EP 59: Choosing Yourself

Episode 59 of the Hope4Med podcast features Dr. Mamta Kumar, a board-certified internal medicine and integrative medicine physician. She is a mom, a wife, a real estate investor, and the CEO of Tera Firm Investments. Dr. Kumar shares her story of juggling being a mother of a special needs child and managing her personal health as a full-time physician. She discusses how she knew it was time to prioritize her family and her own needs, and how she was able to find time and financial freedom along the way.

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[00:00:00] Dr. JB: Welcome to Hope4Med.

[00:00:05] Alright, hi everyone. Welcome back to the Hope4Med podcast. I am your host, Dr. JB, and today’s featured guest is Dr. Mamta Kumar. Dr. Kumar is a board certified internal medicine and integrative medicine physician. She’s a mom and a wife. She also is owner and CEO of Terrafirm Investments and a real estate investor. Welcome to the show.

[00:00:30] Dr. Kumar: Well Dr. JB, thank you for having me.

[00:00:33] Dr. JB: So I am excited to learn about your story. So let’s go ahead and start moving beginning, share with my listener your origin story.

[00:00:43] Dr. Kumar: Oh, well, yeah, so my story, well, I was born and raised in India and went to the medical college over there, in one of the top 10 medical colleges and you know, got married, and my husband was here, he was IT professional. So came here to join him, had full intention to go back to my own country, but you know, with time took USMLE exams and stuff, and finally got into the residency, did internal medicine residency, and then I graduated from that in 2012.

[00:01:12] After that, I had two girls which were high risk. After the high risk pregnancy complications, the youngest one was born at 24 weeks and I have been trying– like two years after residency– so for the last eight years, I’ve been just trying to juggle, you know, taking care of her, my own work, and the whole family and everything. Yeah.

[00:01:36] Dr. JB: And how has that juggle been for you?

[00:01:39] Dr. Kumar: Oh, very, very hard. Almost impossible as you would assume, because I really think as physicians, we’re ingrained to take care of others and that is just so ingrained in us so that we don’t even think about, like, we need to slow down to take care of ourselves as well. So I really think it was very hard often being in the bed rest, you know, having that baby who was at high risk in our medical system, in our healthcare system, it’s not as forgiving, I guess for them, we are just physicians and we need to get back to work, so I remember leaving my baby in NICU and going back to work, which was so traumatic.

[00:02:19] And I didn’t know what was going on with me about time, but she stayed in NICU pretty close to five months, and among that five month period, three months, I was back to work. And after that I was like, well, something is wrong here, something is just not making sense. I’m a physician, I see the patients like this or the moms, and I would tell them to prioritize their own health, take care of themselves and their kiddos and do whatever is needed for that, and here I was compromising my own health, my daughter and my family safety, and then going back to work and leaving that baby. Anyone in their sane mind, even a physician, we know that we want moms to be with a kiddo, in NICU. But here I was like, just because I was a physician, I was not given a chance to be a mom. So after that, things definitely changed in my mind that how I viewed medicine, parenting and things like that, and after that I had switched, like I was fresh internal medicine graduate at that time, I was working full time as a primary care physician. Then I switched to urgent care, switched to PRN, then did nocturnist, full-time nocturnist job, and then finally, before I left my last job, I was part-time daytime hospitalist. So I had switched to jobs like every one and a half years and was just trying to find that job and so that I could balance it all, but there was just no balance because I don’t think it was possible.

[00:03:49] Dr. JB: So walk me through what you were thinking about when you made all these switches and why you thought that with each switch, things would be better, you’d be able to better balance. Can you explain that a little bit more?

[00:04:01] Dr. Kumar: So in my mind, I think what was going on was, I went to medical college when I was 20 and I left my home. I have no physician in my family. I was a first physician. I was first female who had done this much education, so there was no one there to guide me or connect with me. All my friends there were the doctors, we are very type a personalities who want to achieve this and that. So when I have this 24 week baby who was having complications after complications, for me, it was still a struggle that maybe if I push hard enough, you know, I’ll be okay and then I can go through this.

[00:04:43] And I almost became a therapist for her, like as a doctor, just like when we see the patients, when you commend them to have this kind of therapy, that kind of therapy, for this many hours, so I would be working and I would come back home. I was just not able to switch to mom hat. I was still in the fixing mode and I would be like, oh, PT suggested to do this many exercises well this many times, so I’m going to go ahead and do this. And then the OT suggested this. So my days with my daughter went like that. And after like a year and half, I realized that there was something was just missing. I was not treating her like my daughter, but I was treating her like a doctor would to her patients. So that was something which was eyeopening for me. And I was like, you know what? Then in that case, what do I do to become a mom? Somebody who can support her. And then it realized, well, I didn’t have any support system as well at that time.

[00:05:39] And I had switched places. You know, as physicians, we talk so much about other word. I was just not able to talk to anyone about this. I didn’t know any other mom who would be going through this, like living a different life behind, you know, A successful physician job. Everybody was like, oh my God, you’re doing such a great job. You’re able to do both, but how hard it was for me to be able to do both jobs. That’s why I was trying to kind of just switch the jobs because each time I would make a goal that, oh, she would be doing way better in one year, and then I’ll be able to go back to work full-time because I had known nothing in my life other than a medicine. So my goal was to keep up with my peers. And then go back to work, when the time is right.

[00:06:23] So that was, and then until like two years ago, because now she is now she’s seven, but at that time she was five, but she was still acquiring so much that I was like, you know what? Bay’s no way I can balance it all. I have to just make a choice. Is she my priority or my going back to work? And I think things became way easier when I just decided about, well, it’s okay to be her mom first and do whatever is needed to be done for her benefit and be with her because that’s what I would tell to my patients anyways, or any good pediatrician will tell their patients. I know it was a very hard call, but I think that’s what was going on in my mind at that time.

[00:07:05] Dr. JB: So, just to clarify with each of these switches, so you said when you graduated from, from internal medicine residency, you want to work in what setting, the hospital?

[00:07:16] Dr. Kumar: It was outpatient setting. Outpatient setting full-time.

[00:07:20] Dr. JB: Okay. And that was what, Monday to Friday, 40 hours a week?

[00:07:26] Dr. Kumar: Yeah.

[00:07:27] Dr. JB: And then you transitioned from outpatient to what next?

[00:07:31] Dr. Kumar: Well, in the same, I, I have hard time negotiating that, but finally I was able to negotiate that I’ll be doing certain shifts because my daughter was acquiring too many, she had too many appointments and there was like too much therapies to keep up with. And I had started to feel sick too at that time, I was diagnosed with autoimmune illness, and I was not surprised because I was just trying to push through so much. So I cut down my shifts at the same workplace, but they didn’t want to take away me from a PCP status, so everybody was still looking for me because the patients, they were like, I think at that time, 2000 to 4,000, I don’t remember the exact number. But they were assigned to me as a primary care physician and they will just randomly, sometimes they will just bump into me when I was doing my cut down general shifts.

[00:08:21] They’re like, oh, now I see you are my primary care physician. I have been looking for you for a year or so or something like that. So that was very traumatic for me because I was like, you know what? I do not want you to be looking for me because there’s no way I’m going to be going back to work full-time. So I fought hard for that. And eventually they’ll let me go off the PCP status would re hard time if the same institution and this switch, when we do a different location, which was an urgent care in that I would just choose the shifts which I could do to depending upon my daughter’s schedule.

[00:08:57] Dr. JB: But then you transfered urgent care to hospitalist?

[00:09:01] Dr. Kumar: Nighttime hospitalist, because my daughter was still requiring quite a bit of, she had feeding issues, she would just not eat so there was no way I could just leave her in hands of others. So I thought maybe the nocturnal, I’ll be gone in the nighttime and the daytime. It wasn’t, I didn’t even, I don’t know why and how I came up with this. I don’t think my sleep was so important. And I was like, you know what, I’ll be at home. And at least, even if I will have help, I’ll be here. She’s playing too hard. If she was hiring buzz, then, and I had like a feeding program, which was putting intensive. And I knew about time that it’s not going to be one- or two-month deal. It was going to be months or years deal so that’s what pushed me towards choosing that shift and the role.

[00:09:51] Dr. JB: And how did that work out?

[00:09:52] Dr. Kumar: Oh my gosh. Like after I was already diagnosed with autoimmune illness at that time within four months, my body just started to give up. I just could not. But, I have six months’ notice period. So within four months I realized that it was time to go ahead and get the notice. I didn’t care if I was going to find a job or not about time, or I will find a job because I, my place, like where we stay is a very complicated place. So I was like, you know what? I don’t care if I don’t get a job or not, but I need to go in and put this resignation in. So I’d put the designation in six months. I still continued to work with six more months before I left there.

[00:10:32] Dr. JB: Did you say 6 months resignation? So it’s not like a two week thing, right?

[00:10:39] Dr. Kumar: For the nocturnist, are we made it six months. I was like, gosh, like are we slaves, like aren’t we humans, like we have a choice? Yeah.

[00:10:48] Dr. JB: Wow. And then after the nocturnal hospitalist’s job, what happened next?

[00:10:55] Dr. Kumar: So I, I had no job when I left, but I felt free. It took my time off, focus on my daughter. My goal was again, like in six months to get her where I wanted her to be, so that she’s going to be independent and I can go back to work. So I know I was still chasing that goal by that time. So I think in. I signed a contract in four months and it started to work again in seven or eight months after eight months gap, I was back working as a part-time day hospitalist where I would work seven days a month. So it was 80 hours per week and three weeks off. So I’ll work, you know what? That’ll give me enough time to focus on the other things, everything and my own health too. So that was the last setting I was in.

[00:11:39] Dr. JB: You mentioned earlier that when you were working as a physician, you felt like you were compromising not only your, your, your care to your daughter who was in the NICU and you had to leave her there for two months in the NICU to go back to work, but also your own health too. So, can we explore that a little bit more, what you meant by that?

[00:12:02] Dr. Kumar: Oh, well, so when I was working as a nocturnal. I think to make it a little more clearer and easier the audience, I think it’s good to know like where my daughter was. She had a G-tube and we used to feed her through the G tube and you, most of the feedings would go into nighttime because she was not able to tolerate the daytime feedings. And we were trying to keep her hungry so that she would be hungry and to eat and explore more foods. So that was a plan, which we were trying to do. So that meant even in my last, like nocturnist, full-time nocturnist job, so one week while I was gone, my husband will do that, like, make sure that she was getting to feedings in the middle of the night and somehow she would have pain or something and she would stay up.

[00:12:43] So whoever was giving the feeding had to do, like set up timer which would go on twenty minutes periods until 2:00 AM so that we will go and do the bolus feeding in the nighttime. So when I was working for a week, she would be doing that. And when I was back at home, I would be working intensively with her in the daytime, where she’ll cry. She doesn’t want to eat, so that was like a lot of emotions to take, but I will write down away with all the help of all the therapists are like, you want to just step it out and we’ll just give her some time and then let her be home in the but in the nighttime, we had to do the same drill. So basically I was up in the daytime, was up in the nighttime, so there was no recovery time for me. It was not a job where– so I was stressed out the job as physicians as we always are, at home it was the same because I just couldn’t let it go. I don’t know if I should’ve let it go or I could’ve let it go, but it was just becoming so hard to just find that time to relax, even get enough sleep. Yeah.

[00:13:50] Dr. JB: And then you yourself had an auto-immune disorder.

[00:13:53] Dr. Kumar: Mhmm. So I was dealing with the fatigue and the brain fog from lack of sleep you know I was put on something for sleep at the night time by my doctor at that time, I was given stimulants in the morning time so my heart would be racing then my whole day, I was like, you know what? What game I’m trying to play with my life and my own health, this just doesn’t make any sense. Yeah.

[00:14:20] Dr. JB: And so what– and you were diagnosed the auto-immune disorder after your second child was born?

[00:14:26] Dr. Kumar: Yep. Same year after she was born, so, yeah.

[00:14:30] Dr. JB: Wow. But you are no longer practicing actively in the hospital. So tell me about that transition. What, what made you decide to, completely pull, pull back?

[00:14:43] Dr. Kumar: So, I think in my last job, when I was working for a week 80 hours per week, and I have three weeks far, I started a side gig where I started to buy and sell vacant land. So that was something which I was like, you know what, with my state, I don’t think I can ever work full time. And I stayed part-time because I loved medicine, because that’s what I thought about time. And then I wanted to some other investments, real estate investments, on the side to keep up the income so that we will, you know, my goal was nothing else other than to supplement the income, to match my regular position income, but when pandemic hit, my daughter at that time was requiring pretty close to 46 hours of therapy, and she was going to a specialized center and here I was dealing with autoimmune illness.

[00:15:31] So just over the weekend, almost two years ago, like today’s February 16, I think it was March 18th in 2020, where my shift was about to begin, and then this whole drama was going on about how my hospital was preparing for the COVID patients. They have the same mask, w you will be given one N 95 mask that you would be waiting for five days of floating shift, and then you return it. They not enough PPE, there are not much protocols going on. So with my own auto-immune illness, I was at high risk of COVID complications and here my daughter was going to go to, so I didn’t think it made any sense for our family to just get affected by this. So I and my husband decided that it would be best for me to just stay at home.

[00:16:17] So I put in a leave of absence, medical leave application, even at that time in the hospital, they have, they had no rules. They were like, well, you can come back to work, and once the patient is confirmed with the COVID, then we’ll take the patients away from you. And I was like, well, that will be too late because I have something affecting my lungs. I was dealing with respiratory infections every three months anyways at my baseline, I was taking steroid. So it was taking on the politics. I was like, you know what? This is not acceptable to me. So I had to reach out to the CEO of a big organization that, and they were like, yeah, I totally agree, if I were you, to stay at home. So just decided to stay at home at that time.

[00:16:57] Dr. JB: And I know that you love medicine. So how was that decision? What were the emotions around that, that decision for you?

[00:17:03] Dr. Kumar: Yeah, that is a very interesting question because I thought medicine was the only thing which I loved way before I had family. And I have never questioned that I love medicine and I will always be doing medicine. That was something which my 20 year old had decided. And now I was almost like 39 at that time. I was like, you know what, it’ll be so painful and probably it’ll be so hard, but just after two days of turmoil, I think by Monday I was like back in love with my life because there was no more stress and there was no more dilemma as I totally before I was always trying to juggle and find that balance where. How could I continue to practice medicine because I love it so much and there’s nothing else I know, but just over the weekend, I just felt free somehow. I was like, you know what, now I do not have to go back and look for another job to see which job will fit my need the best. And I can just be a mom and I can just be me and our family can just, you know, so it was very freeing. It was very, very freeing. I thought it would be traumatic. I never imagined I would have any other response other than just feeling so torn. But honestly, I have felt that being all this long that I was just trying to find that balance. So I just felt relieved. Somehow I felt very calm at peace. It was like, wow. I’m like, yeah. I felt like freedom.

[00:18:31] Dr. JB: Okay, You know, it sounds to me like you are trying, you’re trying so hard, right, by changing from one job to another job and, and, and trying to juggle and do it all. And, especially with having a special needs child that needs so much of your time and your attention and your daughter has all these different like appointments and specialists she had to see. And then you also mentioned that you didn’t have a lot of support. So do you like, do you have family or anything around you or anybody around you that you could lean on during, during this time?

[00:19:10] Dr. Kumar: No, since we are immigrants and like we have no family members same country. There was sometimes where our parents were able to was that for the short period, but usually I just, I’ll be usually until two years ago before the pandemic, we used to have a live in nanny for my daughter, because she was just too much for me to be able to take care of her by alone by myself. And we always had maybe a therapist at home, OT, PT, speech. So basically they were my always the support system and they would just come at home with home. you know, I could just to strategize plan and do things which was best for our family and her.

[00:19:49] Dr. JB: And so, and then you also mentioned that you got into buying land, so tell me a little bit what made you decide land as the vehicle to operate out of?

[00:20:00] Dr. Kumar: So I was always looking for something which I could do virtually, because I was dealing with automated lives. I had fatigue going on and I wanted that something which I could do virtually on my own terms, in my own free time, I wanted that flexibly. So I started this virtual land business. After one of our family friends, he was doing it and he was successful at that at that time, he was profiting from that. So I was like I don’t know anything else to do, but this is something which I could do in between my daughter when she’s playing with her therapist or getting therapy or between appointments or in the middle of the night or whenever I want to, because it was, this whole model is virtual. You can do it from anywhere. All you need is a laptop and have that ability to analyze the deals and do the marketing to get the land and then market and sell it. So I started that way because I had an example right in front of uh, you know, as told us, or this is how so we started just to try again, to see if it’s, this is even possible for us, like I, and my husband at that time. So yeah, that’s how we started because I was looking for something which will just give me time freedom and can be done virtually, I don’t have to like travel and things like that. So that’s how we got the feed feet wet.

[00:21:15] Dr. JB: So is it scary to buy a land if you don’t actually see it? You know walk it?

[00:21:20] Dr. Kumar: You know, I really, I really think with a, with a house, I think definitely anybody would be very scared because there’s so many things which could be wrong.

[00:21:27] But with a vacant land, if you do enough research, then there’s way limited things which could be wrong. Well, there’s no structure in there which needs to be appraised or stuff like that. There’s going to be no termites. There’s going to be no flooring, roof issues. So the vacant land is a vacant land. So I really think the way that is valued is way different. You need those skills, but you know, the way that is valued is way different than the houses. So I really thought, even though we were thinking about doing some house investments, which we did last year, but land was something I was like, you know what? All you need is to spend time to just analyze the area, know the neighborhood and things like that and then once you do enough research and know the fine, tiny details on that, I really think I felt comfortable.

[00:22:14] Dr. JB: And that was able to supplement your income?

[00:22:19] Dr. Kumar: Yeah. Yeah. Till then I think even when I was working as a part-time hospitalist, it was able to supplement the income and bring it to where I wanted it to be as a full-time hospitalist salary. But in the pandemic, when I pushed through more and I did more and expanded, hired the team, built little more structure in that then we had definitely able to do way more than what physician salary would have been.

[00:22:42] So I really think it’s definitely replace that for me, and it still gives me the freedom where I do the business when my daughter is at school and then I go and pick her out. Then after that, depending upon it, she has hope of, one of them are getting it because there’s so much flexibility in this. Especially since I have the team, I can tell them what to do and things like that and make the major decisions in my freedom in my time. So, yeah.

[00:23:06] Dr. JB: So you mentioned freedom, I think we were talking a little bit earlier, you said there is another freedom that you’ve experienced. Can you explain a little bit more about what that, what you meant by that? You said about your finances and freedom.

[00:23:22] Dr. Kumar: Yeah, so definitely what I was looking for, not when honestly, financial freedom was not the goal at that time. I want them to lead them off. And I was looking for freedom of place. I wanted to do something which would produce income from anywhere. Like in-between my daughter’s appointment. If I’m waiting there, then there, I wanted to be able to just do that or if I’m travel. And then freedom of time I wanted, I didn’t want to get stuck with an eight to five job, I wanted to do things when I have time, which was around my family and my daughter’s schedule. And then financial freedom was not the goal. I just wanted to supplement by financial freedom was also something which I achieved during the pandemic the real estate, the land and the other investment, which I made last year.

[00:24:09] Dr. JB: What do you mean by financial freedom? What exactly do you mean by that?

[00:24:13] Dr. Kumar: Oh, financial freedom usually means like, and that number can be different like everybody, that means that you’re going to have enough passive income coming in each month that you do not need to be. We just pretty much equal to your W2 job and covers all the expenses that you do not have to be employed if you don’t want to. So, so that, that was the goal at that time for me.

[00:24:37] Dr. JB: That’s a nice place to be.

[00:24:40] Dr. Kumar: Yeah. Yeah, this was definitely freeing, and I’m like, gosh, like, I don’t have to juggle around anymore. It’s hard to find this and that, like what up a job. And as I was telling you, I was like, like I know it was like in a month is going to be almost two years. I’m out of medicine, but I’m like, who wants to like, do I want to truly do I want to go back to a W2 job? probably not. I still love medicine, but that doesn’t mean I wouldn’t compromise my own needs and priorities. Again, like I did before. I’m not going to do that anymore.

[00:25:14] Dr. JB: So what does the future look like for you?

[00:25:16] Dr. Kumar: Well, he’s just wanting to continue to feel this freedom. How about five household fleet? Freedom of time and place. And I do know my daughter is still going to continue to need support because OT, I was like, you know what? I want her to turn into a normal at one point and I want to go back to my life. Well, she is who she is and I love her. She’s a lovely little girl is not a toddler anymore, but she’s still wanting me some support. And I like my lifestyle. Like this, where I have this freedom now, I definitely want to continue to grow in the real estate, so I do have quite a bit of plans on that arena which we’ll see how that will go for this year.

[00:25:55] Acquiring more properties maybe giving others an opportunity to have a passive income, So maybe starting a debt fund or something like that for others to invest and grow with me. You, so that’s something which is I’m kind of thinking about and probably will be able to implement with me. I get a month or two.

[00:26:14] Dr. JB: So, if my listener wanted to find out more about what you do and how to do what you do, how could they reach out to you?

[00:26:22] Dr. Kumar: Yeah. So, they can reach out to me on LinkedIn, Facebook, and on my website, like mamta-kumar.com. Yeah. These are the three ways to reach out to me.

[00:26:33] Dr. JB: Okay. And do you have any pearls of wisdom that you would like to leave with my audience?

[00:26:40] Dr. Kumar: I really think everybody has an inner knowing and they know what is right for them. And the worst thing that you would do is continue to disregard that. I really rushed a, I followed my inner, you know, truth out. I needed to cut down work and just take care of myself and there’s nothing wrong. And I don’t think we can take care of the patients if we don’t take care of ourselves, you’re not going to last long. So, everybody should prioritize your own needs first.

[00:27:11] Dr. JB: Who says a doc can’t rap? D O C T O R J B. The greatest doctor to ever touch the mic. The greatest podcast ever broadcasted or prerecorded. Come learn some. Each one, teach one. I’m done.