you know, we, I'm not doing this anymore, we really are done. I feel like, in a lot of ways, we're like, you're not going to disrespect me at Starbucks, you're not going to follow me around the store. Like, there are ways in which we have decided we're not dealing with this nonsense anymore. We're not dealing with Chad at work and his nonsense anymore. And this is just an area where I want us to have that energy. It's like, you know, what I'm not dealing with this anymore. I'm not suffering like this anymore. I'm not, you know, I.. I'm gonna have good womb health. Like, I'm not gonna pretend that these organs don't exist just because I'm not pregnant. I refuse, and I want that for us, because for so many.. I mean, when 80% of black women have fibroids.. like, when these things are so common, that means that there's a lot of us who actually need to reset that norm, just so we can have full, like, full expression of our lives to go run off and do whatever it is you want to do, girl,

Jamila Souffrant 43:48

right? So you gave great tips on how we can advocate and figure out what's going on, but what is the approach to the people around you in positions of power, so your boss, your coworkers may be on getting the necessary support you need to help you through these situations, whether that is, you know, the pain you're in and needing to take off work, or if your workplace doesn't even can accommodate, right, like so many workplaces don't have the, would you say, the menstrual leave, or

Dr. Kemi Doll 44:19

yeah, menstrual leave is like a new, like snappy thing that workplaces have, which, yeah, and I get why, because, like, I don't want women taking vacation, you know, because they, they need to be home for their period, it's just like crazy to me. I think there's a few things, like, I think one, I think we can normalize that, like, womb health is a thing, it does exist, so, like, I know there are workplaces that, you know, they do different focal things about, you know, I don't know, breast cancer awareness, etc. etc. Like, why can't womb health be one of those things? I think number two, basics of having like supplies in the bathrooms for people who might need them, so they don't have to think about having to go home in the middle of the day because your period starts or something like that. These are basic things. If you're the employer or the person in power, that just should not be a question. Everybody having obviously ready access to a bathroom, I mean, I know that that is like a legal thing, but you know what? Does that mean what kind of bathroom is it? Is it a place where people can really take care of themselves or not? On the side of gynecologists, I talk a lot about, like, ask people what their workplace is like and what accommodations they need from a physician's office, because we can do more of saying, listen, this person needs a comp, they, the workplace doesn't have to know why, they don't have to know what it is, but we can also say this person needs to work from home these days, or this person, you know, needs this kind of accommodation, where they are taking enough breaks, you know, to be able to do whatever they need to do for their womb health, like I think that's another place where we can step up a little bit more, because we see it in other fields, but you don't see it as much as in gynecology, especially if workplaces aren't open to the conversation. So, I think that's another thing that's important.

Jamila Souffrant 45:53

No, I was gonna say, but you just finding someone, a gynecologist, who can, who will advocate and listen to you is important too. We talked a little bit about just maybe feeling dismissed, and or just horror stories, right? And where you don't feel you don't know what to say, or the end of the doctor who you hope will know better than you tells you it's fine.

Dr. Kemi Doll 46:14

Yeah, I'm talking a lot to my colleagues, so that I just do want to make it clear that I don't think this is an individual solution, but I also, I talk in the book about, like, myths, vocabulary, and power, and, like, how they can shift these clinical interactions hugely. So, there are a few ways that you can explain what's going on with you that basically they kind of hijack the gynecologist's mind, because they help us start to think about how we learn about severity of disease, so for example, people will say things like, well, my bleeding is really heavy, but you know, I make it through. Well, that sounds to us like, oh, okay, she's not having severe symptoms because she's doing fine, like, right, she's making it through. So, instead, we need to say things like, in order for me to be at work a full day when I'm on my cycle, this is what I have to do. These are the commendations I have to make. I have to wear four pads and an adult diaper. Now we're having a different conversation. So one of the things, one of the ways is that the way you express yourself, which is listed in the book, the way you express yourself is going to actually be keyed into how we think about severity, because now I'm going, oh, these are major adaptations just to do regular daily activities that put you on the severe scale right away, and you have to be specific. You can't hide what it is, right? We have to be honest. I'm layering my under my sheets, I put trash bags under my sheets, so my mattress doesn't get stained. You got to actually say that. Number two is another way you can talk about, especially if something's different, and you're not sure what's going on. This is a significant change from my baseline. This is not my normal. That is another phrase that locks us in, because when something has changed from baseline from normal, we have to go investigate it to figure out what is the change. So, there are several phrases like that that can help you have a better interaction where you're immediately getting into what's going on with me, combined with that journal of symptoms, so you're not spending the whole visit right just trying to detail what's been going on. So all of those things are helpful. There are more in the book, but that's one thing. The second thing I talked about already, which is like bring somebody else with you, and then the third thing is, how do you find a good provider? And I kind of noticed that I feel like the way that, not, I mean, physicians, we don't find providers like we don't find doctors for ourselves the way that I see people do online, like we're not following, not looking for somebody with high follower accounts, we are not reading reviews, we're not going on Google starts, like we don't do any of that. It is all about the network, so what do I mean by that? What I mean is that we're always leveraging whoever we know in whatever area and asking them the low, like who locally do you know who is good at this thing that I need taken care of. So, for example, people ask me all the time, like I need a gynecologist to take care of my girlfriend's fibroids in Boca Raton, Florida. I have never been to Boca Raton, Florida, but why can I help that person? Is because what I will do is I will say, okay, first of all, did I go to school with anybody? Do I know anybody in Florida at all? If I don't, that's cool. Atlanta is getting a phone call, right? Like, I know somebody in Atlanta. Hi, I have a friend who's in Boca Raton, Florida. Who do you know down there specifically? There, her issue is fibroids, specifically, not generically. She's probably going to need surgery. Who's the best person, or do you know anybody who's down there? So we go like from A to B to C until we get a local recommendation from somebody who's in that area that can tell you this person is good. What does that mean for somebody who's not a physician?

Dr. Kemi Doll 49:42

It means one, if you got one doctor you trust, even just one, your PCP, whoever, one person, you activate them in that same way. Hi, I am looking for a gynecologist, and my specific issue is that I think my periods are too painful. I need you to find somebody who's really good with periods. Pain for me, that person now can help you use their local network. Who do you go see? Who do you send your sisters to? Same, so that is how we follow along. And if you don't have even one doctor you trust, that's when you start to use your own network, right? Like, okay, who knows somebody who's seen somebody. And so I like, we really get very local, and it's really not about like what you see online, so that's a way to find a better provider who you feel like is going to be really listened to you, because they've already established like their local chops.

Jamila Souffrant 50:31

Yeah, and I mean that's how I found my current OB-GYN is IXO group of women, you know, in a chat, like, "Hey, who are you going to? I'm looking for a person.

Dr. Kemi Doll 50:41

Yeah,

Jamila Souffrant 50:42

so I learned actually a lot, and loved our conversation. And, but before, like, we close out, I do want to kind of just go back to more of, like, the personal side, and how you are managing. I feel like it's still, you still seem to, like, do a lot. You wrote a book, which is not an easy thing to do while you know, working, so can you talk a little bit about managing all those hats, and then also you said even though it helped you get through, like the resilience and pushing and not giving up and being hyper independent, how you're able to not use that or not have that hinder you moving forward to know when to relax, know when to rest.

Dr. Kemi Doll 51:20

Yes, yes, I learned to use it as like a beautiful tool and skill that I have, instead of like as the only engine, right, in my life. I think that's what Howard say it. I also talk about this in the book. I think, so it really began with, for me, I had to switch from the threshold of me saying yes and doing things used to be, can you do this, Kemi? And the answer would be, yes, I can do it. And I had to switch to that, because I'm simply, I'm too capable. Of course, I can do a lot of things. A lot of us can do a lot of things. It's not can, right? It's, do I actually want to, and if I want to, why, and for what purpose. So, there was a time where I was also running a nonprofit, on top of everything you just said, I was also still operating in the OR every week, like there was a time where it was worse than this girl, and I really had to say, okay, I have to pull back to the things that are giving me life, and the things where I feel like I am still building and moving, there's like momentum there. So, right now, I'm a professor at the School of medicine and schools of public health, and I run a research center that I built, and so I'm still like, my science game is still fully on, because I love doing that, and I really enjoy it. That's actually part time, so I'm 70% on paper right at my university. And then I started a coaching company in 2019 I started off like one off, one on one peer coaching other women of color in academic medicine and public health, just to help them get their like lives together. Frankly, because I wanted a little extra spending money. I mean, I was like I was paying off my loans, I mean I had some low repayment, but I was also doing that. I have a spouse, I got two kids, we got all the stuff right, we're paying for a nanny, all that stuff. And I also found out, I forgot, I found out I was making 30% less than my colleagues, girl, right? So I was fighting that, I had, I had already had a plan, so I was, where I was working on my plan to like fight that and get pay equity, but I also remember thinking, like, I don't want y'all in charge of how much money is in my bank, I don't like this idea that, like, you are the only arbiters of how much money is in my bank, so I started this coaching company, also like just to have something on the side, and it blew up. So now I run that company, and we have like eight coaches, four national programs, and that's like the other 30% of my time, but that just gives me so much more flexibility to do things like hire an operations manager and spend two years writing a book, you know, and so my what I say is like, why I'm, how am I doing all these things? I'm not a workaholic, like, I, for you know, I do the things I coach around are our efficiency and productivity and boundaries and all of that stuff, so I use everything I teach, I really focus my energy and stuff I care about a lot, so I am, I have a lot of energy, and I'm efficient, because what I want to be doing, you know, I took email off my phone, and when I'm home, I'm home, when I'm with my kids, I'm with my kids, so I try to think about using my energy and my time where it's like most valuable and the things I most want to do, and recognizing that I can do a lot of things, but I should only spend time doing the things I really want to do that are that are impactful for me and for others.

Jamila Souffrant 54:32

Wow, I love, like, practical, just like specific tips, and you saying, okay, like, you took email off your phone, I

Dr. Kemi Doll 54:38

took email off my phone,

Jamila Souffrant 54:39

right? Even, like, I just think, for some, so many people, like, you know, you can, you, you are in charge, you use your free will, so

Dr. Kemi Doll 54:46

yes,

Jamila Souffrant 54:47

it's social media on your phone, I mean, I'm guilty, I just like scrolling sometimes, you know, so

Dr. Kemi Doll 54:51

yes, I have social media on my phone, but not email,

Jamila Souffrant 54:55

someone might say, like, if you find something to be a hindrance, then. It, you, you, you know, you can like remove it, like, unless you know, for the most part, it could be removed, you can stop, you can break the cycle, right.

Dr. Kemi Doll 55:08

Well, and I think we like to talk about it like we have no power, because then we don't have to examine what's underneath it, right? Because the thing is, you know that you can take email off your phone, but you're worried about what about x, what about what this person will think, what about y, and like, I think part of that is like, well, if do you trust the caliber of your work, do you trust, like, I remember, I mean, I was an odd duck, don't get me wrong, like, my colleagues were like, what the hell, like, what is like, you're supposed to be available at all times, this is the culture that everybody is available at all times, and I just remember thinking, if I can demonstrate that my work is solid, right, and like excellent, and I'm meeting all the metrics that I'm supposed to be meeting, then I don't need to be responding to an email at 9pm unless that is a stated metric, then that's not what I need to be doing, and there's a place I think that we have to acknowledge, there's a place where you have to bet on yourself a little bit, and you have to have that faith, right, that's like I'm not going to live this way, and I'm going to show you that I can do my work anyway, and that I can succeed in this way anyway, and if you're an environment that says, well, your work is great, but we want all of your time and energy, isn't that a great sign, like, okay, I need to leave, because that means that no matter how good your work is, that environment is predicated on sucking you dry in other ways. So that's how I think about it too, is like it's it's the thing that you have to say, okay, I do have free will over this thing, but then also, am I ready to examine whatever meaning I'm making over always being available, or always saying yes or always whatever, because you got to deal with that too, and thus therapy, which we have not brought up, but let's like, okay, therapy for the win, therapy for everybody.

Jamila Souffrant 56:48

Yes. Oh my gosh, Dr. Kemi, this was so insightful. Can you please tell everyone more about the book, where they can get it, and then any other places they can connect and with you and follow your work?

Dr. Kemi Doll 57:00

Yes, my book is called A Terrible Strength: The Hidden Crisis of the Black Womb and Your Survival Guide to Healing. This book is for all black women, and it's for everyone who loves a black woman. This book will have you reexamine how you think about yourself and your body, but it's also just very interesting, entertaining, and very educational. So, I'm really hopeful that you will pick it up and give it a try. You can find me on all places that my government name, Kemi Dole, K E M I D O L L. I'm on Instagram. My Tick Tock is Dr. Kemi Dole. I think I'm never on there, my instance. I don't mess with my Tick Tock. I'm like, I'm too old for this, but I'm on there. And then my website is Kemi dole.com where you can find my book. Also, any place you buy books, Amazon, etc. it's on all those places, and in bookstores as well. And I'm also on LinkedIn, though I'm pretty bad about messages on there. So, thank you for listening. And just know that all of you just deserve, you deserve good womb health, and you deserve like a happy and healthy and fully thriving life. And I wrote this book to get all of the work that I do on the academic side out into the actual real world. So, thank you for having me.

Jamila Souffrant 58:05

Love it. Thank you so much. And we'll link all of those things you mentioned in the show notes. Thank you. All right, take care. Thank you. Don't forget, you can get the episode show notes for this episode by going to Journey to launch.com or click the description of wherever you're listening to this, and you can still grab your Jumpstart guide for free to help you on your journey to financial freedom by going to Journey to launch.com/jumpstart if you want to support me and the podcast, and love the free content and information that you get here. Here are four ways that you can support me in the show: one, make sure you're subscribed to the podcast wherever you listen, whether that's Apple Podcasts, that purple app on your phone, your Android device, YouTube, Spotify, wherever it is that you happen to listen, just subscribe, so you are not missing an episode. And if you're happening to listen to this in Apple Podcasts, rate, review, and subscribe there. I appreciate and read every single review number two, follow me on my social media accounts. I'm at Journey to Launch on Facebook, Instagram, and Twitter, and I love, love, love interacting with journeyers there. Three, support and check out the sponsors of this show if you hear something that interests you. Sponsors are the main ways we keep the podcast lights on here, so show them some love for supporting your girl. Four, and last but not least, share this episode, this podcast with a friend or family member or coworker, so that we can spread the message of Journey to Launch. All right, that's it until next week. Keep on journeying, journeyers,

Unknown Speaker 59:35

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Transcribed by https://otter.ai