“A Year of Gratitude” – with Gina Hamadey

This episode of High Risk Birth Stories features Gina Hamadey, who wrote a book on gratitude including a thank-you to Dr. Fox, who delivered her second baby. She explains the different experiences between her first delivery with a midwife and no pain medications, after which she developed Strep A and sepsis, compared to her second baby delivered with MFM Associates.

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Dr. Fox: Welcome to “High Risk Birth Stories” brought to you by the creators of the “Healthful Woman” podcast. I’m your host, Dr. Nathan Fox. “High-Risk Birth Stories” is a podcast designed to give you, the listener, a window into life-changing experiences of pregnancy, fertility, and childbirth. Gina Hamadey, welcome to the podcast. So nice to see you. 

Gina: So nice to be here. Thank you for having me. 

Dr. Fox: So Gina, you are an author, and you wrote a book that is terrific. It’s called, “I Want to Thank You: How a Year of Gratitude Can Bring Joy and Meaning in a Disconnected World.” And we were in touch, obviously, because I delivered your second baby, and you reached out to me and told me about the book and about the project, and I thought at the time, and I think now that it’s terrific. 

Gina: Thank you. 

Dr. Fox: And so we were in touch regarding that, and I said, “You have to come on the podcast.” So thanks for coming in person. It’s nice to see human beings again. 

Gina: I know. I remember that conversation. I called you to check whether it was okay that I quoted you in the book, and that was last summer, and I was in the Berkshires, you know, quarantined at my in-law’s house. So it’s a totally different situation. I took the subway here. It’s wonderful. 

Dr. Fox: It’s amazing. And I thought that the way we would do this is we’ll start today with that pregnancy that we’re talking about, and sort of from there, we’ll go backwards and talk about your past, go forwards and talk about this book and the project you did. And I think that all of it is going to be really fascinating for our listeners. 

Gina: Perfect. 

Dr. Fox: And we’ll go from there. So when we met, this was in your pregnancy, it was your third pregnancy, your second child, and you came to our practice because you had some complications with your first pregnancy, right? In 2013. 

Gina: Correct. 

Dr. Fox: Right. This is with your son, Henry. 

Gina: Right. 

Dr. Fox: What was it about the prior pregnancy that sort of made it a little more concerning that you were, you know, switching to a high-risk practice, so to speak. 

Gina: The pregnancy itself, I felt good, but there were some complications. I had gestational diabetes. That was the main one. And then toward the end, my midwives, she said, “You’re looking like you’re ready,” even though it was five or six weeks early. So she just said, “I’m not going to put you on bed rest but sort of take it easy.” So the last few weeks of the pregnancy were a little, you know, nerve-wracking for my husband more than me. He made me take a cab to and from the office and… 

Dr. Fox: When they checked you out, you mean, like, your cervix was soft or short or open or something? 

Gina: Yeah. My cervix was soft, ripe. 

Dr. Fox: Got it. 

Gina: I think that was the word she used, which was… 

Dr. Fox: Yeah. We like to compare women to fruit. 

Gina: Yeah. Ripe sort of didn’t sit great with me, but the last few weeks were, you know, just a little on edge. And then my water broke four weeks early. 

Dr. Fox: Right. So they were right, actually. 

Gina: They were right. Yeah. They were right. Yeah. And I had been just sitting watching a movie. It just popped. And the same thing happened actually with my second , I was just, I don’t know, early and just spontaneous water breaking with no…just in repose. I don’t know why. That’s my deal. So the main thing, though, all those were, you know, a little bit annoying and maybe I would have sought you out anyway because of the gestational diabetes or because of the early delivery. But more than that, after I delivered Henry in 2013, did it with no drugs, and it was actually a lovely experience what I was looking for and I felt like I could handle it. And I did push for four hours. 

Dr. Fox: When you say no drugs, you mean no epidural? 

Gina: No epidural. 

Dr. Fox: Got it. 

Gina: I mean, no, nothing else, I don’t think. I mean, no pain management. 

Dr. Fox: They probably gave you antibiotics because your water broke pre-term. You may not have realized it. 

Gina: Antibiotics, but I guess no pain meds. 

Dr. Fox: Yeah. No pain medicine. 

Gina: Yeah. 

Dr. Fox: Got it. 

Gina: It felt amazing. Pushing for four hours was not great. I don’t recommend that, but the kid finally came out, and for four weeks early, he was super healthy. He had to go and get a touch of…His blood sugar was low so they gave him just a little bit of formula to regulate that. So he had to go to NICU for that but just for a few hours. So he was fine, and I was too. I felt great, but 36 hours later, and thank goodness I was still in the hospital, my temperature spiked, and it was the weekend, and, you know, just felt like every time I came to a new person was coming in and, you know, guessing I had mastitis. Am I saying that right? 

Dr. Fox: Mm-hmm. Although they were wrong. 

Gina: They were wrong, yeah, each one. 

Dr. Fox: The word is right. The diagnosis as well. 

Gina: Exactly. And I was on some antibiotics, but later they said that was like chicken soup antibiotics, like tiny. Just sort of like…whatever. 

Dr. Fox: Right. You were on the cheap stuff. 

Gina: The cheap stuff. And I went the whole weekend without really any oversight, and I had, like, a high fever and very low blood pressure, but it turned out that it was Strep A and a really bad strain of it, and then everybody got really scared. And I went into the ICU. 

Dr. Fox: Right. You were septic as we call. 

Gina: I was septic. Yeah. And I went into the ICU. 

Dr. Fox: For our listeners, that’s bad. 

Gina: It’s bad. It’s no good. And people were talking about this really openly with me that there was…One of the OB-GYNs at that hospital had this exact thing happen to her and she lost half of her nose because it’s a flesh-eating… 

Dr. Fox: Well, it’s nice then to share that story with you. 

Gina: Yeah. I know. It was like [inaudible 00:05:36]. 

Dr. Fox: Yeah. That’s great. That’s great present. Thanks. 

Gina: So, I knew that was on the table and, you know, my fever was still really high. I don’t know, they tried all this stuff and it was just a misery. I was there for a whole week and I couldn’t see Henry for quite a good chunk of that. And I was, you know, pumping and dumping because I didn’t want to lose the milk and… 

Dr. Fox: Was he in the NICU or was he just there because you hadn’t gone home? 

Gina: No, he was just there because I hadn’t gone home. 

Dr. Fox: Yeah, but they don’t discharge him without you because they don’t have a way to get home, you know. 

Gina: Right. I mean, they kind of framed it like it was a favor. I think it probably was. Like, they could have given him to…My husband was there and my mother-in-law was there, but they were just sort of, like, keeping him under…I don’t know, just sort of keeping him. 

Dr. Fox: They usually don’t discharge the baby until the mother is discharged. 

Gina: Really. 

Dr. Fox: Unless there’s extenuating circumstances. 

Gina: Right. Like months and months or something. 

Dr. Fox: Yeah, just because it’s just not cool to do that. You delivered at a hospital but you were being cared for by midwives. How did you make that decision? I’m curious. 

Gina: It was the midwives that were associated with…now it’s Mount Sinai West. It was… 

Dr. Fox: St. Luke’s Roosevelt at the time. 

Gina: St. Luke’s Roosevelt. And they had the…you know. 

Dr. Fox: Birth center. 

Gina: Birth center. 

Dr. Fox: So you delivered in the birth center. 

Gina: I didn’t, you know. I mean, I never would have gotten in there because, first of all, diabetes. 

Dr. Fox: Diabetes, preterm. 

Gina: Second of all, preterm. Yeah. 

Dr. Fox: Right. It was like the hypothetical birth center. 

Gina: Right. Which everybody had said, you know, “You probably won’t deliver in that birth center,” but it’s just is like a thing. And, you know, I liked having the midwives. I have nothing bad to say about the midwives, but because…I think I did get sort of angry at the practice over that weekend when, you know, they did come in to check on me and saw the fever but they didn’t call in a doctor and they didn’t raise the flags, so it felt a little bit like…Everything was felt late with that. 

Dr. Fox: Yeah. Yeah. Unusual things are tough because a lot of women get fevers after birth, and it’s very, very rarely, you know, progressing to sepsis or group A strep sepsis. That’s an unusual thing, but then when it’s realized you’re suddenly, like, “And that’s it?” Like, “My face could fall off?” You know, like, “What?” 

Gina: Right. Right. Right. 

Dr. Fox: Yeah. So that’s pretty terrifying. 

Gina: Right. And it was just a bad experience where I never left the labor and delivery floor. I felt like a burden, for sure. Like, I feel like nurses and doctors kept coming in and being like, “She’s still here.” I don’t know. I just felt like I was in the wrong place. Every time somebody came in, they’d want new blood to the point where I was like, you know, saying, “No, you can’t have any more of my blood. I just gave this a few hours ago. Like, “Just look at what…” I don’t know. Anyway. So it was just a bad…It just ended really badly. 

Dr. Fox: Right. But you did recover. 

Gina: I did recover. 

Dr. Fox: You got out of there. 

Gina: I got out of there a week later. 

Dr. Fox: You were [inaudible [00:08:13] at home. 

Gina: I came home. Thank goodness. There was a resurgence where I got home and I got full-body rash. I think I had developed a slight allergy to penicillin over that week with all the… 

Dr. Fox: Got it, yeah, yeah, yeah. 

Gina: …antibiotics running through my blood. So, when we got pregnant the second time, I definitely wanted a fresh start. And I had heard from a number of people about this practice in different parts of my life, just…I don’t know. I always heard good things. 

Dr. Fox: I was going to say you either got upgraded or downgraded to high-risk practice based on how you look at it, based on your perspective. 

Gina: Right. Exactly. 

Dr. Fox: You went from business to coach or from coach to business. 

Gina: Yeah, yeah, yeah, yeah, exactly. Right. So I met you guys pregnant, but then I ended up losing that pregnancy. And so I lost that here. That was like…I now know that there are so many ways you can have a miscarriage. I’ve talked to so many people now, but the one I had felt very dramatic. I just started bleeding. 

Dr. Fox: Right. You wrote about it your book. 

Gina: Yeah. Yeah. I just started bleeding and then I was in a cab by myself and the cab driver sort of…I don’t know. I feel like he understood a little bit where he was, like, going fast, but then I was like, “Please, don’t go that fast. I don’t know.” And then I just, like, ran from the cab past the desk over here into the bathroom, and it was just like a bloody mess, like horror. And then you guys were so wonderful and made me feel…I don’t know. At the end of that day, I felt, like, so much better than I thought what if…? 

Dr. Fox: That was…You wrote…that was one of the letters…and when we get to your book, that is one of the letters to Mike Silverstein. 

Gina: Yeah. He was really great, actually. He just has a great bedside manner. 

Dr. Fox: He is very kind. He just really is. 

Gina: Very kind. Yeah. He really made me feel calm about it as far as miscarriages go. It went [inaudible 00:09:54] about as well as it could have gone. 

Dr. Fox: I refer to when the room afterwards looks like a crime scene, it’s not good. Yeah. 

Gina: I didn’t know there were so many ways you could have a miscarriage. I mean, so many of them are quiet and no heartbeat, and I’m sure that’s its own absolute heartbreak. This was just so physically intense. 

Dr. Fox: Yeah. It’s definitely a wide range. And so, the next pregnancy. So you come prenatal care and, obviously, we did have to watch you a little bit closer and we were doing things and sort of, you know, giving you injections of progesterone, and you ended up not having diabetes, which is nice. 

Gina: Yeah. That was great. 

Dr. Fox: How about that? 

Gina: That was exciting. 

Dr. Fox: Yeah. So that’s a plus. You had a potential scare with the placenta previa, but that went away, but things sort of just evened out. It ended up being pretty low-risk overall as things go, and your water did break, but you were full-term. 

Gina: Right. I was only two weeks early, not four weeks early, and yeah, it was actually a lovely pregnancy and a really lovely delivery. I didn’t know whether or not I would again do no-pain medication. I was open to either way because that part really was a positive experience. The first time around, I felt great about that, except for the pushing for four hours. I was not going to do that. But it was so interesting how different the labor felt this time. I don’t know if it was…Why do I feel like maybe there was some back labor to it? But it just felt a lot more intense. 

Dr. Fox: Well, there was back labor. 

Gina: There was back labor. 

Dr. Fox: So, I mean, back labors, there isn’t a real definition of what that term means, but some women, when they have labor pains, they feel a lot more at their back than in their front, hence back labor. And one of the things that can cause that or, you know, attribute to that is this idea of the baby being what we call OP or the baby is…also known as sunny side up facing the sky instead of the floor. I don’t know if you recall, that’s how your baby was facing. 

Gina: I don’t recall that at all. 

Dr. Fox: Yeah. I went back to our delivery notes, my delivery note actually and everything, and that’s how it was, baby was facing that way. So that would make some sense. 

Gina: Like he was looking up. 

Dr. Fox: Up at the sky. Right. So when the head enters the pelvis, it starts at usually sideways facing to your right and to your left, and then it rotates. So usually, the eyes end up facing the floor, right? Towards your tail bone. 

Gina: Right, which I remember with Henry because I remember seeing his little head. 

Dr. Fox: Correct. Exactly. But your baby, you know, set number two, decided to face the sky instead and just geometrically, that’s a little harder to push out just because the way that the head tilts and this and that, so okay. And also remember he was two weeks bigger, right? 

Gina: Right. Right. Right. A little bigger. Right. 

Dr. Fox: So he was almost seven pounds, right? 

Gina: Yeah. That’s right. 

Dr. Fox: Yeah. So a little bit bigger. So that would do it. 

Gina: Right. So I… 

Dr. Fox: And you had to put up with my jokes, which makes all the labor more painful, right? There was three reasons to have more pain. 

Gina: No, no, no. No, you had just truly great energy. I’m not like an L.A. crystal energy “person,” but you had great energy in the room. You really did. I remember once I figured out how this pain felt so different from Henry’s, I never felt like I couldn’t manage the pain when I was in labor with Henry, and this time I was like, “Wait, there’s a cure for this,” right? Like there’s like something. 

Dr. Fox: We have something. 

Gina: We have something. There’s something, right? Somebody has invented something that’ll make…yeah. Whatever that is, give me that thing. And now epidurals are like…That’s like my favorite thing. It was so wonderful. It was such… 

Dr. Fox: You should write a thank you letter to the epidural. 

Gina: Oh, my God. Yeah. 

Dr. Fox: Dear epidural. 

Gina: Dear epidural. You were there when I needed you. It was wonderful. And then you did, you said, “All right, well, I have one C-section to do. I’ll be back, and then you’re going to be ready. That was exactly right. 

Dr. Fox: I went back and I looked and I recall it was a busy night, and one of the ways I recall it was a busy night is because I looked at the emails that I sent out that night, and when the email came in that you were coming in labor, I responded, “It’s going to be a busy night” because I remember I was on call and I had a few people in labor and I had a C-section to do but, you know, it kinda worked out. It’s all good. I mean, it wasn’t an issue on my end is what we do. Like it’s fine. Yeah. My recollection of the birth was very pleasant. You know, there was stuff going on, you know, the baby was facing up and the cord was around the neck and there was meconium, and like, I think these are the things we sort of work with, but otherwise it was very pleasant. It was good, you know, baby Charlie. 

Gina: Baby Charlie. Yeah. Yeah. He was happy right away. I feel like he’s still a happy kid. 

Dr. Fox: So you have this birth. Obviously, it’s really nice that you don’t get septic and stay in the hospital for a week afterwards and have people telling you that your face might fall off. So that’s a plus. 

Gina: Right. 

Dr. Fox: How was your recovery otherwise? Because now not only do you have, you know, a newborn, but you have a newborn plus I guess a three-year-old. How was that going for you? 

Gina: It was good. My recovery felt easier. I think I was in a little bit better shape. I was exercising more in this pregnancy. I remember thinking that Henry was harder because, you know, he was just so needy. He’s almost three and a half, and he just was so needy for my attention. It’s so common. He wanted to sit on my lap every meal that we ate. That was like his new thing. 

Dr. Fox: Right. These three-year-olds are so selfish. It’s unbelievable. Yeah. 

Gina: So, yeah, I just remember Charlie feeling easy. I felt like the nursing was not an issue. Yeah. I don’t remember anything out of the ordinary with recovery. Like, I felt good. 

Dr. Fox: Amazing. Now, take us to this idea of all the thank you notes that you decided to write. When did that start in relation to this? 

Gina: Okay. So Charlie was born August, 2016 and then flash forward, not quite a year and a half later, January, 2018. I was taking the train from my home in Brooklyn out to Summit, New Jersey. I had a consulting gig out there with this brand, Boll & Branch. It’s like a home goods sheet brand. It’s about an hour train ride and… 

Dr. Fox: And you’re a writer. 

Gina: And I’m a writer. I’m a writer. I came up as a magazine editor. I’m a writer, and I do brand work, content marketing and anything content-wise with brands I help out with. And this train ride was, you know, after a hectic holiday season with these little kids. Charlie is, you know, not even one and a half, Henry is, you know, four and a half, whatever he is. It just felt like this heavenly quiet train ride that I was kind of wasting on my phone. I, you know, spent that hour in my lists, on my feeds, just hectic. I had this vague sense that this should be this peaceful, pleasant time, and I was kind of wasting it because, I don’t know, you’re on your phone and you’re…And then I turned to this task which I had done a fundraiser for City Harvest, which is an organization that fights hunger in New York City. And I had raised a bunch of money and promised thank you notes that Henry would help me write to everybody who donated. 

And so, one day, I kept my phone in my bag and I took out a stack of thank you notes. And this wasn’t something that I was looking forward to necessarily, or necessarily dreading. I guess I felt neutral about as one other thing on the list that I had to do was write a bunch of thank you notes to these donors. And I spent that hour writing the notes and it felt oddly and sort of undeniably good. It just, like, felt exactly like what my brain needed at the moment to slow down and focus. And it just felt like a blanket of calm and relaxation. And when I got off the train, it felt like that mood carried into my day. Like, I was just more focused and calm and less frantic. That’s how I felt. 

And I don’t know that I was necessarily thinking about it, but I did have a sense that this was a really nice way to start the day. And I had a bunch of these notes to write. So every day that I spent doing that, I had those same feelings. And I was kind of mulling this over at the end of the month on January 31 when I’d finished, and I felt sort of sad about it and I was like, “This is bizarre.” I was never a thank you note person. I’m meeting these people now. There are people who, like, treasure writing thank you notes. It’s like their big thing. I was not that person, but I was thinking this was really, really nice, and I kind of want to keep it up, and I don’t know what that…like just seems strange. And I noticed that on my list, I had written 31 thank you notes. It was January 31. So the idea sort of came to me all at once that I’ve written a thank you note for every day of the year so far, and what if I kept it up? And how would that work? And because I came up in magazines and in content, I sort of saw it as a content calendar. You know, like if I were to write a thank you note every day of the year, you know, I would need to put some structure behind it. So I, you know, thought, “Well, January was charity, you know, what would be the other 11 themes be?” You know, I could write to friends, that was one, family member, that was another, career mentor, was another. So I brainstormed that list and then started, you know, executing. 

Dr. Fox: When you decided to do it, were you confident you were going to go through 365, or did you think, “Oh, I’ll try it and see how it goes?” I’m just curious because, you know, some people are like, “I’m doing it,” and they know they’re going to finish. 

Gina: I was pretty confident because I am a very goal-oriented person, and if I make that kind of goal for myself and if I decide…You know, I was sort of mulling it over, you know, would this be something I wanted to do or not? Once I decided to do it I knew I would finish it. And that being said, if I had just declared that I was going to do this once in a while, I never would do it again. That’s something that I know about myself that I need to set a goal and then make a plan and then I will do it. No matter what, I’ll finish it. 

Dr. Fox: Yeah. I have a similar personality and the same thing, like, you know, “I’m going to train for marathon. I’m going to run 6 days a week for 13 weeks. Like, I’m going to do it unless my leg is broken. That’s happening.” 

Gina: It’s just going to happen. 

Dr. Fox: You throw it in your schedule. And some people are good at that and some people are…It’s just not their thing. They like to sort of just, you know, flow with things. So I like that regiment also. Did you find it at any point to be like a burden, like, “Oh, I got to write my thank you note today,” or was it like this blissful joy every day or a mix? 

Gina: A mix. So I didn’t write one a day. I wrote 365 in a year. So generally what I would do is, at the beginning of the month, I would, you know, start the process of writing a list of, you know, what is this? Okay. Neighbors. What does that mean? Who are the neighbors I’d write to? What would I say? You know, I’d start working it out and writing that list. And then I would write in batches, you know, over a lunch break. When I had that train ride, that was great. That ended in the spring, so then I had to find a different kind of time and space to do that. 

Dr. Fox: I’m taking the train. Where to? Nowhere. 

Gina: Where to? Doesn’t matter. Got to do that. 

Dr. Fox: Very bad. Yeah. 

Gina: But I would sort of batch it out maybe 5 or 8 or maybe 10 at a time, and I was always running late, you know, like even though I knew I would finish it, I was always two or three weeks behind, and then I would remind myself that nobody cares at all except for me, and is fine. 

Dr. Fox: Right. Especially because a lot of these were from years before. 

Gina: Yeah. 

Dr. Fox: It wasn’t something that they did yesterday necessarily. 

Gina: Right. Nobody is waiting for it. It’s a gift. So it can come anytime. 

Dr. Fox: And, you know, as a writer and as someone who is doing this, did you feel on some days like you sent you’re like, “That thank you note was awful,” and others like, “Yes. Like, I nailed it,” or was it just very straight the whole way through? 

Gina: Well, I definitely got better at it as far as I accumulated some, you know, tips I would say, and, you know, I got better at my process, which is basically almost never, although I made some exceptions to this, but I didn’t outline before or write a draft on my…you know. I wasn’t precious about it. I would just sit and write, but I would think about it for a minute or two. I think that’s an important piece, you know, just to kind of think about the person for you, think about that night that I delivered Charlie, what do I remember? How did I feel about it? Just a couple of minutes, and then you have all this stuff in your mind that you can just sit and write quickly. It’s important to me that it felt like we were talking. I think people get caught up in, like, “writing,” and I think that’s not the point. It’s not the point to be well-written. That’s, like, so silly, I feel like. This is just a…It’s a correspondence. 

So, to me, a good thank you note or a good gratitude note feels heartfelt and authentic and kind of shared something that maybe you didn’t know, which is how could you know my perspective on that night? You looked at your notes and you know how it went, maybe remember little bits and pieces. Maybe. I can’t even imagine how if you…I mean, you have so many of these, how could you even remember? But you look at your notes and you have your perspective on it but you could never know how it felt from my perspective, so in that way, I’m sharing something new. So that, to me, is a successful one and it was only a few sentences, you know. I think the only ones I was disappointed, and I remember the month that I wrote to authors, that was in October, so I had, you know, most of the year behind me, but now I’m writing fan mail for the first time, really, aside from a couple. In my food month, I wrote to a few cookbook authors that I hadn’t met, but this was a whole month of fan mail. And in the beginning, I didn’t know how to do that in a way that was satisfying or interesting. You know, I was sort of writing book reviews for the first couple, and then I found my way there too, which was just to make it more personal to me what the book meant to me, what I was going through in that time, maybe. 

Dr. Fox: Right. So one of the themes I’m getting in terms of a tip for people who are thinking of writing thank you notes, and correct me if I’m wrong, that obviously showing any form of gratitude is going to be appreciated, but if you’re sharing something other than like thank you, it’s share something about you, the writer, that that person might not know, you know, what you did for me, not just I thank you for it but here’s how it changed me. Here is how it made me feel better. Here is how it helped me just in a way that they may not grasp. 

Gina: That’s exactly right. 

Dr. Fox: That’s pretty straightforward. And don’t worry too much about how it’s written. 

Gina: Yeah. My most frequently asked questions, or the obstacles that people bring up the most are I’m late, which is like we were just saying. For something like this, as opposed to, you know, thank you for the Christmas gift you got me, you know, nobody is expecting this. It’s pure…It’s just a gift, so there’s no statute of limitations and, in fact, it means more the more time that goes by because… 

Dr. Fox: You’re still thinking about it. 

Gina: You’re still thinking about it. 

Dr. Fox: Yeah. 

Gina: Exactly. And also people get very caught up in their handwriting. I get it all the time. I’m like, “It’s fine. You’re fine.” Like, nobody is opening this so that to, like, frame it on the wall as like a specimen of calligraphy. It’s like nobody cares. 

Dr. Fox: Right. Did any of them backfire? Like, did you…? I’m just curious, did you ever write one and then like, you know, it was taken the wrong way or someone was upset? I’m just curious. 

Gina: No, it’s a great question. You know, not that I know of. I definitely had that fear a lot because I didn’t keep it, you know, surface. I reached out to a few estranged friends, for example, and that was scary. I didn’t know if this was the right way to reach out to them. You know, if it felt like a cop-out instead of, I don’t know, calling them and saying something like, “Wow, we’re not in touch anymore,” you know. This was just…In my friends month, I turned old postcards into gratitude notes, so I just put a four-by-six mailing label on the back of a photograph and made it into a little postcard. And I did that for four or five friends who I hadn’t seen in years and years, and some of whom ended, you know, maybe not great. And all those came out great, and though I was really scared about that. 

Dr. Fox: Yeah. I mean, I can imagine if you just think about it, you know, if I were to receive something, what circumstances would I receive it and be upset by it, right? I mean, unless they wrote me to, like, insult me, right? So, if they’re saying, “Hey, I haven’t heard from you in a long time, or we haven’t been closer long time. I just wanted to reach out and say something,” of course, it would make me feel good. I’d be like, “Yeah, that’s so cool. Like, thank you,” but people get very caught up in sort of their own, whether it’s shame or whether it’s just sort of discomfort that they’re worried about reaching out. Because I was going to say on the flip side what was the response you got from people? 

Gina: So the first thing is that at the beginning of this project, my neighbors month, which was my first month after the charity month, I started by opening up a spreadsheet and listing my recipients, you know, in one column, and then I sort of started out with the spreadsheet, but I erased the spreadsheet when I realized that there would be this natural column for a response, and I did not want to keep track because I knew that if I were sending out hundreds of gratitude notes, not everybody would respond, of course. That’s just a numbers game and I didn’t want. It was already hard enough just that I made this big, you know, ambitious project for myself when I was a full-time, like worked full-time and have these little kids. It was already ambitious and I didn’t want to start getting caught up in, oh, well, did you get it? Or did you…? I don’t know, or did you think it was weird? You know. I just needed to send them and… 

Dr. Fox: Plus you have 365 of those. It’s one thing to do it once. 

Gina: Exactly, exactly. Right. 

Dr. Fox: I mean, every day it’s just…Yeah. 

Gina: Overwhelming. So I erased that spreadsheet, turned it into a Google Doc, and I wrote to myself, “Give everything, expect nothing.” Like, these are gifts. Do not expect anything in return and people aren’t…you know. I don’t know. This is my way. I’m in this place right now where this feels good for me. This is my idea. Nope. I can’t expect anybody else to respond in kind or to…I don’t know. I can’t expect anything of anybody else, which was really I think helpful, and I’m glad I did that. 

And that being said, of course, I got a lot of wonderful responses. A lot. I remember you left me a lovely voicemail. I got a lot of…I did get some snail mail back, probably maybe a dozen letters over the course of the year which were lovely. In that friends month when I sent out postcards, I got a lot of selfies with pictures of friends with their little pictures. And I think the phrase I heard most often was, “This made my day,” “This made my week.” And that is such nice phrase to hear a lot. And I also heard a lot of “I’m going through a tough time right now in this helped.” Like, that is a phrase that I never would have expected to hear at all, and I heard it quite a bit throughout the year, which was a surprise. 

Dr. Fox: Looking back, do you still think it’s a surprise now that you know what you know going through this whole process? 

Gina: Well, first of all, if I had done this in COVID, it would not have…you know. I mean, like right now, we’re all going through a tough time where we all work. I guess I learned that, you know, if you’re reaching out to a lot of people, a fair percentage of them are going to be going through a hard time, and that’s sad, and you never would know, like if you don’t…I think just a fair percentage of people are going through a hard time a lot of the time, and you just don’t know unless you happen to get into, like, a real conversation, and how often do we do that with people who aren’t in our family? 

Dr. Fox: Yeah, no, it’s true. At what point over this process did you think about turning it into a book? Because you were discussing a project and you were going to do it and it was cool, and you thought about it and you planned it out, you mapped it out, but you never mentioned I’m writing a book, right? You said, “I’m just doing this.” So at what point did it turn into, “Hey, I’m going to make this and this?” Like, you know, X amount of pages that’s going to have a hardcover and, you know, sell. 

Gina: Oh, gosh, well that was very late, the X amount of pages and it’s really going to be a book, but I felt that there was enough in the year and enough interesting things happened. And, you know, I knew that throughout the year I would maybe get in touch with some old friends and I hoped that I would continue to have that feeling of calm and peace, you know. And I didn’t have any real other expectations for other benefits or anything, but there were so many that in my book, every chapter, which every chapter is a month, I list at the beginning of the chapter a benefit, a lesson, and a surprise because every month because they were so different, you know, thanking healthcare workers, which you were in that month, of course, is so different from thanking career mentors, is so different from thanking family members, is so different from thanking neighbors. 

So every month felt really like its own little experiment, and every month brought all these different, you know, things, the surprises. Like, I wrote in the book about my mother-in-law who I wrote to her a lot throughout the year because I started sort of breaking my rule of the topic. Like I would stay on topic, but then if other people had done something that I felt warranted a thank you note, I would, you know, go off-topic for a few of those notes. 

Dr. Fox: I’m sorry I can’t thank you this month. 

Gina: Right. Exactly. 

Dr. Fox: You do not cook. 

Gina: Right. Right. Right. Exactly. And, early on, I sort of realized that because of my mother-in-law that I wanted to write her a thank you note but, you know, it was early in the year and she’s not a neighbor, and I was like, “That’s so silly.” Yeah. 

Dr. Fox: Right. You’re not a healthcare worker. Screw you. 

Gina: Right, exactly. So I wrote her so many throughout the year that it ended up, I think, you know, changing our relationship and she was so…I felt like it really touched her how much I had noticed. And to me, I felt like, oh, man, this woman is constantly, constantly thinking of us and how she can help us. Anyway, that was one thing, and I sat down and interviewed her for the book. There were all kinds of surprises like that. When I reached out to those estranged friends, for example, I got all these nice replies back, but one of them, we became friends again. I mean, we talk all the time now. That really opened a door for us to repair our friendship. So, at the end of the year, when I was reflecting on the year, I felt that this could be a book, and especially if I started interviewing experts to sort of help explain the things that I was personally feeling, maybe they could help, you know, explain it in a more scientific way. 

Dr. Fox: Right. Because the book is not just 365 letters you wrote. 

Gina: Right. 

Dr. Fox: The book is about the process. 

Gina: It’s about the process. 

Dr. Fox: I mean, you talk about a lot of individual letters and you quote some of them and tell stories what the response was like….you know. You spent a lot of time in the book talking about your mother-in-law like you just said, but you had to actually write a book. It wasn’t like, “Oh, I’m just going to throw this together and, you know, mail it to somebody.” You had to actually write. 

Gina: At the end of the year, I felt that it could be a book, and I started then the process of asking friends to introduce me to agents and asking those agents for advice and looking at samples of book proposals, which are really hard to find, and that annoys me so I send my book proposal to anybody who ever wanted to see it. Email me and I’ll send it to you. It just feels like there should be more of those book proposals in the world that people can look at and just starting that process. So that was at the end of 2018. And then I sold it in the summer of 2019. 

Dr. Fox: So six months. 

Gina: Yeah. Six months to write. I wrote two drafts of the book proposal. Found an agent, and the agent took it to market and sold it in the summer. 

Dr. Fox: That’s great. How’s the response been? 

Gina: It’s been great. It’s been great. Yeah. I just got an email last night that I saw. She just wrote me a long letter about how much it meant to her and it was just really nice. 

Dr. Fox: That’s nice. And you got to be on the “Today Show.” 

Gina: I got to be on the “Today Show,” which was exciting. 

Dr. Fox: Yeah. I got to be on the “Today Show” because of it. 

Gina: Yeah. Oh, my God. 

Dr. Fox: So I got to read the letter on the “Today Show.” 

Gina: How did I forget that? It’s been a couple months. 

Dr. Fox: Well, I mean, you know, that’s my thank you to you. I got to be on the “Today Show” in a peripheral role. 

Gina: You were so great at it. I don’t believe I forgot that. I’m so sorry. Because I had said earlier today I was like, “Oh, I’m on the “Today Show.” He’s like, “Yeah, yeah. I was too.” 

Dr. Fox: So they featured you. I just read. I’m very happy to report I’m still able to read and there you go. It was…But the crazy thing is we were saying that they wanted us to read the thank you note, and I said, “Oh, I save all of my thank you notes.” So, when people send me thanks, I had like a whole box of them, and unfortunately, they all accidentally got thrown out literally one week earlier, so I don’t have any of my thank you notes. So I had to look at the photo you had. I was like, “I was on yellow card.” So I had to go home and find, like, a yellow piece of construction paper and fold it in half and like fake write on it. 

Gina: You actually found the color. Oh, that’s really sweet. 

Dr. Fox: Well, you know, so I’m holding up a yellow something. 

Gina: There were some [inaudible 00:34:28]. 

Dr. Fox: And I’m basically reading what was on there, a printout of what you emailed me was written here. 

Gina: Good work. Good work. 

Dr. Fox: Arts and crafts. I was… 

Gina: Do you know I forgot that you were one of the people that read it? First of all, when that…So I’ve only seen it once. I can’t bear to see it more than once. So I only saw the day that it came out, and while that was happening, like, you know, so I was in my house, had my phones all set up. It was through FaceTime, which feels like really “Today Show.” That’s how you like to do this. Anyway, it was through FaceTime, and, you know, after a minute of staring at a black screen with a smile on my face because they were like 60 seconds for a commercial, and it’s just like…I wasn’t actually all that nervous, but those 60 seconds when I’m staring at a black screen and like hearing my heartbeat I was nervous for the moment. And then they’re on and, you know, Jenna and Hoda are introducing the idea and they go to the clip of you and five other people reading them, and my phone cuts out. It says, you know, like poor connection. 

Dr. Fox: No battery. 

Gina: Poor connection. And I’m like cursing, and my husband who’s my IT guy is like, “What?” You know, and I’m like, “Can they hear me cursing?” So I just took it off of Wifi and I did the thing through LTE and it was fine. But anyway, so I didn’t see anybody read the notes until later that day when I watched the whole thing once, and I haven’t seen it since, but I do remember you being great. 

Dr. Fox: Oh, yeah. Thank you. No, listen, it was a nice piece. I think they did it in a nice way also. I get a lot of thank you notes, obviously. Every single one is appreciated. It really is. I mean, honestly, sometimes people send them with a photo of the baby. Some of these people send gifts like small…like whatever, a bottle of wine or this. It never matters. Anytime someone takes the time to write something as a thank you, I love it. It’s so nice. I try to always, you know, reach out back. 

Usually, I’m not going to, you know, hand-write something because, first of all, my handwriting is terrible and they’re, like, literally illegible, but it’s also, you know, either I’ll shoot them an email if we’re an email correspondence or texts or I’ll try to call them and just thank them because it does make the entire experience more…You remember it nicer. It’s just…oh, like I’m so happy, you know, that they reached out and they thought about me. It just does make your day when you receive something like that. So I’m a big fan of it. I’m curious, this is a massive process that you went through, you know, a year of doing this and then whatever, call it six months plus writing it, and then… 

Gina: Well, six months selling it, and then eight months writing it and then all the press and marketing. 

Dr. Fox: Yeah. And it’s talking about it. So this is years that you’ve been thinking about this. I’m curious, what have you learned from all of this? There’s a lot, but what are some of the top things that you’ve learned either about yourself or about this idea of gratitude? 

Gina: Well, about the process of writing a book and this whole thing, I have to say, you know, I felt like at every stage that was my own steam, you know. People have ideas, and I felt like at every stage I wanted somebody, an agent or an editor or somebody to come in and help in a way that…I don’t know. It takes a lot of self-starter. It just takes a lot of energy and time. And I don’t know. It’s like I feel like when people are asking me for advice, it’s sort of like, “I don’t know. Do it and keep doing it and keep trying and then keep going.” It’s been wonderful. It’s been so much work and it’s all my own steam. I don’t know. So I guess I don’t know what to say about that except it’s been great but it is a lot of work. I feel like people want a little bit of a shortcut for some of this stuff and there’s no shortcut. 

Dr. Fox: No, it’s years. I want to talk about gratitude for a moment because that’s obviously what the theme of the book is and I’m a big fan of gratitude. I think it’s awesome. And I wanted to ask you just because you’re basically an expert in gratitude now, whether you like it or not. 

Gina: Yeah. I like it. 

Dr. Fox: Yeah. You’re one of the experts people are going to, you know, interview you for their books. So I wanted to ask you, what is the difference or maybe the benefit of showing gratitude, right? Actually, sending the thank you note versus having gratitude, right? Because someone could be like, “I’m so grateful for that person and…” that sort of feeling of gratitude versus actually doing it, sending the note. How does it take you to the next level? 

Gina: Right. Thank you for that question. That’s my whole sort of thesis I feel like is, you know, people know that gratitude is good and helpful. I certainly knew that before this project. I feel like, you know, open up “The New York Times” and there’s a new headline about a new study that says gratitude is very good and very helpful, you know. And I think people experience it when they see a sunset or the, you know, baby smile and they say, “I’m so grateful for this moment.” And those are great, wonderful, helpful things. 

But there’s a big difference between feeling it and expressing it, and that really unlocks a whole lot of potential and it’s sort of where the magic happens in that difference, you know. And even a gratitude journal, which is lovely because it’s intentional and it’s a space where people, you know, put those thoughts. My feeling is it’s even better to take those thoughts and share them, you know. And the reason it’s so much better is that it’s basically…I don’t know. It’s doubling this thing, you know, like if I had been sitting in that train and writing in a gratitude journal, first of all, I would have gotten bored, I think. 

For me, gratitude journals are…I feel like I’ve gotten them over the years a couple times and I start off great and then they taper off, and I don’t know, they get buried under novels on my nightstand. But, you know, this never got boring, I mean, to go back to your question before, was it ever boring? You know, it wasn’t something on my to-do list and so I had to make time for it, but it never was boring because it sort of curates the thing. For me, it sort of helped me curate these wonderful things in my life that I hadn’t necessarily thought about for a long time and helped me sort of bask in them and then to share them with the people that were responsible was this extra layer where it’s not just sitting for a moment and thinking, you know, the birth with Charlie was great, wasn’t it? My face didn’t fall off. There was no even chance my face was going to fall off. That was great. Wow. I’m happy about that. 

And then, you know, just sitting for a few minutes and sharing it with you and sending it, and then hearing your voicemail and response, I don’t know. It just feels like it didn’t take me long to write that to you. It wasn’t like something that was a major…you know. This was just a few minutes, just a little focus and a few minutes and a stamp and an address, but it just meant…It just extended those feelings for me and then shares it with you, you know, and then times hundreds, obviously. 

Dr. Fox: I think that some of it is also this idea there’s two benefits to the gratitude. 

Gina: Right. 

Dr. Fox: Or two, I guess, categories of benefit. One of them is just this idea of feeling grateful like it’s good for the soul. It’s this idea that we do rely on others. It gives you some humility. It gives you, you know, just this appreciation of life. Okay. Like, that’s idea of gratitude, and maybe you can get that from a gratitude journal, although journals are tough. I get it. I think that the other aspect is it really either makes or strengthens or like you said, you know, elongates that relationship aspect of it, whether it’s to another person, which is typically the case, but it doesn’t have to be a person. It could be something, you know, an object, it could be a place, it could be something, but it just makes that connection closer, and so much of that is what makes us tic as humans, the fact that we had this experience together, right? So your birth, and it’s a profound experience in your life. It’s a experience for me and it’s happy, but okay then, we go our separate ways, but sending a letter links us as people for a longer period of time. 

And I just think that adds so much and it’s what you said about…There’s a quote, you know. There’s a lot of quotes in here, but one of them is this idea that expressing gratitude made you a happier person. It just made you happier, and, like, why would that be? And I don’t think it’s just because you had gratitude because you were very precise. You said expressing gratitude made you happier. The fact that you sort of, like, made that connection, like that link, you know, reach out and grab someone in a sense. I just think that that’s…it makes people happy to have connections with other people, particularly when it’s about, you know, these deep events or even mundane events, anything. 

Gina: A reason not to do that project at the time was that I had these two kids and this busy life in rush hour of my life, but it was actually the perfect time to do that because of that because that was my whole life was just looking after kids and then looking after my business and then, you know, marriage sometimes. And it’s like those three things. That was it. And I had no time for friends and no time for hobbies. And I felt disconnected from a lot of people and even disconnected from however I used to think of myself. It’s like I had all…I was only a mother and a content marketer, I guess. I don’t even know what to say what I was…you know. I’d lost track of a lot and I missed it, but it was in this vague way that I had no idea how to get it back, and this felt like this little plan to re-establish connections with people that meant something to me. 

Dr. Fox: Right. And from an efficiency standpoint, I mean, we don’t have time to go out to dinner with all of our friends for three hours, you know, which will be lovely, right? And that’d also be great, but you could spend three minutes and write a card or a text or an email and send it and you get almost the same sort of value from it. Obviously, it’s not the same benefit because you don’t have the experience of, you know, dinner and spending time and talking longer going back and forth, but just in terms of a connection standpoint, you… 

Gina: Yeah. It was quite efficient. 

Dr. Fox: Yeah. You can maintain so many relationships with just short messages because the people receiving them are probably busy too, and so for them, they just have to read it for three minutes and then they feel great. 

Gina: Right. I think I said that those notes were acting as a bookmark until we did have time to sit down or that’s what I hoped they would do. 

Dr. Fox: Any dos and don’ts you want to give our listeners in terms of thank you notes? Because people are going to be like, “All right. I’m doing it. I’m on this. I’m writing some thank you notes.” Anything you learned? 

Gina: Yeah. I mean, they all have to do with getting out of your own head. I mean, the more I talk to people, people are nervous that their handwriting is bad, that they’re not a great writer, that they’re too late, and it’s just that those…I think that all those things are masking the fear that we were talking about, the awkwardness and the… It is, you know, a deal just, you know, write something that’s earnest. I feel like we are trained in life to be cool. You know, it’s like that is a thing that we strive for is to be cool. 

Dr. Fox: I missed that training. I missed that day in school. 

Gina: And I feel like I’m in my adult life just trying to strip away all my coolness and just be earnest, and I feel like this is an earnest practice of…and not that you can’t be funny or silly or strange in the…like be yourself in the notes, but it does take this little bit of bravery to sit down and say, “I still think about you, even though we haven’t seen each other in years, and I remember this thing we did, and this is what it meant to me.” And so, I feel like people’s hang ups, honestly, are about that if we were like on, you know, a shrink’s couch. But to address the literal ones, no it doesn’t matter that your handwriting is bad. If it’s such a hangup, just type it and mail it. I mean, email is fine. I do feel like getting something in the mail is this gift and it’s not next to, like, a restoration hardware sale email. I don’t know. It’s like there is a… 

Dr. Fox: It’s next to restoration hardware mailing. 

Gina: Mailing, but it’s its own thing. 

Dr. Fox: So it’s tactile. 

Gina: It’s tactile. 

Dr. Fox: Yeah. 

Gina: Right. And, you know, so type and mail, if you must. What matters is that you sit down and just try to think about that person and what they meant to you and what they did and thanking them for it and how it made you feel. 

Dr. Fox: So what’s next for you? 

Gina: I have on my list to figure out some gratitude like seminar talks kind of thing. Like, I want to talk to schools and companies, and I feel like it’s all there in my book and etc., but I need to actually organize it. Yeah. I’d like to sort of share it in that way. Like, I have it in this book, but people actually have to buy the book and then open it and read it. And so, I want to find new ways to share it. 

Dr. Fox: It’s amazing. Well, thank you so much for sharing with us, and for coming in the podcast, A, coming to talk about it, B, writing the book because it really is. I read it. It’s a fast read because it’s interesting. It’s easy. You’re a good writer. It’s not…you know. You want to hear what’s up next. You want to hear you throwing all the personal touches and some of the excerpts from the thank you notes. So it’s really cool. Really, there is so much to learn from this. I think a lot of people get it what a benefit gratitude is but don’t think enough about it of how we can all incorporate it into our lives in a more regular manner. And I think that it’s important to spend some time to think about that because we could all do better at showing gratitude to the people we care about and the people we are grateful for in our lives, and you brought that to the world, so thank you. 

Gina: Yeah. Thank you. And nobody has to write 365 in one year. 

Dr. Fox: Yeah, I hope not. 

Gina: No, definitely not. 

Dr. Fox: Just, you know, what would you say? What’s the right frequency? 

Gina: For me, it’s nice to just come up with some goals. So maybe it’s like 30 in a year and maybe that means you come up with 6 topics and…I don’t know, do that math. You know, whatever it is, just like fill in. Instead of, you know, I did 12 topics, 365 notes, you could do 3 topics and 15 notes, whatever it is. It’s nice to make a little goal and then write a little list and then write and send. 

Dr. Fox: It’s amazing. Well, Gina, thank you. The book again is called. “I Want to Thank You.” I assume it’s everywhere people get books. 

Gina: Everywhere people get books. Yeah. 

Dr. Fox: Everywhere you get books. Thank you so much for coming on. 

Thank you for listening to “High Risk Birth Stories” brought to you by the creators of the “Healthful Woman” podcast. If you are interested in telling your birth story on our podcast, please go to our partner website at www.healthfulwoman.com and click the link for sharing your story. You can also email us directly at hrbs@highriskbirthstories.com. If you like today’s podcast, please be sure to check out our “Healthful Woman” podcast as well where I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Have a great day. 

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