“Dr. Fox Finally Sits in the Guest Seat” – with Guest Host Dr. Stephanie Melka

Dr. Fox: Welcome to today’s episode of ‘Healthful Woman’, a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB/GYN and maternal-fetal medicine specialist practicing in New York City. At ‘Healthful Woman’, I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness.

Dr. Melka: Hi, this is Melka. Welcome to ‘Healthful Woman’. I have taken over. I’m your first guest host with our fearless leader, Dr. Nathan Fox.

Dr. Fox: Hi.

Dr. Melka: I’m interviewing him for his own podcast.

Dr. Fox: Beautiful.

Dr. Melka: You have so many listeners, and we don’t know anything about you.

Dr. Fox: I’m a mystery.

Dr. Melka: I know, we’re gonna break that down.

Dr. Fox: All right. Hit me, hit me. I’m glad to be here. Thank you for inviting me, Malka. This is really kind of you. I’ve been waiting for this for a long time.

Dr. Melka: I gave him no choice.

Dr. Fox: Yes. It’s all good. I’m happy to do it. If I can dish it out, I should be able to take it myself. So I’m in the hot seat.

Dr. Melka: We’re not doing a mailbag. There’s no medical questions, so just social.

Dr. Fox: Beautiful.

Dr. Melka: Tell me about yourself.

Dr. Fox: Yeah. What do you wanna know?

Dr. Melka: Where are you from? Where did you grow up?

Dr. Fox: So I was born and raised in Chicago, Illinois, which was…

Dr. Melka: A lovely little town.

Dr. Fox: Awesome. A big fan of the city, a big fan of Chicago. So I was born and raised there, my parents are both from there, and I was there through high school. And then after high school, I went abroad for a year to Israel. And then I went to college in New York, which was, I’d only been to New York twice before in my life for like once for a Model UN and once for a basketball tournament. I didn’t know much of anything. I wasn’t a big traveler. I hit New York, went to college, and that’s where I met my wife. So I’ve been stuck here ever since.

Dr. Melka: What brought you to New York?

Dr. Fox: So, it’s interesting. I was not what you would call a serious student in high school. You know, I mean, I guess I got pretty good grades. You know, I was bright and it wasn’t like I blew off school. Like, I went every day and, you know, I wasn’t like a troublemaker or anything. But I didn’t really think too much about my future, so to speak. And I was just telling this story recently. So when it was time to apply for college, I know nowadays I have kids applying to college or in college and it’s like, psycho, and I get. It’s like that’s the world we live in now. And back then, it was definitely different. It wasn’t as different as I’m about to describe it. I was an outlier then also, but I really did not care.

I put no thought into it. I did not care. I applied. I was going to apply to only one school, which was gonna be Yeshiva University in New York. And I figured, yeah, I have friends who go there. I know people who went there. I’ll probably get in. It seems fine. And so I applied there. Fun fact, they sent me back, this is all by mail at the time, a letter saying, “You know you actually do have to write the essay,” because I figured I’d just get in, like, whatever, they’ll take me. And actually, for the essay, I was so irritated that they wanted me to write an essay. I’m like…

Dr. Melka: Tell me, what did you write your essay about?

Dr. Fox: So I didn’t. So I was like, so I’m like, “Of course, you’re gonna take me. I have good grades. I’m a nice guy. Like, why wouldn’t you take me?” It’s not like they were that rigorous. So I actually pulled out one of my school notebooks, like an assignment, and I just tore it out of the notebook, like, you know, da da da da. Like, not like a loose leaf. It was one of those, you know, notebooks with the spirals. I tore it out, handwritten, folded it up, and just mailed it to them. They accepted me.

And so I was sitting, I remember in history class, and Justine Levin, who was sitting next to me, whose mother was our guidance counselor, Mrs. Cynthia Levin, Justine said to me, “Where are you applying to college?” I said, “I’m applying to NYU.” She goes, “Are you gonna apply anywhere else?” I’m like, “No.” She’s like, “Well, why don’t you apply to Columbia?” So I said, “Oh, where’s Columbia?” I’d never heard of it. I’m 100% honest here. I’d never heard of Columbia University. She’s like, “Nathan, it’s an Ivy League school. It’s in New York City.” I’m like, “Oh, who knew?”

So I went to her mother’s office. And at the time, this is again pre-internet, at the time that she just had stacks of brochures from the colleges at, you know, local colleges and, you know, Ivy League schools and places around the country that, you know, kids from my high school had gone to. And I pulled one from Penn, one from Brandeis, and one from Columbia. I knew about Penn and Brandeis because my older brother had applied to them, and I pulled all three. nd I only applied to Columbia because they were of the three, they only required one essay.

Penn required three. Brandeis required five. I said, “There’s no way I’m applying to these schools.” So I applied to Columbia. I wrote my essay famously about the bathrooms at Wrigley Field, about the toilets there. And I think it was actually a tremendous college essay. It’s probably what got me in. And ultimately, I got in off the waitlist and I said, “All right, I’m going to Columbia.” So that’s how I chose New York. It was, again, not much deep thought process there.

Dr. Melka: Did you know then you were heading into medicine?

Dr. Fox: I did not know then. I had an inkling that I might. So in my house growing up, my father’s a doctor. His father was a doctor and it seemed cool, like, okay, you know, my strength was more math and science. I was predominantly illiterate before college. I didn’t read much. I was a horrible writer. But I was good at math and I got it. Math and science was my thing. So I said, “Okay, that’s good.” And again, I didn’t put too much thought into it. When I started college, I started pre-med. But then I definitely thought maybe I wouldn’t do it. And then I quickly came back to it.

I didn’t greatly consider any other careers. At one point I thought maybe architecture. Yeah. But I have a horrible sense of design. I mean, horrible. I mean, I can understand the geometry of architecture. I guess I’d be more better more like a structural engineer than architecture because I have no style. I have no panache, like nothing.

Dr. Melka: We know.

Dr.Fox: I’d be horrible. I could build like factories, you know, I suppose. But ultimately, I didn’t even think about that too much. So it was pretty much medicine from day one, I guess. Yeah.

Dr. Melka: And you said you met your now wife in college.

Dr. Fox: Yeah, so we met freshman year. She was at Barnard. I was at Columbia. It’s interesting because we had each met all of the others’ friends beforehand. Like, in our year in Israel, you know, when you come out of a Jewish high school, a lot of the kids nowadays, it’s like 90% will go to Israel for the year. It’s just like a thing to do. Everyone does it. There’s programs for it, I mean, there’s boys programs, there’s girls programs, there’s like university programs, there’s travel programs. Like, pretty much everyone does it. And so you meet like kids from around the country, you know, around the world even who are your age and doing the same thing. So I knew all of her friends and she knew all of my friends, but we had never met. Just coincidentally, we never met.

And I remember we’re sitting at a kosher meal plan and it was Hawaiian Chicken Night. And I was sitting across from this, you know, nice girl, it was a young woman, whatever we call freshmen nowadays at Barnard. And we’re talking, and it came out at some point that she played tennis, I think, for her high school tennis team and I’m from the Midwest. I’m a nice guy. I’m just trying to make friends here. So I said, “Oh, I also play tennis. Maybe we should play sometime, right?” That’s like not a pickup line. That’s a very Midwestern thing to do. Just, “Hey, we’ll play tennis sometime.”

And so she looked at me and said, “Well, are you any good?” And I was like, “Oh.” I was like, I’m intrigued. And I said, “What do you mean?” She said, like, “Well, like if we play, like are you gonna suck? Are you gonna hit into the net every time? Is it gonna be like really annoying? Are you good? Are you gonna kill me?” Like this, that, and I was like, “Wow, I’ve never met anyone like this before. I think I’m in love.” Yeah. And so I asked her out shortly thereafter. We went to Disney on Ice for our first date. We sat in the second to last row because, I mean, just like $15 tickets or whatever it is.

I remember I had to, for our first date, we had a mutual friend who said to me, Nathan, “What are you gonna wear on this date?” I said, “What do you mean?” I was like, “I’ll wear my clothes.” She’s like, “Dude, you can’t wear high tops, acid-washed jeans, and a t-shirt on a date with her.” I was like, “Well, I don’t have any other clothing.” So I had to borrow a button-down shirt, a proper shirt from Robbie Finklestein. He had one and I still wore the acid-washed jeans because that’s my pants. And I had to buy a pair of shoes. I had no shoes. I just had sneakers like high tops. And so I went to Harry Shoes on the West side. I bought my first pair of proper brown shoes. More than the date, we were in the real cheap seats. She said, “Oh look, there’s our high school custodian is like the section in front of us.” And yeah, I was in love immediately. I dunno how she felt, but I was in love immediately.

Dr. Melka: Yeah. Did you ever play tennis?

Dr. Fox: Yes.

Dr. Melka: Did you suck?

Dr. Fox: No, I crushed her. I crushed her. She’s a great tennis player. You know, I’m a foot taller than her. So, you know, I have reach and, you know, I guess I at the time served harder than her. You know, whatever. She’s a really, really good tennis player. But I did beat her and we still, or I still, hold it over her for sure, yeah. But we didn’t play till, I think it was like that winter she came to Chicago to visit me during winter break and we went to like the local tennis club or something.

Dr. Melka: She probably wouldn’t have married you if you crushed her at the start.

Dr. Fox: Or she could, maybe she would’ve respected me more. I’m not sure. I mean, when we first met, she’s seeing a guy again in high tops, jeans, and a t-shirt from the Midwest who’s a little strange and probably uncomfortably friendly to her. And I impressed her because I was also kind of gross. I mean, it’s still kind of gross, but I did the thing where you take a chicken leg and you put the whole thing in your mouth and then you just pull out the bone.

Dr. Melka: Pull out the bone like they do at the Wing Bowl

Dr. Fox: Yeah.

Dr. Melka: The wing-eating competition.Yes. Gotcha.

Dr. Fox: So that was one of my moves. And I’m sure she thought it was horrific, but she’s like, “Oh, he’s a little different than all the, you know, normal guys I know.”

Dr. Melka: All the rough New Yorkers around here.

Dr. Fox: Yeah. So they weren’t doing that. Yeah. So, I mean, we started dating at the very beginning of college. I knew very soon that like, I’m marrying this woman. I think she came around to it eventually. And we got married in college. We were juniors.

Dr. Melka: That’s amazing.

Dr. Fox: I was 21 years old, she had just turned 22. She’s a few months older than me.

Dr. Melka: And everyone in New York at the time remembers the weekend of your wedding.

Dr. Fox: Yes. For anyone who was alive in January of 1996, there was a four-foot snowfall on that day, the blizzard in ’96. And that was during our wedding. So it was awesome. I mean, it’s memorable. I mean, literally just last summer, so in 2022, I was at a wedding. And the guy at the band, the keyboardist, was the guy who played at our wedding. And I went up to him. I said, “Hey, just to say hello, I’m Nathan Fox.” He goes, “Oh my god, blizzard of ’96.” So he said, “That was unbelievable,” because the wedding was a Sunday and pretty much everyone was stuck at the venue till Tuesday or Wednesday. They closed the turnpike.

Dr. Melka: That’s amazing.

Dr. Fox: Like, literally they closed it. You couldn’t get anywhere. None of the flights went out and it was just like a three-day… It was awesome. They emptied the bar of all the alcohol. The caterer had a ton of… They kept serving food from the wedding. Just like, you know, they kept serving whatever they could. It was really awesome. It was a lot of fun. It was, you know, for some people stressful. But us, we had a great time. All our friends were there for three days. it was really pretty cool. Yeah. That was our wedding, the blizzard in ’96.

Dr. Melka: Nice.

Dr. Fox: Good times.

Dr. Melka: So you finished college and you go right to med school?

Dr. Fox: Yeah.

Dr: Melkaa: At Sinai.

Dr. Fox: So actually I graduated college a semester early…

Dr. Melka: Of course.

Dr. Fox: … Which I guess, it was probably the dumbest thing I ever did in my life. I was like, yeah, I’ll graduate early. It will be great. And then I’m like, well, what the hell am I gonna do now? So I worked at a bank, Bear Stearns, from January to August as a temp, like as a secretary. I wasn’t a banker. I was like literally like I was doing someone’s travel plans and like, you know, typing things for people. I couldn’t type. I don’t know. It was terrible.

Dr. Melka: My mom worked for AT&T and had Bear Stearns as a client.

Dr. Fox: Interesting.

Dr. Melka: You very well might have overlapped.

Dr. Fox: I remember, yeah. There was Hans Bald was the name of the guy in charge of our group. I’ll never forget that name. Hans Bald. But, yes, I worked as a secretary for eight months. We had to leave housing because when we got married, right, you can’t live in the dorms really as a married…I guess you could, but we didn’t want to. And so I went to the dean of students I’m like, “What do I do about housing?” He’s like, “Huh, I don’t know what we do about housing. He’s like, this doesn’t come up often.”

And apparently, Columbia guaranteed housing to all of their undergrads and they didn’t specify single. And so he said, “I guess if you show me like your wedding invitation, like some proof that you’re like, not bullshitting me, that you’re really getting married, we’ll get you an apartment.” So we went into grad student housing at Columbia. We lived at 112th and Broadway across from Tom’s, which is the famous diner from Seinfeld. We looked out our window and saw that sign and it was unbelievable housing. It was 542 West, 112th Street, Apartment 2H. Wow, what a place. Great rent.

Dr. Melka: It probably costs like $500 a month.

Dr. Fox: At the time it was like $800. But it was less than we had been paying combined for our housing at college. Right. Let’s say we each paid $500 a month. This was less than $1,000 a month. And so we moved in there. But after I graduated a semester early, we got kicked outta housing. And Barnard does not support their students marrying in college and was not gonna offer us housing. They were, I think, very disappointed in that. And so we moved to Riverdale for eight months. We subleased from the Kornblaus [SP], who were in Israel at the time. We subleased a two-bedroom there. We had a lot of friends there at the time, so it was nice. And then I started Mount Sinai in, I guess, August or September, whenever you start medical school, and then we moved to Sinai married housing at Park in ’96, 1245 Park.

Dr. Melka: It still is Sinai Housing.

Dr. Fox: We were there for eight great years. I loved that building. Loved it. What amazing housing. Yeah. We had a Smitty, Jose, Malcolm. We had all the guys at the front. There’s some of ’em are still there. Yeah, a great building. It was a great neighborhood. The rent, it was more than we were paying before, but it was well under market value, and it was awesome.

Dr. Melka: And walking distance to the hospital. What more could you want?

Dr. Fox: Walking distance to the hospital. We were near Central Park. I mean, it was…

Dr. Melka: A block from the Subway, it’s perfect.

Dr. Fox: It was a great location. It was really, really good. We’re very happy there. Yeah.

Dr. Melka: Yeah. So in med school, when did you decide on OB?

Dr. Fox: So when I was at Sinai, they had this program for the second-year med students. The curriculum is a little different from what it is now, but as a second-year med student in, I think the second semester or whatever it is, you had an afternoon a week where you were supposed to do something clinical, like either shadow a doctor, or go to the emergency room, or something because it was mostly classroom during the first two years.

And there was a guy in Mount Sinai, his name was Jay Bauman. He was an OB/GYN and I don’t know why I asked him where I got hooked up with him. I don’t remember how that happened. But I’d go to his office on Tuesday afternoons and I would see patients with him. And Jay was a great OB. Do you mind? I mean, his patients loved him. He saw a ton of people. He was really nice to them. He was really nice to me. He would, you know, let me see patients with him and he would teach me. And then he said, “Hey, if you want like to do deliveries with me, just let me know.” And I said, “Yeah, I’d love that.” So I got a beeper, right? This is, I mean…

Dr. Melka: Before cell phones?

Dr. Fox: Pre-cell phone. I mean, the only people who had beepers back then were med students and drug dealers, right? And so I was certainly not the latter. I was like the cleanest guy ever. So I got a beeper and if he had someone in labor at night, usually Tuesday nights, but sometimes he would page me and I would come in. So it was so cool. I’m a second-year med student and I’m coming in 10:00 at night, 11:00 at night. I’m doing a delivery with him. I’m doing a section with him. And it was amazing. Like, I loved it. It was so cool.

So I was really intrigued by OB. Now obviously, had I done that with general surgery, that would’ve been very cool too or medicine or cardiology. But it definitely, it was the first time I thought about OB/GYN as a possible field. I certainly going into medical school had no idea what I wanted to do. I mean, really, I can’t think of it at all what I wanted to do. And my father’s a neurologist. My father-in-law was a gastroenterologist, which are very different, but, okay, they’re both interesting. And then when I did my clinical rotations in my third year, my first rotation was OB/GYN.

I had an amazing rotation. I loved it. I did it at Mount Sinai. And pretty much every rotation after that, I compared to OB. And, you know, I liked a lot… Most people break down into people who like things and people who don’t, right? So I liked pretty much all the rotations. The only one I really didn’t… I didn’t like psychiatry too much just because I think the experience I had was not very good. You sort of found yourself rooting for the patients over the doctors, you know. You’re like, I started with the schizophrenic on this one. You know, like, you know, I’m with them. But I think it’s just because it was inpatient psychiatry, which is very different from outpatient. They’re much sicker. It’s a much different situation and it’s very painful because none of ’em wanna be there. It’s very, very hard.

And I didn’t really like pediatrics. I thought it was almost like veterinary care. Like, I felt bad. The kids had no say. It was all like, it’s like the parents. And I said like, “I root for the underdog. the same way. I just felt like what does he have to say about this, or what does she think, you know?” So there’s only two I really knew I wouldn’t do. I liked medicine, I liked neurology, I loved general surgery. I knew I didn’t wanna be a general surgeon, but I love general surgery. The great Brian Katz was my preceptor. It was just amazing. And then ultimately I was like, you know what? I really just love OB. I like the science of it. It’s fun, it’s interesting, it’s good for someone who’s got a short attention span, and likes moving from one place to another. And, you know, one day I’m seeing patients all day in the office. The other day I’m operating. The other day I’m on the labor floor and I love that, you know.

Dr. Melka: It sums it up perfectly.

Dr. Fox: Yeah. And also I knew I was interested in it, meaning this was sort of the first… When I was in med school, sort of the first time people started talking about like quality of life and, you know, balance and wellness. It was like the seeds. Like, before that in medicine you just got killed. Like, forget it, you’re getting beaten to death for like your whole training. And I was like, the beginning of that renaissance was when I was in med school. But I was like, well, I’m gonna go into the field because it’s easier, but like if I don’t like it, I’ll be bored. And so I really didn’t want to be bored. I bore easily. So then I did a lot of electives for OB, I did like a uro-gyn elective, I did oncology elective and I did, you know, MFM, and really, I loved all of it. And so I was pretty certain I was doing OB.

Dr. Melka: Nice. And somewhere around this time was when you and Mihal had the twins.

Dr. Fox: Right. So they were born…

Dr. Melka: In med school?

Dr. Fox: Yes. So they were born in November of 1999, right before Y2K. They were literally born right between my… it was between my OB… No, it wasn’t OB. It was right after my peds rotation, right? That’s right. She was pregnant during my OB rotation, which is pretty cool. And then they were born when I was on my peds rotation, which was definitely a wrench in the system when you’re a third-year med student, and now you have twin newborns. But, I mean, my wife is a saint. She took the brunt of that obviously.

Dr. Melka: I couldn’t even take care of myself as a med student. You’re married, you got kids. That’s like way ahead of the game. What was that like?

Dr. Fox: So people asked me at the time because, you know, in my class, we definitely had… there were plenty of people who were married. Some of them were older. You know, started [inaudible 00:20:21] high school, other than the year high school, college, med school, like the traditional path. So I was on the cohort of like younger med students. But there were certainly people who were, you know, 5, 10, 15 years older than us. So many of them were already married. Maybe it’s, you know, just going back to school, whatever it is.

I always felt it was better in a sense for me because I didn’t have to worry about my social life, right? So when you’re a med student, it’s hard to have a social life when you’re a med student or a resident because you work really hard and you’re in school and you’re studying and then you have to like, all right, I gotta go out. Do I go to a party? Do I go to a bar? Do I go on dates? What do I do on weekends? And it can be very stressful because either you’re trying to do things and you don’t have time to study or you’re not doing them and you feel like you’re only studying like, I’m such a loser. Like you’re, you know, it’s like miserable.

I came home every day. You know, my wife is there, my kids are there. It was wonderful. And, you know, I definitely had friends. I mean, you know, my friends from school, you know, beforehand and med school, I made a lot of friends. So I was social, but I didn’t feel any pressure to be social. Like, it just sort of was waiting for me. So I felt it kind of grounded me, which was nice. And it also made my hours much more regular. Like, I would go in the morning, go to class, study, and then come home like early evening.

And then I was pretty much done. Like, it was like a job because, you know, you’re in class for like three hours. And so I would just sit and study at school for four to five hours. And then when I got home, I didn’t feel like I had to study at night so much. Like, a lot of my classmates would in the afternoon, like go work out, go do stuff, go to the movies, take a nap, and then they would study at night, and I was much more regimented, I think, because of my family.

Dr. Melka: That’s amazing.

Dr. Fox: Yeah. It worked out nicely. They were really cute kids also. They were good. They were fun. We had a lot of fun then. It was also crazy because Mihal, she was in school, at the time, she was doing her [inaudible 00:22:15]. You know, she was in school full-time. And when the kids were born, we had to have like someone come to our house and watch the kids during the day and whichever one of us got home first would relieve them and feed them. So I couldn’t come home until I was like ready to be dad, but it worked out well. So evenings we were dealing with them. My daughter was a psycho for the first six months. She didn’t sleep. She just cried the whole time.

Dr. Melka: That’s awful.

Dr. Fox: So we had to, you know, deal with her. But, yeah, I really enjoyed medical school. I look back on it quite fondly. Yeah.

Dr. Melka: And then that regimented schedule must have continued into residency and intern year.

Dr. Fox: Yeah. Residency even more so. I mean, residency is really brutal. I mean, you’re waking up. It is. We had the work restrictions that they have now because in New York they were sort of ahead of the game with, you know, limiting to 80 hours a week and, you know, 24 hours and not more. I mean, it was…

Dr. Melka: Were they followed back then?

Dr. Fox: They were followed. I mean, I think they weren’t as militant about it then as they are now, meaning it wasn’t like a hard stop at 24 so and so like drop what you’re doing and get outta here. But it was like, yeah, you go home the next morning. And so I thought it was very reasonable. I mean, it’s hard, but it wasn’t crazy. But you’re working 80 hours a week every week. That’s a typical work week is 40 hours. So you’re working twice as many hours as, you …

Dr. Melka: Yes.

Dr. Fox: …most people are. So I woke up very early, which was never a big issue for me. And then yeah, when I would come home, that’s it. I was home. It was great to come home with my kids, my wife. You do have to do more at night as a resident. Sometimes you have to read or this, but it was, you know, the weekends I was off, I didn’t have to worry about what am I doing. We had stuff going on and it was actually nice. She would frequently… If I was on call like on a Saturday, she’d walk over with the kids and bring ’em to the labor floor.

Dr. Melka: Oh, that’s so cute.

Dr. Fox: And like they would eat, you know, graham crackers and apple juice. That’s what we had on the labor floor and the nurses got to know them and the residents. I mean, I still like some of the nurses on KB4 still ask me about my kids because, you know, they’d come by and we live so close. It was really easy. You know, there was no commute basically, other than we were covering Elmhurst, which is a little bit of a commute, but nothing crazy. So it was good. And we had our third, Nelly, was born when I was a third-year resident. And, in fact, people ask how much paternity leave I got. Zero. She was born on a Thursday. I didn’t work that day. I worked Friday.

Dr. Melka: Sure.

Dr. Fox: And I was on call for the weekend.

Dr. Melka: How fun.

Dr. Fox: And so I was the resident on call when Mihal was in the hospital.

Dr. Melka: Did you have to round on her?

Dr. Fox: So I didn’t round on her. We knew the proper boundaries. I visited her obviously, and I figured, well she’s there, my daughter’s there. Like, why not take call? Like, what am I gonna do at home? Like, I’d rather be in the hospital. But she did astutely say about her roommate, she was like, “Do you know this doctor so-and-so?” I’m like, “Yeah.” She’s like, “He’s kind of terrible, right?” I was like, “Why do you say that?” She’s like, “Because I heard him talking to the patient across from me and he does not sound too impressive.” She was correct. No longer at Mount Sinai, but …

Dr. Melka: Amazing.

Dr. Fox: So I got no paternity leave and then we had, yeah, so that was during my third year. So for half of my residency we had two kids and the other half we had three kids all shoved into that apartment in 1245 Park, which I’m not complaining about, all three kids in one bedroom. It was great. I loved it.

Dr. Melka: And then you leave Mount Sinai for Cornell Fellowship.

Dr. Fox: Yeah.

Dr. Melka: Have I got that right?

Dr. Fox: Yeah. That’s another crazy story. So in my class for residency…

Dr. Melka: Oh yes. Who was your class?

Dr. Fox: Right. So at my time, there was seven, right? And of the seven of us, four were gonna go into maternal field of medicine, do MFM. So my class was me, Manashck Fear [SP] doing MFM, Ryan Longman, AKA, Long Pants who was gonna do MFM, Laura Friel, who was gonna do MFM. So the four of us were doing MFM. Then there was Carmit at the time, Archibald Sterin [SP], now Archibald. And there was Julie Clark and Christina Tassi. So that was us. Christina and I were the chief residents, the admin chiefs. Good cop, bad cop.

Dr. Melka: Yeah, admin chiefs.

Dr. Fox: Yeah. Although we were both good cops, which is why we were not very effective. So the four of us wanna do MFM, but I was the only one who wanted to stay local. Manashck went out to San Diego. He’s still in Southern Cal. Ryan went to Michigan. Laura went to [inaudible 00:26:28] Detroit, Wayne State, and one, two, three, oh, now, I’m the fourth. So I wanted to stay at Mount Sinai and I like them, they like me. There’s a match. But it was like, all right, you know, listen, I’ll rank you first. You rank me first. We’re done. So I really didn’t look around. I interviewed at NYU. I did not think that was so great. Interestingly, when I interviewed at NYU, Andre Robbar [SP] was an MFM there, I did not interview with him. It was actually someone else who ran the fellowship. I interviewed at Cornell and I interviewed at Columbia. That’s it. Those three and Sinai.

But I knew I was staying at Sinai, so no big deal. And two weeks before the list is due like you have to hand in, it’s called the rank list. I got called into Joanne’s office. She was the head of MFM and she said, “Nathan, we just lost our fellowship,” right, because a lot of attendings had left. It was just her and Keith at the time. And she said, “The board took away our fellowship,” and she said, “I’m pretty sure we’re gonna get it back, right? We’ll fix what they need to fix, but I can’t like in good conscious tell you to wait and hope that we get it back.” She goes, “You really should go to a different place.” And so I didn’t wanna go to NYU.

I was deciding between Cornell or Columbia. I think both were options for me just based on conversations, but ultimately, I wanted to go to Cornell. And that’s where I end up. Ironically, one of the fixes to them losing the fellowship is recruiting this practice from NYU that had two MFMs, Andre Robbar, and Daniel Saltzman. And so they actually came to Sinai so they could get the fellowship back. This is when I was finishing residency, 2004, 2005. And so in 2005 in June when they came, I still had three weeks left at residency. So we overlapped at Mount Sinai for three weeks and I was finishing and they had just showed up and then three years later took a job with them.

Dr. Melka: I never knew this.

Dr. Fox: Yeah. See, so that was…

Dr. Melka: A small world.

Dr. Fox: Yeah. So they got the fellowship back. And Lauren Ferrara took that spot. So Lauren and I are the same year. So she was ultimately Sinai. I was at Cornell. And as it turned out, it was probably the best thing that ever happened to my career that I ended up at Cornell. I mean, there’s some comfort in doing your fellowship the same place you do residency. You know, we had our apartment, I knew the people, they knew me, I liked them, they liked me, and there’s a big advantage to that.

But there’s a disadvantage because you don’t learn new ways of doing things, right? There’s different ways to do things. So when I went to Cornell, which is 20 blocks away, but it’s like going to a different universe, you know, no one at Cornell ever trained at Sinai. No one from Sinai ever trained at Cornell. I went to Cornell, they’re like, “Oh yeah, where’s Mount Sinai?” I’m like, “It’s right there. It’s that building. You can see it from the window.” It’s like so close, but they’re so far apart. But I learned like totally different skills than I had learned at Mount Sinai. I got to learn like Steve Chase, who was my mentor, and, you know, he taught me how to do research and, you know, it was a different way of looking at ultrasound maybe. And it was great for me. It was a really good experience to do [inaudible 00:29:34] somewhere else and then ultimately, I did come back to Mount Sinai for my job, my first job.

Dr. Melka: And we started at Sinai on the first day together. You wouldn’t remember it, but your first day back.

Dr. Fox: July 1, 2008.

Dr. Melka: Whatever that Monday was, you did the first-ever Fox Rounds with Janine Popo

Dr. Fox: Ah, that’s right.

Dr. Melka: And I was there as an intern sitting there like, please don’t call on me. I don’t know anything.

Dr. Fox: Right. So July 1st, 2008, which was my first day on the job, was a Monday, I believe, and that’s when…

Dr. Melka: I don’t know.

Dr. Fox: …we did the rounds. July 2, 2008, was my first day on the labor floor with Dan. And that’s the day we did seven deliveries, including four C-sections, one hysterectomy. It was like the craziest thing ever. I was like, “What the hell is going on here with you guys?”

Dr. Melka: Like, what did I sign up for? Oh, my God.

Dr. Fox: And they were like, this is an unusual day for us too. Like, this is not what every day is gonna be like. But I remember I was like, this is my first day and I’ve got a patient in the intensive care unit. Like, what’s going on here? I was like, yeah, it was … Andre drove me in. We went rounding on like the weekend in the ICU. I was like, “Oh my God, Andre, you did not tell me about this.” But so that’s the first day, trial by fire as they say, but everyone’s okay. It all worked out well.

Dr. Melka: Amazing.

Dr. Fox: Yes. That takes us through 2008 starting here. Good times. And that’s when we met. So now I’m gonna throw it back at you.

Melka: Oh, God.

Dr. Fox: What was all y’all’s impression of me at the beginning, the early years, Fox, the early years?

Dr. Melka: We were all like, “Oh my God, this guy knows his shit, we gotta be careful. Like, we can’t just bullshit him and pretend like we read the article. Like, you gotta actually read it.”

Dr. Fox: Right. I was illiterate in high school, but I learned to read afterwards, so now I can read.

Dr. Melka: That came through sometime in college?

Dr. Fox: A little bit in college. I mean, at Columbia, they make you read a ton. It’s like crazy. They’re like, all right, read these 600 pages in the next week, I was like, what? I’ve never read 600 pages in my life. Yeah. I guess in college.

Dr. Melka: This is actually what I remember as an intern. You…I forget the exact thing, but it was something going on with a patient that wasn’t good and the labor floor wasn’t busy. You took my vocera, you gave it to the chief and you said, “I’m taking her to learn how to talk to this patient.” And it was just, sit down 40 minutes, just not a good pregnancy, going over everything. And I was like, “Nobody has done that for me before.”

Dr. Fox: Oh, you mean because you can’t be disturbed during the…

Dr. Melka: Correct. You were like, “You’re not getting phone calls. You’re not getting called out of the room. You’re part of this case.” I was like, “Oh, cool.”

Dr. Fox: That was nice of me.

Dr. Melka: It was.

Dr. Fox: Yeah. I was really, you know, the journal club the Monday morning. I don’t remember whose idea that was, if it was Janine’s or if it was mine, but we both really liked the idea. I loved the idea of meeting with the residents every week. I mean, I was always, you know, I loved that camaraderie and just interaction. You know, when I was a resident and then when I was a fellow. I did it at Cornell a lot and I thought it’d be pretty cool. Because I’m joining like, “a private practice,” it’ll gimme a chance to be with the residents. It’s been…in two weeks, it’ll be 15 years every Monday. I have every article, by the way, I emailed out.

Melka: Oh really?

Dr. Fox: Every single one. I have ’em all.

Dr. Melka: Well, you just reply to your own email. So you probably can just scroll back 15 years.

Dr. Fox: I save all those emails. I can go all the way back to 2008 from all the articles we did. And every single person who went through that, so you’re talking 15 years of, you know, 7 or 8 residents, so whatever, 120 plus minus, I always invite them to stay on the list. And I would say most say, yes, a few opt out, which is fine. And so I’m still in touch with all these residents from all these years past.

Dr. Melka: That’s awesome.

Dr. Fox: I still have the articles. Occasionally, someone will say, “Oh my God, I loved this article, or “What do you think about it?”

Dr. Melka: Sometimes you pick an article because it was written by a Sinai alum.

Dr. Fox: Occasionally. My one rule is I never reviewed any of my own articles. I just thought it wasn’t cool. And also I think that people might be afraid to criticize. I wouldn’t. I’d be happy to criticize my own articles. I mean, they’re all… No article is perfect. So there’s always room to say what a strength and weakness is, but I never wanted to do it. And I also thought it’d be a little like that’s not the point of this. Like, it’s not, you know. So I never reviewed one of my own articles.

And I did love it when it was like former Sinai residents or a fellow or this. I just said, “You know what? Like, this came outta Sinai. Like, let’s look at it and talk about it.” And, you know, but I usually would try to go easy on them. I don’t know why. Everyone knows this person or this, you don’t wanna like give ’em a hard time. But even when I would “criticize the articles” I would say like, “The authors of this article know this. Like, these are smart people. They know this is a weakness.” Usually, it’s limited by what you have. It’s not that their brain power isn’t high. It’s just that you can only, you know, report what data you have and sometimes it’s just limited. So, yeah, and then when did you know you wanted to work with us? And I’m throwing it back at you again.

Melka: Oh, man.

Dr. Fox: Were you pining for a job from day one? Were you like, “Oh, I gotta get with these guys?”

Dr. Melka: Wait, did I tell you this story?

Dr. Fox: I don’t know.

Dr. Melka: I haven’t listened to my interview. I dunno if I told you this. I went into labor thinking I wanna be an oncologist because like they’re badasses. They can do everything. And then as I go through residency, I realize what you see as an onc subi or med student or intern is not what being a GYN oncologist is like. I was like, okay, maybe I don’t wanna do that. And then I like doing deliveries and I was like, okay, I think I’m just gonna be a generalist. Not just a generalist, I’m going to be a generalist. And then somewhere in the third year, you were like, “Melka, what are you doing next year?” And I was like…

Dr. Fox: That sounds like something I would say.

Dr. Melka: Yeah. I was like, “I don’t know yet.” And you were like, “Are you thinking you wanna stay?” And I was like, “Why are you asking?” And you’re like, “I don’t know. We’re just, you know, keeping our options open. We’ll talk. And I was like, “Okay.” And then start I fourth year, I come back from a vacation, and I’m at the hospital checking my email because I think this is even before we had email on our phones. We had little flip phones and there’s an email from you that says, “Please let me know when we can talk.” And I was like, “Oh, crap, what did I do?”

And then I guess you got my auto-reply and you replied to that. “No rush. Let me know when you’re back.” And I email you right away. “I’m so sorry I was away, I’m here. Call me, whatever.” And there’s nothing going on in the labor floor. So I go up to the peds rooftop to go sit out and [inaudible 00:36:05] and hang out as you do as a fourth year. And you call me and you’re like, “Are you busy? Can you talk?” And I was like, “What did I do?” I was like, “I’m just at work. Like, I’m worried I’m gonna get in trouble,” and you’re like, “Well…”

Dr. Fox: Yeah because I got residents in trouble all the time. Yeah.

Dr. Melka: The Melka complex. You say you have to talk to me I assume something is wrong.

Dr. Fox: Yeah. I had no authority to discipline anyone.

Dr. Melka: And you were like, “Well, we’re expanding. We’re looking at hiring. We think you’d be a great fit. Do you wanna come work with us next year?” And I was like, uh,…

Dr. Fox: That’s my pitch.

Dr. Melka: Yes.

Dr. Fox: Easy.

Dr. Melka: And then I was kind of like, well, I wanna stay in New York and it can kind of let me be like the guide on of the labor floor and do everything. And like I can come out and do, you know, some [inaudible 00:36:51] and high order sections and twins and keep doing everything.

Dr. Fox: Yeah. Good stuff.

Dr. Melka: And it was really easy because like you had only tried to apply to one college. It was just like, okay, I have this. It was like, I don’t have to worry about this anymore.

Dr. Fox: Yeah. I felt the same way when I took [inaudible 00:37:09].

Dr. Melka: So you might look at it that way that I was just like, eh, okay, fine.

Dr. Fox: You know what? It works, but it’s like that. I mean, how much can you think about these things? It’s the same thing when I looked at two jobs, you know, when I finished I was like, oh well I like this one. Andre’s a nice guy, I’ll work with it. I’m like, seems like what I wanna do but because, you know, it’s [inaudible 00:37:26].

Dr. Melka: And I was like, and this sets me up for anything else I want to do, you know, because I’ll have really good obstetric skillset.

Dr. Fox: Right. And a career in radio and entertainment, you know, so that’s good. I didn’t mention, I don’t want her to feel left out that when I was a fellow I did have another child.

Dr. Melka: Okay.

Dr. Fox: Sweet, sweet Mia, which is actually interesting because the first time when my wife was having her ultrasounds, I knew what the hell was on the screen. So she was the only one where we knew it was a girl because you know, I just see, you know, what was going on. And when she was born, I was a fellow at Cornell, but I’d come back to Sinai to deliver because that’s where my wife’s OBs were, which was really nice because, you know, again, I still knew the residents and the nurses. And I remember Andre was like, he had one of his patients in labor and he came in, he was like, “That guy talks so much.” I was like, “Yeah, he does.” And that was before it was known that I was gonna be working with him. This is just a year into my fellowship.

But the crazy thing when I was a fellow, right, I had three little kids and then four little kids. But you don’t make that much money as a fellow. I mean, you make maybe enough to cover like one person’s living expenses maybe. And, you know, I had like a family. So I was moonlighting my ass off. It was just crazy. It was insane. I was working at Elmhurst 24 hours at least a week, like a full day a week. I qualified for benefits there if I wanted, so I would work. And that’s how I got to stay close to the Sinai residence because I was there every Tuesday, right, in the morning. I’d be there Tuesday day, take Tuesday night, leave Wednesday morning, and then go to Cornell for fellowship.

Dr. Melka: I did the same.

Dr. Fox: And in your second and third-year fellowship, you’re doing mostly research and I was able to do that. Like, I did it, I’d bring my laptop and I would do it at the hospital or I would do it nights and weekends. And so no one cared that I did that. I was also moonlighting at Cornell because they needed someone. One of their MFMs left and needed someone to be in their delivery call pool. So I was on call for Cornell every fifth night and I was working for the ODA in Brooklyn taking,…I would go there one-half day a week to do ultrasounds on patients. And I was on call every third weekend for them. And this in addition to my fellowship and I needed, those are three like there paying jobs so I could like, you know, put food on the table.

Dr. Melka: Yeah, feed your family.

Dr. Fox: And it was crazy. And so when Mia was born, it was a Saturday and I was on call for the ODA for that weekend. And I remember because, I mean, I knew Mihal was due, I said to Tepper, I was like, “Listen, you know, I’m on call this weekend, but if Mihal goes into labor, are you around to take over me?” He said, “Yeah, I’m around and I’m in town. Just call me if you need me and I’ll come in.” It was the summer, so he was probably, you know, upstate or whatever it is. And he’s said, “I’ll come in. It’s not a problem.” So she delivered on Saturday. There was no one in labor.

She’s delivered on Saturday in the late afternoon, and like literally the second the delivery was done, and like Mia’s wrapped up and given to Mihal, my pager goes off and I have someone, it’s Nolab, it’s her first baby and she’s going to Beth Israel because that’s where they delivered. And I said to Mihal, I was like, “Do you want me to call Tepper?” And in true Mihal Fox fashion, she’s like, “No, why would you do that?” She’s like, “We’re done here.” You know, she’s like, “Don’t owe him a call. Just go. Like, I don’t need…

Dr. Melka: I don’t need you and you’re gonna have to pay him back. So just leave.

Dr. Fox: Yeah. Here she is and she’s like, “Their kids are at STNL tour.” It’s her brother and sister-in-law. “Like, I’m good with the baby here. You’re not doing anything for me anyways. Maybe it’ll get Andre to shut up, you know, so like, just go,” and so I went and I didn’t disagree with her, but it’s kind of bummed out. Like now, I’m like driving to Beth Israel. My baby’s just born. And I’m thinking, “Oh, I’m gonna be stuck here like all night. It’s her first baby.” So I get there, it’s like 8:00 at night. I go in, and it’s not her fault, the patient. She’s lovely, she’s young, it’s her first baby. And I check her and she’s fully dilated and ready to push. Like, she showed up like that. She pushed like three times. The baby was born. I showed her my wristband…

Dr. Melka: I was gonna say you must have had the dad band on.

Dr. Fox: Yeah. I showed her my wristband. I said, “Look, the same birthday.” And so her baby and my baby have the same birthday. And I was literally back in Mount Sinai like within two or three hours of leaving. And Mihal was like, “What happened?” I was like…

Dr. Melka: You called Tepper, didn’t you?

Dr. Fox: I was like, “The baby’s born.” I was like, “It’s done.” It was crazy. It was like a miracle because that’s not what would be expected, yeah, and that was pretty cool. So that was Mia’s birth, Sweet Mia.

Dr. Melka: That’s amazing. You have such an extensive pedigree. It was 45 minutes. What do you do outside of work?

Dr. Fox: That’s a good question. I do a lot of work. Nowadays, honestly, there’s nothing… It sounds cliche. I’m just happy to sit at home with my family. Like, I mean, like, the pandemic was delightful for me in that sense, that I really enjoy my kids. They’re older and so I don’t have to like, tell ’em to brush their teeth or like, you know, bathe them or feed them or like put their socks on. I mean, they’re adults. I mean, so I like hanging out with them. They’re fun, they’re funny, they’re interesting. So that’s like…

Dr. Melka: They are wonderful.

Dr. Fox: They’re great. I have great kids. I mean…

Dr. Melka: I’ve been to Shabbat dinner at Fox. A wonderful family.

Dr. Fox: Yeah. So Mihal and I have a great marriage. We appropriately, you know, deal with each other. No, but we hang out. We enjoy spending time together with our kids. So that’s great. I run, I swim, you know, I do…

Dr. Melka: You watch bad action movies.

Dr. Fox: I like watching bad movies. You know, I sort of play in a band, like, music. I dabble just as a hobby.

Dr. Melka: Tell me about this band.

Dr. Fox: Yeah, so it’s like a fantasy camp. It’s five like amateurs at various levels and three pros. And we practice twice a month and then we put on a concert like once a year. And so when you’re with three, it’s like if I were to play, pickup basketball with like the Duke basketball team, right? It’s awesome. Right? It’s not like I’m no good, but to play with those guys, it’s unbelievable. And they make you better, and they teach you and so when we play, I sing and I play guitar, but I just started learning guitar. So, I mean, I’m terrible at guitar. Like, I could play chords, but I’m not a good guitar player. But when I play with them, it sounds good because they’ll tell me what to do.

They’ll say, “Oh, no, no, like hold it this way. Play this chord. Don’t play this. Do it this way. Here’s how you strum,” and they play. So you can’t sound bad if you have, you know, professional like a pro guitarist with you. So that’s a really cool hobby. I enjoy that. Yeah. I enjoy it a lot. And you know, we hang out. We have a bunch of friends in our neighborhood.

Dr. Melka: Nice.

Dr. Fox: And you know, we travel from time to time. I like sitting on a beach, looking at the water, reading. That’s it.

Dr. Melka: And you do the podcast.

Dr. Fox: And I do the podcast. The podcast is a new love of mine.

Dr. Melka: It’s taken off. What prompted you to start this?

Dr. Fox: I started the podcast because I would say mostly I was doing a ton of time on research, which I loved and I still love. But I really wanted to pivot. You know, I’ve been doing it for 10 plus years, 15 years, and sort of like, do something that was more for my audience, right? Who’s my audience? My patients. Right? And so my patients aren’t reading my articles and like, why would they? Like, it’s ridiculous. And so there’s not any doctors reading. Like, no one reads them and you do it because it’s interesting and it’s intellectual.

But I just felt there was something that there was a void in this, what the kids call space, you know, where there’s something for pregnancy and women’s health that’s, number one, not boring, and, number two, accurate. And I couldn’t find anything really like that. I found some that were interesting, but very shallow and some that were accurate, but horrifically boring. I mean, I was going, “Oh my God.” And I had just started to listen to podcasts myself at the time. So I had a sense of like which ones are good, which ones aren’t, how long should they be, and what’s the format.

And I said like, “What the hell? Let’s do it.” It was a small investment in money, I mean, just to buy the equipment. It was mostly time and we started toying around with it and then the pandemic hits. We had a lot of stuff to talk about and then, it really started taking off. I mean, listen, I mean, if you’re still listening 45 minutes after this stupid interview, I mean, you know, there’s a void out there. It’s hard to get good information. These are topics that people are curious about. You google about it. You have no idea what to read and what not to read. And we try to contextualize it, keep it light.

I mean, I have so many patients who say, “Oh my God, you’re the guy from the podcast.” I’m like, “Yeah, I am.” And it’s like, and I would say like, “That’s great that you led with that. Let’s talk about that,” but it’s great. And when I hear people tell me that they learn something from the podcast or they appreciate the podcast or it helped them, again, it could be our patients, it could be someone random from another state or country, I think it’s awesome. It gives me certainly a lot of satisfaction, but it just makes me happy. Like, that’s why we do it. It’s cool.

Dr. Melka: Is there anything about this that surprised you or that you didn’t expect or something you thought that would happen that didn’t?

Dr. Fox: From the podcast?

Dr. Melka: Yes.

Dr. Fox: I am surprised how many people listen. When we started again, like, I was like, oh my God, we got 100 listeners. I was like, oh my God, it’s so cool. And we have thousands and thousands who listen every week which, again, I never thought it would be that sort of busy. I mean, I never expected to be like, you know, Bill Simmons and have like millions. I guess just there’s no audience for that. It’s not meant to be like for everybody, but that was one thing.

I was really not surprised, but I never paid a lot of attention to, I guess like, the experience of birth for people. Like obviously, I know about it and I’m part of it and I talk to people about it. But just like when people started telling their birth stories on the podcast, it was just like, it’s a world that I never really entered because no one gets to tell their story for an hour unless I’m asking them like a medical history. But then, it’s very pointed like, what happened, what happened next? What happened next? What happened next? Whereas someone just gets to like free talk and how it made them feel and how they recovered and how it affected them later in life. That’s awesome.

Like, I was so moved by all that. Like, I really love it. And so those podcasts I’m very, very proud of. And I think a lot of people also gain from that. Just all these like, themes, you know, about, you know, fear and about guilt and about happiness and appreciation and all these things that are very deep topics that come out with someone because births like, for many people, it’s the event of their life, whether it should or shouldn’t be, whatever, but it is for a lot of people. And to get to talk about that has really been pretty cool for me.

Dr. Melka: That’s awesome.

Dr. Fox: I like that. Yeah. And I like, you know, bringing people on, talking to them, either people I already know or new people. I’m a schmoozer. I like to talk.

Dr. Melka: We know.

Dr. Fox: So it works, it works for me. It works for my personality.

Dr. Melka: All right. Well, thank you for letting me take over your podcast.

Dr. Fox: Good job, Melka.

Dr. Melka: I’m the first-ever guest host. I have big shoes to fill, but I hope I did okay.

Dr. Fox: Great job, Melka. Thank you.

Dr. Melka: Thank you, guys.

Dr. Fox: Thank you for listening to the ‘Healthful Woman Podcast’. To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s H-E-A-L-T-H-F-U-L-W-O-M-A-N .com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day.

The information discussed in ‘Healthful Woman’ is intended for educational uses only. It does not replace medical care from your physician. ‘Healthful Woman’ is meant to expand your knowledge of women’s health and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.