Treat Your Body As If You Were Pregnant with Dr. Kathryn M. Rexrode
about the episode
Can Pregnancy Predict Future Heart Health? Dr. Kathryn Rexrode on Prevention, Menopause & Women's Health
On this episode of Innovate and Elevate, Sharon is joined by Dr. Kathyrn Rexrode, Chief of the Division of Women’s Health in the Department of Medicine at Brigham and Women’s Hospital and Professor of Medicine at Harvard Medical School.
In their conversation, Dr. Rexrode discusses the progression in her career from experiencing imposter syndrome to stepping into her confidence and authority as a physician, professor, and woman in leadership. She also highlights how rejecting a scarcity mindset and supporting other women professionally has helped bolster her self-confidence. In Dr. Rexrode’s words, “The more we support one another, the more collective success we’ll have.”
Dr. Rexrode describes her nonlinear 26-year path to becoming a full professor at Harvard Medical School. For anyone wanting to start a family and become a full-time professor, or generally devote themselves to climbing the career ladder, Dr. Rexrode emphasizes that there isn’t a one-size-fits-all approach. Sharon and Dr. Rexrode share how they navigate motherhood and career growth, which often requires a willingness to redefine what success looks like on an individual level.
Finally, Dr. Rexrode brings listeners back to the early days of her career and the shocking realities that sparked her passion for improving healthcare standards for women. She continues that mission today, encouraging everyone to treat their body with the same respect, care, and attention they would if they were pregnant.
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“Being told you don’t have confidence does not give you confidence. What helps is pointing out the expertise that you do have, and helping people own their own experience and develop that belief in their true expertise and value.”
About Dr. Kathryn Rexrode
Dr. Kathryn Rexrode serves as Chief of the Division of Women’s Health at Harvard’s Brigham and Women’s Hospital. She is a Professor of Medicine at Harvard Medical School. Dr. Rexrode is a board-certified general internist who focuses predominantly on women’s health. In her role as Division Chief, Dr. Rexrode advances women’s health clinical services, research, and education at BWH. Her own NIH funded research focuses on stroke and cardiovascular disease in women.
Connect with Dr. Rexrode on LinkedIn: Dr. Kathryn Rexrode
Episode Outline
00:08 How The Chief of the Division of Women’s Health at Harvard’s Brigham and Women’s Hospital Developed Confidence and Belief in Herself
03:33 Rising In Your Career and Lifting Other Women Up Along the Way
10:37 An Invitation for Nonlinearity and Career Messiness
16:00 Let’s Talk About Women’s Health
19:49 Stepping Into Dr. Rexrode’s Office: Treat Your Body As If You Were Pregnant
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Sharon Kedar 00:02
Behind every pioneering idea, method, and device is a fellow human or humans. A trailblazer who is daring enough to ask the questions that push the boundaries and make the impossible possible.
Sharon Kedar 00:14
I’m Sharon Kedar, co-founder of Northpond Ventures, a multi-billion-dollar science-driven venture capital firm, and the host of “Innovate and Elevate.” In each episode, we’ll have candid, in-depth conversations with top doctors, scientists, and innovators about leading-edge discoveries and how they impact our lives.
Sharon Kedar 00:33
Season one focuses on women’s health, with the aim of helping women lead our healthiest lives. You’ll hear from leading experts such as Dr. Kathryn Rexrode, Division Chief, Women’s Health at Harvard’s Brigham Hospital.
Sharon Kedar 00:46
This podcast is dedicated to my late niece Thorn Wolfe-Kedar, who passed away in 2023 at the age of 17. Thorn was transgender and struggled to live her life feeling safe. It's time for all of us to innovate and elevate.
Chapter Title 01:02
Chapter 1. How The Chief of the Division of Women's Health at Harvard's Brigham and Women's Hospital Developed Confidence and Belief in Herself
Sharon Kedar 01:12
Our guest today is Dr. Kathryn Rexrode. Dr. Rexrode serves as the Chief of the Division of Women's Health at Harvard's Brigham and Women's Hospital. She is a Professor of Medicine at Harvard Medical School. Dr. Rexrode is a board-certified general internist who focuses predominantly on women's health. In her role as Division Chief, Dr. Rexrode advances women's health clinical services, research, and education at Brigham and Women's Hospital. Her own NIH-funded research focuses on stroke and cardiovascular disease in women. Dr. Rexrode, welcome to the podcast.
Dr. Kathryn Rexrode 01:48
It's such a pleasure to be here.
Sharon Kedar 01:51
Well, I am such a fan of yours. I remember meeting this summer when we did a women's health panel together at the Wyss Institute. Candidly, you just blew me away, both by who you are, and what you’ve done in your career. What do you think propelled you forward to step into a role where you didn't have a lot of role models? Was it a belief in yourself? Was it a progression? I’m curious however you want to answer that.
Dr. Kathryn Rexrode 02:18
Well, I would say it's definitely a progression. I was incredibly shy in high school. Definitely didn't have a lot of confidence in my own voice. I did well academically, but in terms of having to interact or present myself publicly, that was really difficult for me. But to start with your sense of confidence, I definitely did not have that interior sense of just like, “Oh, of course, I can do this.”
Dr. Kathryn Rexrode 02:45
I did think academically I could do it. I guess I had gotten enough positive feedback in that sense, but I went through many, many years of imposter syndrome, of thinking that I wasn't good enough for the environs that I was, or certainly, I was the last person on the list of acceptances. Those kinds of things that are classic. And I think in many ways, becoming a physician made me have to have confidence in myself and be able to portray myself with some amount of authority. I think I grew into this role, progression, really, in my experience and my recognition that I had knowledge that I could share and expertise that I could share. And that finally I had confidence, truly, in my skills.
Dr. Kathryn Rexrode 03:36
That was definitely a progression, not something that I started with as a strength. And I spend quite a bit of time, as you know, interacting with women and thinking about women's leadership development, particularly for women in medicine and women faculty in our institution. I think often women are told you need to have more confidence.
Sharon Kedar 04:01
Yeah.
Dr. Kathryn Rexrode 04:01
And that's so unhelpful, right? Being told you don't have confidence does not give you confidence. What helps is pointing out the expertise that you do have, and helping people own their own experience and develop that belief in their true expertise and value. And giving people direct feedback about what we observe in that space is the way to give them confidence, not telling them that they don't have enough confidence.
Chapter Title 04:32
Chapter 2. Rising In Your Career and Lifting Other Women Up Along the Way
Sharon Kedar 04:36
When did you decide to – two part question – focus on women's health? And then also, when did you get the memo that I wish all women received, but clearly you did, and Madeleine Albright obviously, spoke about this so beautifully, that “there's a special place in hell for women that don't support other women”? I just assumed that we would support each other, but that’s not always the case. So, just curious, your reflections on that.
Dr. Kathryn Rexrode 05:08
Let me start with the second one in terms of women supporting other women, and maybe not. I think whenever it feels like there's a scarce resource, which we might define successful women as being in our culture, somewhat scarce to find. In my institution, leadership is still predominantly male. There's more women than there used to be.
Dr. Kathryn Rexrode 05:31
But it's still in senior levels, less than a quarter perhaps. And I think when that happens, when there's a scarcity mindset, it makes us competitive. It makes us feel like we're against each other because we're trying to achieve something. I think that's a false construct that we develop, because the truth is, absolutely, if we support one another, we're all more likely to succeed. And there shouldn't be a limit on the number of successful women that become leaders. But I think that's probably where it comes from.
Dr. Kathryn Rexrode 06:05
I think what I have found in my own career is that those relationships with my colleagues, and the relationships I've had in being able to mentor trainees and junior colleagues and peers have been some of the most satisfying things that I get to do. When I feel like you can remove one small barrier for someone, I was just before this in a conversation with a medical student who recently did our women's health rotation as part of their Harvard Medical School rotation.
Dr. Kathryn Rexrode 06:40
And we were having a mentoring conversation, and my goal was to come up with a number of other people that she could talk to that I felt would take her that one step further in understanding how she might combine her many interests as she's thinking about her career path, choosing a residency program or which field to go into. And there's a real amount of joy for me in feeling like even if it's a small incremental step in someone finding their path for their sort of best self of the future. And so, that has been incredibly satisfying for me. I think we have to get out of a scarcity mindset and get into, “The more we support one another, the more collective success we’ll have.”
Sharon Kedar 07:27
But you never had the scarcity mindset. I mean, that's sort of holding up a mirror. What's cool is coming up through the ranks. I think when you became tenured at Harvard Medical School, the number of women faculty that were tenured was something like 20-something percent. Is that right?
Dr. Kathryn Rexrode 07:47
Full professor. Because I'm in a medical center, we don't have tenure. But I became full professor, yes, at a time when about 20% of the full professors are women at Harvard Medical School. And as I said, that's still a small percentage. The ranks each year go up in the number of women entering. I didn't really set out early in my career to say, “I want to become a full professor.” I think that would have seemed far too lofty a goal for me. I don't think I had that kind of belief in myself at the time.
Dr. Kathryn Rexrode 08:23
But by the time I became associate professor, which was after I had been doing research for a number of years, and after I had gotten involved in working in the Office for Women's Careers, and thinking about advancing gender equity, one of my mentors turned to me and said, “Kathy, you have to become a full professor, because you have to show other people that they can do it, too. That they can do it and have a career that is meaningful, and has a family and is involved in different ways.” And so, that really was stimulating to me. I felt as much as I wanted it for myself, it was more that I felt like I have to be part of that club of the full professors because they're the ones who get to make decisions.
Sharon Kedar 09:07
Yeah. How many years did it take you to become full professor?
Dr. Kathryn Rexrode 09:11
It took a very long time. I was just calculating. 26 years from the time I started as a faculty member until I became full professor.
Sharon Kedar 09:20
Wow.
Dr. Kathryn Rexrode 09:21
I will say for a number of reasons, my path was perhaps a little less linear than some. Some of that is because I have a really wide range of interests, and the fastest path to promotion is showing excellence in sort of one pillar or domain. So, a very focused research career and focused on grants and publications. That's what you do. If you're successful at that, that will lead to your promotion. I did define success differently. I do think it's important that we think about what is our definition of success.
Dr. Kathryn Rexrode 09:54
I love that.
Dr. Kathryn Rexrode 09:55
And what it is we want to achieve. I think sometimes it is important to have external validation. And we've shown actually that, or it’s been shown in research, that women benefit even more by those titles, because we have to counteract the implicit bias that women aren't leaders or women aren't scientists. Those titles actually matter more, both for women and others that are underrepresented in medicine, because it goes against an implicit bias in that category.
Dr. Kathryn Rexrode 10:23
So, we tend to benefit more from having that external authority. But, I also think it's important to say, in the context of my life, how am I defining success? And there were several junctures where I chose, for instance, that role as Director of the Office for Women's Careers. Dr. Barbara Bierer, who hired me said, “Kathy, I just want you to understand this will only hurt your promotion.” Because at that job, which was 20% of my time, I was not doing research, and research was absolutely the fastest path forward. I think it was really good for me and my personal development. I think I gave a lot to the community, I’m quite sure of that. That isn't the same as what Harvard values for promotion, which could be summed up as, “What have you done to make Harvard even more famous?” I wasn't making them more famous in trying to improve my environment.
Sharon Kedar 11:16
But why did you do it?
Dr. Kathryn Rexrode 11:19
Because it's where I had my passions, and that was the metric I used. It wasn't, “Is this going to get me promoted or not?” It was, “Is this what's going to feel meaningful to me and where my passions lie?”
Chapter Title 11:31
Chapter 3. An Invitation For Nonlinearity and Career Messiness
Sharon Kedar 11:37
My career was really nonlinear, including taking five years, I think it was, that was part-time. It's exactly what not to do where when I had my first of three kids, she's 17 now, I worked part-time, because I wanted to be a room parent in preschool. It was paid three days a week, but I really worked five, and it was such a nonlinear move. Many would have said it was a very career-limiting move. But the invitation, a concept I thought a lot about is, especially for women, is messiness, and the invitation for nonlinearity and messiness.
Sharon Kedar 12:20
Related to that, I think about you talking about full professor, and I think about gender parity issues and the reality that still, I haven't heard even being on the forefront of science still today, I think this will stay this way for a while, we women are the ones that actually birth the children, and there is that whole nine months during, and then there's the period after, and it's different for everybody, and each child is different.
Sharon Kedar 12:47
Can you speak to if someone wants to embark on family as well, and they are the one who happens to be a woman, what does that mean for what it takes to be full professor? Doesn't that include going out and giving speaking events and stuff like that? And if you could just talk about the time impact and your perspective would be fascinating to hear.
Dr. Kathryn Rexrode 13:15
So, I think you've put your finger on your own personal experience on that moment where our different goals for our life can come to a tension, right? That clearly you are motivated in your own career, and yet, there was a time in which other values that you had, other goals that you had for your whole life, meant that you needed more time for those than you could focus on your career. And I think that's a common thing that women face. Some men face it. The gender normative roles, the room parent. It's rarely a male individual that will tell me they cut back on their job so that they could fulfill these kinds of roles.
Dr. Kathryn Rexrode 14:01
Again, I think we're all imbued with wanting to both fulfill those roles, which were the ones that we were often exposed to, my mom was definitely that way as a role model, and yet also our aspirational goals in terms of our careers and things we hold dear and where we want to make a difference. So, I think there is a real tension, and how that’s solved for each individual is so different. And I want to emphasize that there's no wrong way to do that from the standpoint of a value judgment. It is a personal value judgment.
Dr. Kathryn Rexrode 14:33
In terms of how I see it play out in my scientific, academic sphere, you're right, when somebody works part-time, most often, they're still working full-time. They're getting paid part-time and they're given some flexibility because of that, or they see it as some flexibility, but they're most often still doing the work.
Dr. Kathryn Rexrode 14:53
So, that is a tension. But sometimes, it is what's needed to balance those different goals that people have and how they want to live their lives. And I know that you came back from after that and accelerated back into your career, and I've seen it for others as well. I think it can slow things down. And I think sometimes it is a place where somebody might exit certain kinds of endeavors like research, which maybe are a little less flexible at times. And it's one of the ways in which we shrink the denominator of women that are still in that category and moving forward. I think that we need to do all we can to support women to continue full-time. I think that includes real maternity leaves. In our institution, it's now up to four months of paid maternity leave through a combination of Massachusetts and institutional policies. That's a start. And it's maternal and paternal, or it's family leave.
Dr. Kathryn Rexrode 15:53
If the other partner also spends four months, that would help a lot. So, that kind of gender parity within a family structure is another solution. You mentioned in order to be successful in academic medicine, you have to go around and give talks. You're judged on the kind of impact you're having, you have to go present as a researcher at national conferences. And we have established, for instance, a stipend, a travel fellowship, or family care fellowship stipend for individuals to be able to get either the extra childcare they need so that they can have somebody take care of their children when they travel or the extra person to come along and take care of their child while they are still nursing and at a conference or whatever it is. I think recognizing that otherwise, there's a tax on parents, particularly on women, for metrics that are necessary for promotion but are in tension with those other identities and actually have financial repercussions, I think, otherwise, we're just enhancing those limitations.
Chapter Title 16:56
Chapter 4. Let’s Talk About Women’s Health
Sharon Kedar 17:00
If I may ask you, when did you decide to focus on women's health? And if you could just talk about the journey to becoming the Division Chief.
Dr. Kathryn Rexrode 17:10
The why. I think it really started from some of those values and recognizing inequities for women. And in college, I volunteered at Women Organized Against Rape. I was active in other organizations supporting women, also, in medical school. In medical school, I definitely was confronted with what was a dominant male faculty, but also a dominant way of thinking about health in a sort of male model. So all the examples were 75 kilogram man, except when it was something affecting the breast or reproductive tract. Women's health was what we sometimes called “bikini medicine,” just those bits, and everything else was through a male lens. And then, oh, it must be universal, except, oh, it's kind of messy to study women. They have those hormones. They go up and down. They might get pregnant.
Dr. Kathryn Rexrode 18:09
There were all these reasons women were not included in clinical trials research. Much of our research was based on men. That's why they're presenting that data. But I definitely saw those limitations. And again, they made me mad, seeing those structures. So I think that's really where that germ of “I want to make a difference” came from. I knew that by the time I went to residency, and as a resident, when I was taking care of patients, there were so many questions that we just didn't have answers for in women. I was taking care of primary care patients, and we didn't have data on the long-term effects of aspirin and women and cardiovascular disease. We did for men. We didn't have data on statins. We didn't have data on hormone therapy and its long-term effects.
Dr. Kathryn Rexrode 18:52
And the fact that we didn't have that data just made me mad. It made me feel like this is wrong. I want to be a part of this solution, because it was personal. It's personal for me, but it was personal for my patients, which was really my primary goal was taking good care of my patients. So, I would say that's how it came together, that those values go back a long way around gender equity. Probably in that framework of my family, as you were talking about, and seeing that play out in our medical system and recognizing the gaps, I saw it as an incredible opportunity to try to answer some of those questions.
Sharon Kedar 19:30
Yeah. What's interesting about that is there were probably a lot of people who just took the data as status quo. And so, it's fascinating when it comes to innovation, that you took it and said, “Okay, we have this data.” But what I hear you saying is, “This data's not good enough.” You sent me a Brigham magazine that had an article that said, “Women Are Not Tiny Men.” And I thought that was so powerful. But it's interesting how even today, so many people just accept the existing data when you're saying, no, we need to do better.
Dr. Kathryn Rexrode 20:09
Yeah, I think that's exactly true. It's that thought that we can just take what we know in men and apply it to women, and surely it's the same. But every single cell in our body has a sex. Things are profoundly influenced, biologic sex, our chromosomal makeup, but also, by all the things we were talking about. Our gendered experiences in the world, and how that shapes our health and shapes our futures. So, yes, I guess I just wasn't willing to accept that we didn't have those answers. And I do think we're making progress in getting those answers, and hopefully, advancing the health of women.
Chapter Title 20:46
Chapter 5. Stepping Into Dr. Rexrode’s Office: Treat Your Body As If You Were Pregnant
Sharon Kedar 20:51
So, stepping into the doctor's office, knowing that many viewers and listeners wouldn't have the time, the money, the ability, a lot of different barriers to reaching someone like yourself. If there was just one piece of information that you would want listeners to know about women's health that they might not already be aware of, I’m just curious what you might say.
Dr. Kathryn Rexrode 21:16
Well, I'm going to give you two. One is a framing. So, I'm going to start by framing women's health as the whole health. That's the health of every organ system in our body, our minds, and our bodies, and our lives. I think sometimes that lens is narrowed to think what that means. So, that's my frame. I just want to think about it as the whole person. It is really about the health of the whole person. And I think what I see most often, and I think this goes back to some of the gender roles and expectations in our society, is that women spend a lot of time taking care of their children, of elders, of individuals in the community, their families, and they often put their own health last on the list.
Dr. Kathryn Rexrode 22:08
Even if they want to, they feel like they can't prioritize it, because they prioritize those other things above. I think there's a lot to admire in that, but there's a lot of danger in that. It makes us not the best role models for those who are watching us in terms of how we take care of our health. And obviously, it can have a health impact. I've noticed that during pregnancy, women tend to feel like they can and should take care of themselves, because they're taking care of themselves and this being that's growing within them.
Dr. Kathryn Rexrode 22:42
I have so many women who quit smoking during pregnancy, because they knew it was bad for the baby. And yet smoking when they're not pregnant - they don't have that same sense of agency, perhaps. It’s really thinking about how we prioritize our own needs and our own health for all of us. Where are those pieces where we know we're not taking care of ourselves in the way that we should and that we can do better? I think that's what I try to coach my patients about, for them to set those goals to think about that. To take care of ourselves as well as we take care of those around us.
Dr. Kathryn Rexrode 23:23
I do feel like it's a really important role model issue, particularly for our daughters, because otherwise, we're reinforcing that message that women don't matter. Mothers don't matter. Sometimes that's also a reason to do it. We can sort of like why I said, “Okay, I've got to become full professor because I've got to show other people that we can do it.” Sometimes it's, “I've got to show that I can keep exercise in my life because I want my kids to believe that this is part of a healthy life.” That's my one piece of advice.
Sharon Kedar 23:54
It's such a profound piece of advice. What I love about it is it's not telling someone who might not be able to, we all know things like sleep are important, but maybe someone is in a state where they have a newborn, or currently I have a sick puppy, and it's not giving a piece of advice that someone might know they need to do but would be really hard to do. To me, what I love about it is it's an invitation to think. Sort of like when you talk about career too, about what will work for you, what are the one or two things. And I do think we women abandon ourselves when it comes to our own care, and that is a big generalization, but by and large, I think it's true.
Sharon Kedar 24:37
You said this statement to me before, which really stuck with me about treat your body as if you would if you were pregnant. I'm going to send this to you for your office. But if you can see it: Treat your body as you would when you're pregnant. I just think we should all walk around with that hat. I have one for you and one for me.
Dr. Kathryn Rexrode 24:59
I look forward to wearing it on my walks. And hopefully, a lot of people will read that side.
Sharon Kedar 25:06
I don't think you'll get that much privacy on your walks.
Sharon Kedar 25:18
Thank you for tuning in. Please connect with me, Sharon Kedar, on LinkedIn for additional innovative content.
Sharon Kedar 25:24
If you enjoyed this episode, please take a moment to like it. And don't forget to subscribe to the channel by clicking the button below this video.
Sharon Kedar 25:35
The views and opinions of the host and the podcast guests are their own professional opinions and may not represent the views of Northpond Ventures.
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About Your Host
Sharon Kedar, CFA, is Co-Founder of Northpond Ventures. Northpond is a multi-billion-dollar science-driven venture capital firm with a portfolio of 60+ companies, along with key academic partnerships at Harvard’s Wyss Institute, MIT’s School of Engineering, and Stanford School of Medicine. Prior to Northpond, Sharon spent 15 years at Sands Capital, where she became their first Chief Financial Officer. Assets under management grew from $1.5 billion to $50 billion over her tenure, achieving more than 30x growth. Sharon is the co-author of two personal finance books for women. Sharon has an MBA from Harvard Business School, a B.A. in Economics from Rice University, and is a CFA charterholder. She lives in the Washington, DC area with her husband, Greg, and their three kids.
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faqs
Can pregnancy predict future heart health?
On Innovate & Elevate, Dr. Kathryn Rexrode explains that certain pregnancy experiences and complications may provide important information about future cardiovascular health risks. The conversation explores pregnancy as an early window into long-term health patterns.
Why does pregnancy matter beyond childbirth?
On Innovate & Elevate, Dr. Kathryn Rexrode discusses how pregnancy may reveal important biological information that extends beyond reproductive health and can influence conversations around future disease prevention.
What pregnancy complications may affect future health?
In this Innovate & Elevate discussion, Dr. Kathryn Rexrode explains that conditions such as gestational diabetes, hypertension, and pregnancy-related complications may sometimes be associated with future health risks.
Is heart disease different in women?
On Innovate & Elevate, Dr. Kathryn Rexrode explains that women may experience different cardiovascular risk patterns and life events that influence long-term heart health.
Does menopause affect cardiovascular health?
On Innovate & Elevate, Dr. Kathryn Rexrode discusses how hormonal changes associated with menopause may influence cardiovascular risk and overall health during midlife.
Why should women think about prevention earlier in life?
On Innovate & Elevate, Dr. Kathryn Rexrode explains that prevention often begins before symptoms appear. The conversation emphasizes identifying risk factors earlier and taking proactive steps throughout life.
What are women-specific cardiovascular risk factors?
In this Innovate & Elevate conversation, Dr. Kathryn Rexrode discusses how reproductive history, hormonal transitions, and pregnancy experiences may contribute additional information beyond traditional cardiovascular risk factors.
How can women lower long-term health risks?
On Innovate & Elevate, Dr. Kathryn Rexrode discusses prevention strategies including awareness, screening, exercise, and understanding individual health history.
Why should healthcare become more personalized for women?
On Innovate & Elevate, Dr. Kathryn Rexrode explains that women’s biology and life experiences may influence health differently, creating opportunities for more individualized healthcare approaches.