Dr. Mitra Ayazifar is an ophthalmologist and oculofacial surgeon and owner of Capital Eye Medical Group in Northern California. She is also a courageous survivor of ovarian cancer, celebrating 7 years.
In part 1 of this 2-part interview, Dr. Ayazifar shares:
Tune in to hear these gems and so many more...
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Note this document may have human or computer-generated errors in transcription. Refer to the audio file for the actual conversation.
Dr. Weili Gray, Host 00:00
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[00.:00:48]Dr. Weilli Gray, Host: Welcome back to another episode of the Dare To Dream Physician Podcast. I am so excited to have our guests today. I just can't wait for her to share her story with our listeners, share all her wisdom through her many. She's lived many, many lives in her lifetime, and I just can't wait to hear about it.
[00:01:08] Dr. Mitra Ayazifar is an ophthalmologist practicing in Northern California. We'll let her tell her story because it's going to be so good.
[00:01:20] Dr. Mitra Ayazifar, Guest: Thank you so much. Thank you for having me here to tell my story, share my story. I appreciate it always makes me nervous too, but I'm looking forward to it. I'm in private practice. I'm an ophthalmologist. I've been in practice since 2001 when I got out of residency and did an extra year of fellowship to become more skilled in oculoplastics.
[00:01:42] And for a long time, I have been employed. One of my locations, and my other location, which was closer to home about, uh, 40 minutes away from, from the other ones for there was no competition. So that one, I had set up a private practice in a unique situation because I essentially rent, space, staff and equipment from an established optometry practice. So I have the ability to manage my own patients and everything else, and yet not have as much of the burden for the things that I don't like to deal with, which is, HR and this and that. In my other location, which was like 40 minutes away from home.
[00:02:26] That's the place where I was employed for 13 years. And right before the pandemic. When I realized that perhaps my goals are not in line with that practice was looking at, I decided to set up a similar situation at that location and, pretty close to the other practice. So I left the employed position, started up my self-employed location and right before the pandemic, which was just fantastic timing. But so far it's, it's worked out well, but a little bit difficult in the beginning, just because everything had shut down. Then we were only seeing emergency patients within everything has picked up. And my old patients have found me. It's a small town. So basically word of mouth has worked for me in this case.
[00:03:20] Dr. Weilli Gray, Host: Um, yes. So we had a discussion, before our interview and you shared little tidbits about yourself that I just really want to hear more about. So I don't know if you mind, but, I would love to just start from the beginning or close to the beginning. I just want to hear more about your story, about where you grew up and how you ended up becoming a physician. Cause I, I think there is a lot of, a lot of richness there.
[00:03:49] Dr. Mitra Ayazifar, Guest: So I was born in Iran, in Tehran to be exact. And I lived there before. 13,14 years of my life. So for, we came to the US, I'll backtrack a little bit every year in the summers. My parents used to take us either to France or, just a couple of weeks just to show us the world.
[00:04:10] So we would go to Germany or France or every summer it was something. And this one summer in 1979, the infamous 1979, my parents had decided, oh, we'll just go, visit the U S we'd never been, it was a long way away. And they decided we'll just go for two weeks and visit the US. Well, that was the time that when we came to the U S that's exactly when, when the hostage crisis happened, the revolution in Iran happened where they took over the embassy, that the students had taken over the embassy and taken all those hostages for so many days.
[00:04:44] And so our two week stay in the U S ended up being 14 months. So I was in fifth grade at that time and fifth grade, and we ended up staying for about six months in Houston. And then my dad had a cousin in Southern California. So we ended up going to Southern California after that. But my dad being the only child, his parents had gotten sick and he said, we have to go back.
[00:05:09] We can't stay here. and my brother and I had gotten used to getting acclimated to life here. And then my parents wanted to go back. Of course we weren't going to live away from them or stay with family here. So we all went back and about three or four days after we entered back in Iran, the Iran- Iraq War started.
[00:05:32] And so they closed all the airports. Nobody could get out. And essentially we were there for another two and a half years, two and a half years. we were there.
[00:05:44] Dr. Weilli Gray, Host: What was it like to be in Iran at that time?
[00:05:46] Dr. Mitra Ayazifar, Guest: It was very different from what we had experienced here, obviously. And the Iran we saw was very different from the Iran that I grew up in, at the time of the Shah, as far as any political opinions or anything, it just was very different. We went from dressing as we are dressing here in the US to covering women, having to cover their hair and the, just the oval of the face showing and just things started changing, obviously politically, but also because it was the time of the Iran- Iraq War, there were bombings, or, the alarms would go off at night and everybody would run down to a place, maybe the basement or somewhere to be safe and be away from bombings.
[00:06:34] So that became a normal part of life in the three years that we were. And I had forgotten because obviously there were no, there were minimal supplies, so there were rationing everything. And so I think I shared with you when we were chatting that I found when I went back, a few months ago, I found this ration in the book and they had ration books for each family and, all the members of the family, of course there were four of us and we had check marks for sugar, check marks for oil, check marks know for eggs. So I've forgotten that that's how we lived for three years. But you do what you have to do.
[00:07:13]Dr. Weilli Gray, Host: Hmm. How did that feel when you were living there and how old were you when, when you went back from the U S Iran?
[00:07:19] Dr. Mitra Ayazifar, Guest: So sixth, seventh, and eighth grade. I was in Iran. I had spent fifth grade here. And, you know, the educational system is completely different. Iran is more the European system where everything is very, very difficult through high school. And you actually have to do an entrance exam, even, I think at the beginning of high school, you have to do an entrance exam to decide, are you going more engineering, math, or are you going more health sciences?
[00:07:46] So for me, having lost one year, having spent one year here in a way I felt like I was behind especially literature, all the languages and everything that they were studying there, even math, because I had settled into my fifth grade curriculum here. And when I went back, I had to work hard to try and catch up, but it almost felt like I was not a, I was a little bit there a little bit here, and I'm not quite settled, not quite feeling like I belong.
[00:08:17]Dr. Weilli Gray, Host: Um, yeah, yeah. And then, so you spent three years in Iran before your family left again. And in that time, your country was basically at war and going through all these political and social changes.
[00:08:34] Dr. Mitra Ayazifar, Guest: Uh huh, so my parents decided obviously it would have been easier for them to live there because they knew the language. My father could still work as a civil engineer. My mom had been retired by then because she had worked as a nurse for 20 years. I think the instigator was mainly my brother who was 16. And so at the time, there were boys that were teenagers that were 14, 15, 16 that were willingly going to war. They were going to fight in that Iran-Iraq War. And my brother, obviously seeing all his classmates and everybody else, he was, my parents were worried that he was becoming influenced. And so they decided, that's not, we're not going to let that happen. So we left… essentially. He was 16. I was 14.
[00:09:23] Dr. Weilli Gray, Host: Wow, what was that like? I guess you are used to traveling and you had already been in the U S but then this time knowing you were just leaving for good and not just for two months.
[00:09:32]Dr. Mitra Ayazifar, Guest: Yeah. Obviously I was very sad to leave my aunts. all of my extended family was in Iran and we were very close, you know, every single weekend we would go to my mom's sister's house and that was our go-to place. So it was very difficult to leave them behind. It was difficult to make friends in that three year period and then leave them behind again. But I definitely understood what the reasoning. Well, I understood, but I wasn't happy about it. I think now I appreciate it a lot more what my parents went through to uproot their whole life. And do it for us, do it in order for us to be able to have a better life, have great education and be able to just have different opportunities, but they gave up everything for us. I will not forget that at all.
[00:10:23]Dr. Weilli Gray, Host: Yeah. I love that. Yeah. And I'm, I'm a child of immigrants, actually, my, my parents immigrated. My dad actually went to the U S on a student visa a month before I was born. And then worked on having us immigrate to the US, my mom and I, and we, I came when I was about eight years old. So a little bit younger than you, and, you know, very different experience, but also like I ever since I was little even, when I was like five or six, that the narrative was okay, well, I bet your dad's in the U S so eventually you would go to the U S and so I was expecting the immigration, but also not knowing what to expect at all.
[00:11:00] And there was that little bit of fear of the unknown, but, after I immigrated to the US with my parents and then seeing how, it's a new language for them. Everything is new. You know, My dad was also an engineer in China, but then when he came to the U S he didn't really, he had to find a different,a quote more labor intensive job I don't know, the right words, like beneath what the job he had before, but,. It's, it's really, it's really humbling, you know, what immigrants go through and I'm so in awe and I was a child, so it was easier for me to adapt, but it is amazing to see what immigrants do and what they do for their kids. Cause that's always was the reasoning that my dad would give, Yeah. and my parents were immigrating to the U S also for, to make a better life for themselves, but also for them, it was a big deal. Their child would have more education opportunities, more, more opportunities in the future and more freedom. Freedom was a big thing for them too, coming from a communist China. And it's just, especially when you see what they do in their day to day, you know,when my parents didn't speak great English and people would look down on them and seeing they just live with that.
[00:12:12] They didn't have to just like your parents, they could have stayed in their home country, but just that experience of really being uncomfortable in the new society that they're living in and just choosing that because they felt that their freedom and the opportunities was worth more than the comfort that they're giving up in their home country. So, yeah, that's such a beautiful story.
[00:12:36] Dr. Mitra Ayazifar, Guest: I know. Definitely many, many things that I appreciate about our parents, having, given up everything that they did coming to a country where they spoke some English, but not necessarily as fluent in the language and also yes, giving up the status that they had and doing it all for us, coming here with, with the promise of what was, what was available. My dad wasn't able to work as a civil engineer. So I think when he came, he started, he had an auto mechanic shop or something like that. So while he worked hard, he would go every day, morning til night, and just trying to make a life for us.
[00:13:18]Dr. Weilli Gray, Host: Hmm,Yeah. Yeah. And you then immigrated to the US with your family and then what was life like then and how did you go from that to, going to medical school?
[00:13:30] Dr. Mitra Ayazifar, Guest: Oh, so yes, that's, I didn't decide that I was going to go to medical school until I was in second year at undergrad at Berkeley. I thought, okay, I better really kick it into gear and better start doing something. I knew that I liked medicine. I think I had started working in a GYN office. One of our friend's husbands was an OB GYN. And I would help out in the office with his wife who was the office manager and just managed everything. But, so I had a little bit of exposure and I thought, okay, well, This is something I would like to do. There's so many different ways that this could go and my dad would always tell me, make sure that you, whether you get married or not, make sure that you have a way of supporting yourself in life, because life has twists and turns.
[00:14:23] And you just want to make sure that you're able to stand up on your own two feet, that you don't need anyone. And, and he's definitely right. And of course my mom always, she is one of the most independent people. I know one of the most stubborn people I know too. When I was in undergrad, I studied, I think, I took a year off, did research while I was taking the MCAT. And so when I got into medical school, it was on the east coast. Well, it was in Washington DC, so it was away from California. And I moved over there. At that point. My parents had moved back to Iran.
[00:15:03] It was the, what year was that? My goodness 19, must've been 1990. I think. There was another crash that had happened; they lost everything. And so they had to, had to move back. My parents moved back to Iran and so I was here starting medical school on my own. And my brother was on the, was at MIT at that time. So we were both here and it was an interesting time because I'd never felt with, I think it's the same with your culture. We're so tight. I always felt okay, at least if they're here in the U S I have, it's almost a, they talk about, the rug being pulled out from under you. I felt like I had stability.
[00:15:44] I had a home base, no matter where they were, that was my home base. But when they had to move outside of the US, I was a little bit lost, but I had started medical school at that point. So I had no choice, but to, but to focus.
[00:15:59]Dr. Weilli Gray, Host: Oh, wow. Yeah, and is medicine sort of what you expected. It sounds like you had a little idea of what it looked like to practice medicine, just working in a GYN office. And so, you know, When you did your long schooling and then training and you came out, was it what you thought it would be like?
[00:16:20] Dr. Mitra Ayazifar, Guest: I think I went into medical school thinking I'm definitely going to be a pediatrician, definitely going to be a pediatrician. And of course at that time, I think there was a shortage of primary care. And so George Washington was encouraging everybody to go into the primary care fields. And when I did my rotation, I loved all of my rotation. The kids being sick and all of that, I didn't think I could do it. And so I decided that I would do, fourth year you do more, subspecialty rotations.
[00:16:55] And the beginning of my fourth year of medical school, I lucked out where I had urology and neurosurgery and ophthalmology, in a two week, two weeks, total six week period. And so ophthalmology was the first one and I loved it. I thought, wow, this first of all, I love being in a field where, where it’s challenging to be a woman in that field, which is pretty much a lot of fields of medicine. I thought, okay, I can do surgery. That's great. I can do, I can see my patients long term. So continuity of care. That's great. I can actually have a life. I don't have to be in a level one trauma institution and be on staff at the hospital so I can have my own life.
[00:17:43] I can actually, I can actually see myself doing this and it was very interesting. And another thing about that was that I was, so I felt like I'm going to be so overwhelmed if I go into internal medicine or anything like that, because there's so much for me to know. And I'm always going to feel like, what if I miss something I'll come home and I'll feel like I didn't run that test on my patient. And so I thought, two eyeballs, how much is there to know about it? I thought I couldn't master it. And then I realized, oh, there's a sub special, a specialist, even for every single layer of the eyes. So overall it worked out really well.
[00:18:25]Dr. Weilli Gray, Host: Wow. Okay. And so you chose your residency and I didn't, I didn't realize that you also did a fellowship in oculoplastic. And then did you move back to California then?
[00:18:38] Dr. Mitra Ayazifar, Guest: So we, when I finished fellowship, We stayed in Rhode Island. So this was at Brown. We stayed in Rhode Island for another few years. I was a chief resident at the program. And then I was an attending the program also, but then my husband and I at the time had always known that we want to go back. We want to move back to California because all of his family was in Southern California and thought that's great because we'll have a nice support when we go there. So he got his job first. So I was still here. I had two kids at the time. Well, we had two kids at the time, so my son was two. My daughter was three-and-a-half, four. And my husband had already found a job in Sacramento. So he had come earlier to scout the place. And then I packed up everything after that and moved, moved back. I didn't have a job at the time. Cause I thought, the kids are too young. I want to make sure that they're settled into the school or whoever is going to help us with them. And so I ended up coming back later. So for about six months I was settling everything and then looking for a position, looking for a job.
[00:19:55]Dr. Weilli Gray, Host: Hmm. Was that tough? I mean,did you feel like you were sort of going where no ophthalmologist had gone before, but moving to an area where you didn't have a job and it's, it's interesting.
[00:20:05] Dr. Mitra Ayazifar, Guest: It’s, it’s interesting I should have, looking back, I would have probably done it differently now. I would've probably had a job in mind and then come over. My main focus at that time was the kids and making sure that they don't feel uprooted just because I moved back and forth, not just from state to state or city to city, but I moved back country to country.
[00:20:26] And had sworn that, well, I had made a promise that if I can help it, I don't want my kids to make friends and leave and have to adjust to a new place and back and forth. When we moved to Northern California, Granite Bay Area, We were, I was able to keep that promise because they went into it. They were in the same school system with the same group of kids. Some people left, but they were always with the same group. So I really felt like it's okay if I have to commute, minutes to my second location, but I'm okay to stay here. I'm okay for them to go to the school closer to. I thought that was very important, very important.
[00:21:08]Dr. Weilli Gray, Host: I love that. I think that is really admirable. And this shows as you know,I'm a life planner and this podcast is about helping people figure out what's really important to them and then designing a life based on that. And I think that's a great example right there. thinking about how you were uprooted so many times in your childhood, by these unplanned travels that turned into 14 months stays and then by war and you know,political upheaval and how, how that really became an important value to you when you have children.To help facilitate a more stable environment for them to grow up in that, that's amazing. And I love that you didn't even think twice about, you know, cause you graduated medical school and finished your residency and fellowship before my time. And I think, maybe it's gotten a little bit better, over the years, but I just feel like usually in medicine it's your job comes first.
[00:22:06] Like everything else is secondary. So that's why I was asking whether it felt like it was, um, a rebellious act, By not necessarily having a plan and putting your family first as, as you're moving. So I love that, that just, was very obvious for you to pursue.
[00:22:21] Dr. Mitra Ayazifar, Guest: I have to say, so, I had my daughter first child, when I was in second year of residency, I found out that I was pregnant. I think it was midway through. So I had her. In the beginning of third year. And the program at Brown was very small at the time. I think they have more residents now per year, but we were two residents per year. So,first year or even second year you're, you're basically every third night, you're on call. Well, it, it rotates, but as a third year, you're every, almost like every other night or every third night, you're on call. And so I worked onto the last day when I went into labor. So I was in my third year and I was working till the last day because I thought, okay, this program hasn't had a female surgeon for about eight years and I'm not going to be the cause of ruining it for the rest of them. Now things have come a long way, but, and perhaps this was something that was more on, like I was feeling and perhaps the program was not like that, but I was not about to gamble on that. So I think, I think I had grand rounds on a Saturday and I had to present and I thought, come on, baby, just go into labor.I don't want to do this.
[00:23:41] And of course it didn't happen. I did my grand round presentations and then the contractions started. I'm like, yeah. So I took, um, because my colleague, Brian, my co-resident, he was going to have to handle all the, all the backup call. I thought I said, okay, I'll, I'll take four weeks and I'll come back. So I came back four weeks after I had my daughter, but I was lucky at the time because my mom had. I was able to travel back.
[00:24:10] And so she stayed with us and she helped me with my daughter. And of course, later on, even with, if she hadn't been helping us, I don't think we would've had our second child. So we had my son too, but I have to tell you, it was a lot easier for me to go back to work than to take care of kids. Yes, it was a lot more work to be, to be at home and take care of kids. So it was definitely the more difficult, difficult work to do.
[00:24:39]Dr. Weilli Gray, Host: Yeah. Yeah. As physicians, we know how to do hard things, but sometimes, it's, it's I know for me, they're just things that are part of life that I find very difficult, like cleaning my house and taking care of kids. Those are, there are just other life skills that maybe we didn't have much time to focus on. And so that's yeah. Yeah. I can definitely relate to that. .
[00:25:06] Dr. Mitra Ayazifar, Guest: So I was quite proud of myself that I was taking care of my patients and I was, and I still am, of course, but at the time this was in 2014. Yes, 2014. I, With, employed in the Grass Valley location. And I had my little practice closer to home and I was building that and doing well and taking care of patients and just proud that I'm doing more than just take care of their eyes and their vision. I was actually connecting with them and I was very active with working out. So I was doing kickboxing and doing sprint triathlons, just, basically feeling okay, I'm doing everything I should be doing to take care of myself. And then I realized that I was, there were some symptoms that I was feeling that were just unusual for me. And I thought, okay, I better go and see the doctor.
[00:26:01] And my Primary Care saw me. And she said, I don't find anything wrong. And I had just had a GYN exam, I would say in March. So, what I'm talking about is coming up in October. So June to October, I was having these symptoms where I felt like when I'm waking up in the morning and getting out of bed, I felt oh, I have to go to the bathroom, but it wasn't happening when I was jumping up and down doing kickboxing or, doing weights or whatnot.
[00:26:30] So it wasn't coming on with strain. And I thought ,very weird and I just had an okay exam. So what's going on? So when I went to my primary care, I was sure because of two child births, perhaps it was bladder related. And, she said, I don't really find anything. I'll send you to a urogynecologist.
[00:26:49] So I went and saw a urogynecologist within one week of that appointment. And I was in her office for about two hours. She did an examination, sent me downstairs for an ultrasound. And she basically said, I don't think it's your bladder. I think you have a mass on your ovary. And I thought, oh, it's a cyst because in my mind, like it's probably a cyst, nothing else. So I should not be worried. Exactly. Like why would I think anything else? And here I am, eating right and working out. And so she said that we should do an MRI. Just to get an idea of the consistency. What are we going to do? How are we going to proceed? And I thought, okay, so I'm still going to my work.
[00:27:31] No problem. And of course there's a patient portal type of thing where you can check the results and the results of the MRI popped up. And this is before my urogyn had a chance to talk to me. And I see that it says basically highly likely that it's a malignant tumor and that it needs to be biopsy.
[00:27:53] And then I see a referral to a surgeon and I thought, wow. And I was sitting in my car. I know exactly where I was when I was looking at that. And I thought I just started balling. And I thought, no, this can't be. I'm just beginning to build my practice. I'm just beginning to, but I'm taking care of my patients, all the, all the, the different layers of grief that that one goes through, but I still couldn't believe it. I just couldn't believe it. And I thought, okay, so then we had to look for gynecology gyn-onc person to do the surgery. And he had told me, we finally found one. We went outside of our HMO and found someone that was very well versed in this because I was still operating.
[00:28:46] I had a full schedule going and he had offered to do it robotically. And if he said, if I go in there, I will take a look at that more than likely take that ovary out so we can examine it. If you wake up and you've been in surgery for 40 minutes, then you know that we took the ovary. We did the frozen section. Everything is okay. He said, if you wake up and you've been in there for two, three hours, just know that I had to do staging at that point where I've taken, and he consented to me, for abdominal, the THB. So basically taking out the ovaries, taking out the, do it, doing a hysterectomy.
[00:29:28] And then he said, I have to do the wash and see whether there are cells in the abdomen and then do the lymph nodes. So I can tell how far it's gone. So that's what's going to take longer once you wake up. So I'm hearing this and I just can't believe that I have to do this, but I'm still thinking, no, he's just going to go in there and come out in 40 minutes.
[00:29:52] So this was November of 2014. So Thanksgiving has always been at my house. And of course that year we couldn't do it because the surgery was going to be on the Monday of the week of Thanksgiving. So did the surgery. And of course it was several hours later when I woke up and I'm in recovery, I'm in the room and the surgeon comes in and all I hear is cancer, ovarian cancer. And then I didn't hear anything else. Everything else is just bip, bip bip. I'm still trying to absorb that. It is so strange that we take history as physicians. We take history, we write down. Oh, okay. So you had breast cancer. So you had colon cancer. So you had that, that, that, and it's just the word, but once you hear it and you know, you realize, oh my God, first thing I thought I was like, why me? I take good care of my patients. I take great care of my patients. I know more than what's going on. As far as their eyes, I connect with them. I do all of these why I was, for lack of a better word, pissed but then I thought, and once I recovered and realized that I was supposed to have recovering from the surgery, it was essentially nothing as compared with, having, having to go through the chemotherapy.
[00:31:18] So I have to go through 18 sessions of chemo and they had decided my oncologist who is very good with, or has a lot of experience with ovarian cancer. He had decided to do a high dose and the type of chemo was one that could affect, could cause neuropathy. And I thought, Hmm. So as I'm doing these sessions, in the beginning, I'm thinking, okay, what will I be if I can't be a surgeon? Because, we, it's almost I wasn't sure who I would be.
[00:32:05]Dr. Weilli Gray, Host: Wow. That was part one of a two-part interview with Dr. I'm so grateful and so amazed by what she has shared with us so far, she's been so open and so raw and sharing her experience. I'm just learning so much just by listening to her. I can't wait to share next week's episode with you. It will be an amazing second half of this conversation. Subscribe to this podcast, if you haven't already and make sure hit play for next week's episode. In the meantime, if you're looking for an ophthalmologist in the grass valley and Roseville California area, you can find Dr. Ayazifar at Capital I Medical Group, she's going to take great care of you.
Dr. Weili Gray, Host
Thanks for listening. Make sure you hit subscribe so you don't miss another episode. If you liked this episode, please share it with a friend and give us a five star review so we can help more physicians dare to dream and create their most abundant lives. There's also exciting news at the Dare to Dream Physician. For those of you who wish to get clarity on your own why and get energized as you explore, envision and create your dream life. I'm so excited to announce that I'm taking on a limited number of one on one clients for life planning. To get the complete details and sign up for an exploration meeting. Go to my website, daretodreamphysician.com. I really look forward to working with you. And it would be such an honor and privilege for me to be able to help you create your life plan. I truly believe that life planning will transform your life and will give you that energy to pursue your dream life sooner than you ever imagine. See you next week.