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 OBGYN 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.
I’m here with Dr. Christopher Choukalas, who was with us last week. We started talking about his story and the birth of his twins, and being an anesthesiologist and watching his wife almost die on the labor table. Thank God all is well. And we finished last week with a really interesting talk about depression and the postpartum or postnatal period for men or for partners or for those who did not carry the pregnancy. And I wanted to pick up this week with you, Chris, and talk about your decision to write a book about it. Because a lot of people go through a lot of things and they’re really interesting stories, but not everyone chooses to write a book. So, I’m curious. When did you decide to put pen to paper on this?
Dr. Choukalas: I think, Nate, it started…the pen to paper started early. And in fact, I think I even started typing away while we were still in the hospital in part because, on some level, I knew that what we had…what I had seen, what I experienced was remarkable and not in the way of like, oh, this would make a TV show. It was more like I needed to make sense of what I just saw. And I think I told you last week about the kind of cognitive dissonance of sitting there in the delivery operating room, holding my babies and realizing how sick my wife was. And there was something that was so elemental about that for me that I just needed to get it out and on paper, more as kind of a journaling exercise or like a catharsis. The idea that I would turn it into something came much later.
And pretty much everything good in my life came from my wife, Lindsey, because I think she felt like we had all gone through something that was pretty terrible, that would surprise a lot of people, and that if other people knew about it, they would probably get help a lot sooner. And so, I would…if I had to put a date on it, I’d say the girls were probably a year or a year and a half old when we sat down and said, you know, I know you wrote about this a little bit before. I know you’ve been journaling about it. I know you’ve been seeing a therapist and talking about it. And so, is there something there that could help other people?
Dr. Fox: Had you been very open with others about what was going on in your life related to depression, anxiety, and getting treated for it, and that when you wrote the book, it wasn’t, so to speak, a surprise to your family and friends, or was this something that they didn’t really know was going on in your life, and then when the book comes out or the press about the book comes out, it was sort of like, oh, oh, that was going on?
Dr. Choukalas: Well, it’s funny you mentioned that. It was a little bit bimodal. I didn’t really tell my family, like my brother and my mom, about how bad it was. But a lot of my friends and professional colleagues knew. And I think the reason that I told people was in part because the first couple times I talked about it, I was met with a lot of support and a lot of like, you know, the way you talk about that, I feel like maybe my husband had something like that, too, or God, that sounds like how I was.
And so, in contrast to what you sometimes get on social media with, admittedly, the minority, with the comments of just the hateful vitriol in person, I felt like I was greeted 100% with recognition and acknowledgement that what I went through was something that they understood and that they could see in themselves and to see the value of putting something out there for others. And so, I think that spurred me to be even more open about it. And again, I have consistently been rewarded for that in the form of just people really kind of getting it.
Dr. Fox: How did you decide to structure the book? And did you struggle with that? Because it was really interesting because it’s not quite like a story start to finish, and it’s not really medical, so to speak. And you go into a lot, and there’s a lot of sort of back and forth, and it’s…it really is more of…again, I think I said this last week. It’s more of a memoir, I would say, about yourself. And I think that was a really interesting way to do it. Was that always the way you plan to structure it, or did that sort of just evolve based on you trying to put this in a way that was meaningful to you and potentially to all the readers?
Dr. Choukalas: Well, the way I wrote the book is exactly not how anybody tells you to write a book. And they tell you…
Dr. Fox: They tell you don’t write a book is the first thing they tell you.
Dr. Choukalas: They tell you don’t write a book. Do not do this. [crosstalk 00:05:36].
Dr. Fox: Yeah.
Dr. Choukalas: But being…
Dr. Fox: Just put on a post or a blog like everyone else does. Don’t write a book.
Dr. Choukalas: No, no. Do Substack. Yeah, 100%. Yeah. By the way, yeah, I’m not quitting my day job for book sales. So, as a sort of recovering academic physician, I had written a lot of scientific papers and book chapters and stuff. And I also…not a lot of people know this, and…but I kept a blog during my time in training as a resident and a fellow because I felt like the things that I was seeing…were happening to me was like good fodder for creative writing, like a way to turn awful or heartwarming things into comedy or into something that people would appreciate. And I never monetized. I never advertised it. It was really just a link I would send to my family and friends every couple of weeks when I’d write something.
And so, I felt as though I knew how to turn an experience into something that was readable, but there was also this intense need on my part to put my voice out there to… And I guess this is arrogant, and I guess nobody who isn’t arrogant would ever write a memoir because you’re doing it because in part to share something with people, but also to put you out there. And I guess, from beginning to end, I felt like that…this was never gonna be an academic treatise on postnatal depression and men. I was never gonna write something and send it to a journal. That was never the thing. I wanted something that was me, and I wanted something that other people could relate to and could take something from it.
So, it basically was written at first in kind of a stream of consciousness way, which my wife…I mean she was like, you know… You’ve got a spouse. And I stuck to my guns. I knew I had to…I knew it had to sound like me. And if it was gonna sound like me, it couldn’t be an academic piece. It had to have my voice. And as I was writing about this, I was also going through therapy. And so, I was having all of these realizations about my upbringing and the role that that played. Because believe it or not, I’ve been in denial for 45 years that my father’s abandonment had an impact on me. And of course, that sounds crazy now, but that’s how I lived. Oh, he was a jerk. He was a yeller. We were better off without him. It didn’t affect me.
But as you’re going through therapy and coming to these realizations and dealing with it, I’m also writing a book. And so, it made sense to explain what happened to go into the story of my life. Of course, I think my life is precious and fascinating. I’m sure most people don’t, but it just didn’t feel complete as an explanation for what happened without getting into that. And so, it’s part memoir, part self-help.
Dr. Fox: I was going to ask, how much of it was actual therapy writing the book? I mean, it’s therapeutic. I mean, we’ve had people on this podcast tell their stories. And I would say, uniformly, after, people are like, wow, that felt good because I never get to tell my story. Who’s going to sit and listen to me for an hour? Nobody. And so, it’s like getting to sit and tell your story. It just there is therapy in that and the same thing, putting all your thoughts on paper and thinking about it. It had to have been therapeutic to write, I would assume.
Dr. Choukalas: Hugely. Hugely. And there were really three points that stick out to me. So, firstly, if you want to write a book and you don’t want to self-publish it, you got to go find an agent. And you got to find an agent that thinks what you’re writing is worth pursuing. And when the agent and I worked together to get the proposal together and we were actually able to sell it to a major publisher whose name you would all have heard of, that was a moment where I felt like, okay, there is validation for this experience for what I went through.
The other moment that was really meaningful was that…there’s this part at the end of the book where I talk about, was it worth having gone through all this? Not to say, oh, I had kids and lost my mind and did I have to get therapy or could I have just ground it out? But no. Could I just go back and not have kids? And would I have been better off never having gone through this experience? And a book is written over three or four years. And when I first was writing that part of the book, the answer was a little bit wishy washy. And you come back to it over time and over months and over the course of these three or four years that I’m writing about, the answer became firmer and firmer in the affirmative that, oh, God, yeah, I’m way better off now for having gone through this valley. I am at a much higher peak of joy and happiness and function and life satisfaction than I was before all this. But that took time to get there. And so, realizing how much that answer had changed draft over draft, month over month, that is a beautiful expression of I just feel really different now.
And then the third thing is, when I finally opened the envelope when the publisher sent me the first physical copy of the book and to look at it and say, God, this looks like someone wrote a book. This looks like a book. And to feel like all of the kind of angst and pain and sorrow is now kind of in this physical thing that I can now put on a shelf and set down felt really amazing.
Dr. Fox: Interesting. It’s like a metaphor for having kids almost. You think about it, you plan about it. Am I going to be good at this? And then when that kid’s born, like, oh, that’s good. What has the response been to the book? I guess I’ll start with, you know, colleagues, patients, family and friends, sort of the people who you know and interact with on a frequent basis.
Dr. Choukalas: Well, it’s funny. When you graduate college and you get into med school and you graduate and do residency and you get a job, everybody says, oh, that’s amazing. You must be so proud of yourself. You must think it’s great. And I never really felt like…a lot of people, 20,000 people a year do that. And so, yeah. I love what I do, and I think it’s great that I get to do it, but I never felt the pride and sense of accomplishment that other people were sort of projecting onto me.
When I got this book deal and when this book came out on the shelves, I was like, ah, that is something that almost nobody does. And so, I felt like the kind of reinforcement from others was uniquely moving for me. And so, people say, oh, God, congratulations. Wow. That felt really good. I think that people that have read it, when you go out to Goodreads and Amazon and you read the reviews, I feel really seen and heard. And I really appreciate when people say things like, I was really moved by this or I think the writing is really good. This is about a thing, but separate from that, I think the writing is really…this is a compelling story. I didn’t want to put this down. So, the things that people are willing to put in writing about the book have all been super positive.
We touched on this a little bit last week, Nate, but the…I would say, in the social media world, as everybody knows, it’s kind of a cesspool. I think mostly people have been really encouraging, but there’s also been a lot of, you know, you’re a wimp, you’re a loser, you’re selfish, you’re arrogant, you’re a shill, you’re taking some mythical portion of funding for women’s health away from them by talking about this or lots of really earnestly held beliefs about…that men shouldn’t be feeling this way and talking about it, and that we just need to suck it up and support our spouses and… Just the usual kind of awful things that people say.
Dr. Fox: Are those from randos, or are there people who actually would know or respect or care what they think who gave opinions like that? Even if you don’t maybe know them.
Dr. Choukalas: Yeah. No. This is all…I mean, this is all random. This is not like anybody that I know. These are just people on social media.
Dr. Fox: Yeah. It’s always a wonderful community.
Dr. Choukalas: Every once in a while, I’ll tell somebody…and it’s usually like an older man that…in my sphere, like at work or whatever, some other surgeon. They’re like, huh, I didn’t know that was a thing. And then they just kind of move on. So, I imagine those people probably also think that I’m a huge pussy, but they’re at least not going to say it to my face. And that’s fine. Whatever.
Dr. Fox: That is always delightful. The online community is a fascinating one and never existed in the history of Earth and it is amazing. I hope you don’t spend too much time reading those things because you’re aware they’re mostly crazy.
Dr. Choukalas: Well, something kind of interesting happened. I was interviewed for two mainstream newspaper outlets, like physical newspaper. One was The New York Times and the other was The Times of London. And both have…they publish online and both have comment sections, but one’s in the U.S. and one’s British.
Dr. Fox: Yeah. I imagine they were different. Yes.
Dr. Choukalas: Oh, man. The Brits were terrible. The Brits were so much harsher, and interestingly, too.
Dr. Fox: Well, they’re still angry about the whole U.S. thing.
Dr. Choukalas: [crosstalk 00:16:02].
Dr. Fox: Yeah. It’s too soon. As we say, too soon for them. So, what are you going to do?
Dr. Choukalas: No. There are also Instagram posts about both of these articles from their publishers. And the Instagram…even amongst the Brits, even…really, for both countries, imagine the chi-square table. So, the Brits were worse than the Americans, and both social media comments were much worse than the newspaper website comments. And I just thought that was kind of interesting to see, but the Brits were way worse.
Dr. Fox: What has been, I guess, the best, I would say, experience that you’ve had or opportunity that you’ve had because of writing the book? Something that clearly wouldn’t…a door that would not have been opened otherwise or something like that.
Dr. Choukalas: Setting aside just how it feels to be better, and to be able to show up for my kids without that gnawing feeling of anticipation and need for control. Aside from just how utterly amazing that feels in comparison, I think, to go into fan geek mode around what has it been like to be in the public sphere for this book? There are two things that really stand out. One, getting to go to New York and talk to Dr. Becky, who is this really terrific psychologist and parenting expert was really kind of nourishing, for lack of a better word.
But when I did the book event, the launch event at a large bookstore here in the Bay Area, and having people I knew from as far back as college friends who had flown out to attend, up through colleagues from the University of California and the VA, and up to friends and colleagues from my current job here in Marin County, to have them all in one room at one time and getting to dialogue with them and talk about it and ask questions and laugh together and cry together in front of them as I’m talking about this, there was something so electric and powerful and affirming about getting to have that experience that I kind of walked off the stage after an hour of it and was like, okay, well, that’s it. I don’t need to sell a single book. Because it was just so powerfully moving for me to have had that experience that I was like, okay, well, I’m done.
Dr. Fox: Wow. That’s really cool. And in our last few minutes, tell us about your own social media presence. You’ve become somewhat of a celeb on the Instagram. So, just so our listeners know where you are and tell us a little bit about that so they can find you.
Dr. Choukalas: Yeah, terrific. Well, I have a website, christopherchoukalas.com. And I totally get how that’s impossible to spell, but I bet, somewhere in the podcast post, there’ll be a spelling. And so, you can go there and look at the newspaper articles that I’m talking about, and find all the angry comments sections of those and a bunch of the radio interviews and podcasts are up there to watch and listen. And I’m on Instagram @christopherchoukalasmd. And I post regularly about things like parenthood stuff that occurs to me that I think is interesting, but also, more recently, about the way that COVID impacted my fatherhood experience since COVID’s been kind of back in the news lately.
And I think that what you’re referring to about getting famous, a couple famous people picked up some of those COVID-related posts and then reposted them. And so, now, all of a sudden, I’ve got a bunch of people following me that are interested in talking about public health and COVID and the way that our government relates to us around public health issues. And so, that’s become a super interesting conversation that really dovetails off the birth experience and mental health experience that I had. And so, I think there’s been some kind of neat overlap there that I’m enjoying participating in.
Dr. Fox: Terrific. Well, listen, Chris. Thank you so much for coming on the podcast. Thank you for taking the time to write the book and tell your story. I do believe, obviously, it’s important and therapeutic for you, which is reason enough to do it. But as you said, this is important stuff. It’s an interesting read, but it’s an important one. And I do think it will help people and will continue the conversation about mental health in this country, which is so important. And so, thank you for doing that. The book is called “Even the Darkest Night: A Father’s Journey of Hope and Healing from Paternal Depression.” It is anywhere you can find books. I absolutely recommend it. And I recommend everyone also check you out online and on the Instagram. And we will definitely post all of those things along with the podcast. So, thank you so much.
Dr. Choukalas: Oh. Thank you, Nate. I really enjoyed this. This was a great talk. And I’m glad that you’re out here doing this. This is great.
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 healthfulwoman.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.
