When Medicine Costs You Yourself: A Trauma-Informed Conversation for Physician Moms with Dr. Alice Horrell

Episode 88: When Medicine Costs You Yourself: A Trauma-Informed Conversation for
Physician Moms with Dr. Alice Horrell

• Welcome and Guest Introduction to Dr. Horrell</a >
• How Nature Restores Emotional Energy (+ a Dolly Parton Insight)</a >
• Career Pivot: ER Physician to Executive Coach — Why She Made the Change</a >
• Understanding Physician Burnout, Moral Injury, and the Loss of Purpose</a >
• The Power of Self-Knowledge: How Inner Work Rebuilds Your Capacity</a >
• Practical Techniques for Self-Discovery, Emotional Healing, and Clarity</a >
• Trauma-Informed Coaching: Creating Safe Spaces for Physicians</a >
• How to Find Possibility in Hard Seasons: Reframing Challenges</a >
• Final Reflections + How to Connect with Dr. Horrell</a >

You can be competent, accomplished, and still feel deeply misaligned.

And often, the hardest part is realizing you followed the rules and still lost yourself.

That tension is exactly where today’s conversation begins.

I’m joined by Dr. Alice Horrell, a board-certified emergency medicine physician who stepped out of the ER and into trauma-informed coaching for physicians. A turning point for her was recognizing that some of the most critical codes never happen in the hospital.

In this episode, we talk about moral injury, loss of purpose, and why slowing down is not weakness but wisdom. This is a grounded, compassionate conversation about self-knowledge, safety, and finding your way back to clarity in a world that keeps asking you to push through.

This is where we begin.

Welcome and Guest Introduction to Alice Horrell, DO

Dr. Cindy: I’d like to welcome a very special guest today. Her name is Dr. Alice Horrell. She’s a board-certified emergency medicine physician who became an executive coach and founder of Cultivating Splendor.

After a decade in emergency medicine, Dr. Horrell recognized that most critical codes weren’t the ones in the ER. They were the burnout and moral injury and loss of purpose affecting so many high achieving physicians and leaders.

Through her work as a trauma-informed executive coach, she helps physicians and professionals rewrite survival mode patterns, using self-awareness, the Enneagram and
emotional intelligence, guiding them to align who they are with how they lead and live.

Her approach blends the precision of medicine with the wisdom of inner work, helping others move from exhaustion to clarity, and from hustle to wholeness. Dr. Horrell, welcome to the Inspired Mom MD’s podcast.

Dr. Horrell: Thank you. Thanks for the very kind introduction. I appreciate it.

How Nature Restores Emotional Energy (+ a Dolly Parton Insight)

Dr. Cindy: Oh, there’s so much more about you, but I had to narrow it way down to that.

Before we dive into the work you’re doing now, I’m just curious what’s bringing you energy and joy right now in this fall season?

Dr. Horrell: Time and nature, so that’s probably in all seasons my go-to for restoration and joy. We live in the beautiful Pacific Northwest, and we did a family hike just two weeks ago and it was just, it was right before all the leaves dropped.

It was just gorgeous. And then anytime Dolly Parton brings me joy. I am a big Dolly Parton fan.

She could always lift my spirits.

Dr. Cindy: If you can’t get outside, you can listen to Dolly Parton.

Dr. Horrell: That’s right. Yeah. Dolly’s always there. My kids, it’s a long story, but we call her Aunt Dolly, so Aunt Dolly’s always there for us.

Dr. Cindy: Oh, I love that. I love that.

Career Pivot: ER Physician to Executive Coach – Why She Made the Change

Dr. Cindy:
Now shifting to your career, you took a career pivot actually and described it to me earlier as hitting the brakes in this productivity driven world. Can you take us back to that time and what was happening and what was this pivot you talked about?

Dr. Horrell: Oh yeah. Well, we’re just going to dive right into the deep end. Love it. Yes.

So, the honest answer is that at that time I was completely overwhelmed all of the time. It was the beginning to take a physical toll, and I could do an entire podcast on this one question. I’m happy to come back and do so and share more personally.

It was simply a nervous system overwhelmed, coupled with moral injury, and knowing that this was not the way I wanted to live my life anymore, and every single box in my life.

Physical, mental, spiritual, emotional, relational – they were all on “E”. So, I got a coach and I said, I have to make a change, but I don’t want to make an impulsive change. I never feel like that’s a good thing to make these impulsive changes and these high stress situations necessarily.

But, inside at that time I felt like everything was on fire and from this place in my life, I can see they were and I’m okay. Many of us were supposed to have different chapters, and this was the turning of a chapter for me.

I worked with my coach for about three months before I made the decision to resign my partnership and the group I was in. And that was exceptionally difficult for me because I’m not the type of person that quits things easily. I give it a whole lot of thought and consideration.

The shift I made did not feel glamorous, and I’m sure it didn’t look glamorous, and again, another podcast, but I basically said, I’m putting medicine on a shelf and I’m working on myself and spending time with my babies and my husband.

Dr. Cindy: Mm. Oh wow. You didn’t come to this decision lightly. You spent three months investigating?

Dr. Horrell: Yeah. Actually, I spent three months, and I made that call after I went into bigeminy on one of my ER shifts.

Dr. Cindy: Oh gosh.

Dr. Horrell: Well, I had been for a while, I knew I was having palpitations and didn’t feel really lightheaded, but hooked myself up to the monitor and saw, and I called my cardiologist friend. She just said this is probably a sign of stress, like you need to take into account.

So, I then kind of change things. Of course, I took the leads off and went back and finished my shift. I figured out what was going on.

Dr. Cindy: Oh, my goodness. That’s a huge turning point for you. And you’re right, we could talk about this for an hour, I’m sure.

Understanding Physician Burnout, Moral Injury, and the Loss of Purpose

Dr. Cindy: I would like to narrow in on some of the terms that we brought up already, because I think there’s a lot of confusion around them and what they mean.

You talked about moral injury, burnout and lost purpose. Can you help us tease out the difference between what those really are? Take the first two, for example, how is moral injury really different from burnout?

Dr. Horrell: Burnout is simply exhaustion. And I kind of think of it a little bit as a scale. It’s when you have physical, mental, and emotional exhaustion and you can think of it as something that maybe changing a couple habits, a vacation, a retreat can help. It certainly can be significant.

Moral injury is actual trauma, and it was a term first coin for military people, but something that we’re certainly seeing in healthcare, certainly in the last five, six years. So, it’s trauma and if prolonged it can lead to post-traumatic stress.

And what happens with moral injury is when you’re asked to do something that goes against your ethics. So, for example, for a physician when they feel they can no longer provide evidence-based or best medicine to patients because of insurance denials, because of corporate health systems telling physicians you, you cannot practice that way anymore.

And that’s starts to take a different type of toll than burnout does.

Dr. Cindy: So, burnout means there might be some things, some actions you can take to help readjust or realign yourself, but moral injury sounds like it takes a lot more than some simple steps to come back from.

Dr. Horrell: Correct. I think with the physicians, we see a lot of bleed into both spaces.

Dr. Cindy: Mm-hmm.

Dr. Horrell: We’re seeing, I think, chronic burnout, with elements of moral injury. So, I think it’s really important to delineate, and I like to delineate, that I always start my coaching sessions first visit with me. I’m going to talk to you about the fact that I may suggest you get a therapist or a counselor.

Because I think that it is important to address trauma with a trauma specialist, which is not a coach. That’s somebody that can help you do trauma work with things like EMDR or other trauma modalities.

Dr. Cindy: That’s an important distinction and true there is such a crossover. So, I do want to identify the difference between the two. But not saying you have one or the other, you can definitely have both.

Dr. Horrell: Right.

Dr. Cindy: And then the third term was lost purpose. So how would one determine, let’s say I’m just burned out versus I have a lost purpose. What does that mean?

Dr. Horrell: Well, I truly think that lost purpose comes from burnout, moral injury. And think, it’s something that accompanies that often, but it comes up when people no longer stop to intentionally take stock of their life.

When they’re not making conscious decisions about what they’re going to do, is their life aligning with their values? Do they take the time to slow down, to pause, to take account of their life and say, okay, I am living the best I can by my values right now.

So, I think when we don’t take that time, when we don’t slow down and we’re not intentional, we do lose our purpose. And that leads to burnout, loss of joy, in our lives and lost purpose.

Dr. Cindy: Yeah. That makes a lot of sense. You mentioned when you first meet somebody, you make sure they don’t need therapy or in conjunction with your coaching.

If they have a lost purpose and you identify that, how do you help them get back to that?

Dr. Horrell: Well, we find out where they got lost, right? Since we are talking about moral injury and trauma and all these things.

This is what I always like to establish with clients, and I think it’s important for people to know.

Coaching is present and forward facing. Counseling is things that are in our past, and its trauma type of work. So, I just wanted to make that distinction for lost purpose it’s such an individual thing.

I think the first thing that I help clients do is to slow down, to have this intentional place of slowing down and thinking very specifically about their life, about maybe their pain point that they came to me with.

Once you’re able to slow it down, you’re able to understand more about yourself. About what’s going on in your situation, and you can more clearly see your options that are available to you. I take you through the process. Also, one of my big things is increasing your self-awareness through different things that we do, and two, your values.

If something is important to you, then it’s important you live your life in alignment with that value and think about how I can make that happen with what I have.

The Power of Self-Knowledge: How Inner Work Rebuilds Your Capacity

Dr. Cindy: I know each topic of moral injury of burnout and lost purpose could be its own podcast. But I am going to move on now that we’ve defined those, to some of the tools that you use to help people identify their own self-knowledge.

You teach that the power of self-knowledge is really the foundation for healing.

Dr. Horrell: Mm-hmm.

Dr. Cindy: What does that mean in practice?

Dr. Horrell: I think we talk a lot to professionals about leaning in and leaning out all the time. But I don’t hear a lot about leaning inward. And I feel like that is the place to start because self-knowledge is liberation from the constructs others have placed on us and the power to reclaim our created essence and live on purpose.

And many of us are doing life without really understanding what actually motivates us. Where that comes from and how we function best and why.

And perhaps even deeper is understanding yourself outside of your relationships and roles. So, to know who you are and what are your gifts and what makes you light up, and what are the needed elements for you to thrive even in challenges.

I think this is important because in your life, your relationships and your job, the common element in all those is you.

Not only does it improve your inner world, but it also improves how you show up at work and in your relationships. So, the most important thing you can do when you hit the wall or you’re really struggling is to check in with yourself, to know yourself and to allow yourself to heal.

From that place, you make more intentional decisions that are right for you, not the author of some book, not your mentor, or whoever else you’re looking to for guidance.

And it starts to look like understanding. You know, maybe the way you show up in conflict. So, are you averse to conflict or do you steamroll others in conflict?

When you can see those things and understand them, you can begin noticing a lot about yourself and how you can show up in a way that is authentic to you and how you want to be.

You intentionally spend time understanding the way you’re wired, your subconscious playbook, and then you can pause and choose your responses that you want. Not the pre-programmed one that keeps leaving you in a place you don’t want to be.

I’ve seen it look like people coming in leadership positions, being frustrated with the things the way that they are. And then they realize, oh wait, look at this about myself. And they’re able to break away from some of these unproductive patterns they’ve been repeating.

Also thinking of some other clients, choosing a job that suits your gifts, your talents, and those elements that I mentioned earlier, that you need to be able to thrive. It just looks like conscious and intentional living, a purposely designed path for you rather than letting life lead you, right?

Dr. Cindy: Rather than responding to the external, you’re driven by the internal.

Dr. Horrell: That’s correct. And you’re able to again, kind of do this pause when the external is going really fast. People say is this something I really want to do? Is this something I need to do? Or, you know, are there other choices?

Dr. Cindy: Right. Slow down.

Dr. Horrell: You practice that. Yeah.

The more you practice it, the more it becomes reflex, right? Whatever you practice kind of becomes your reflex. So, you just learn to integrate that.

Practical Techniques for Self-Discovery, Emotional Healing, and Clarity

Dr. Cindy: I see that. I see that a lot of women are probably struggling to identify those internal factors and, you help them slow down.

What are some techniques or tools that you use so that they can have that aha moment, like, oh, this is the pattern that I’m doing, or, oh, this is what I’m really thinking inside.

It’s hard to turn the mirror on yourself. So how do you help them figure that out?

Dr. Horrell: It’s different for everybody.

Dr. Cindy: Okay.

Dr. Horrell: You know, and it depends on their circumstances. I love Enneagram. And that is something that I help my clients identify, is their Enneagram type.

But through experience, I’m realizing too that one of the first things I need to do is really just kind of help their nervous system get to calm. And I know my clients really get, probably annoyed, because I really like them to have some sort of meditation, prayer, contemplative practice daily for five minutes if they can.

Just this intentional slowing of the brain, slowing of the nervous system because that turns on our prefrontal cortex and it allows us to observe, to accept. To make decisions from a prefrontal cortex, right, rather than our amygdala and our pre-wired roots that we have.

When I’m able to do that and we get in this space where we just develop a relationship, I think clients began to see it in layers – the patterns, the thoughts that they tend to have and their pre-programmed ways and ways that are authentically easier for them to be different.

Dr. Cindy: Okay. Yeah, so there’s no quick fix. I was kind of alluding that there’d be a quick aha.

There’s no quick fix to anything in life, but there are layers.

Dr. Horrell: Maybe, I mean, maybe with some people. But I think about this from a
neuroscientific standpoint. A lot of times people come to me, so maybe you would have a quick aha if you came to me and you’re like, you know, I think I need a career transition.

You’re in a different place than if you come to me and you’re saying, I hate my job. I never see my kids. You know? And your stress level is really high. We have to work through one building relationship with one another, allowing your nervous system to cool off a little. You can, we can start identifying these things.

But you can’t turn down your defenses and see things about yourself until you get to a place where you feel safe – safe in your relationship with me, safe to be vulnerable, and safe with yourself. That means that you’re in a little bit more of a relaxed place.

Dr. Cindy: Mm-hmm. Relaxed and using your brain more efficiently. Not in the defense mode, but using your prefrontal cortex.

Dr. Horrell: Correct. And that’s why I think that I come up with a lot of my techniques and the things that I do after having been, I mean, this is nothing against other methodologies and things people are doing, but you know, I do see some methodologies that are applied and I’m like, this doesn’t make neuroscientific sense to me for everyone.

For some people maybe because if you know how the brain works, if you know that somebody is suffering moral injury, if that’s the case, well that might be different than burnout. because one’s trauma, right? When you’re in these places, your amygdala’s just like jacked up and running the show.

So, a lot of these methods that depend on you to be able to reframe things or really access the prefrontal cortex, you’re not going to be able to easily get there. And until you’ve addressed what your amygdala is trying to tell you. So, I just create space for that, to be able to help people to be able to kind of chill their nervous system out Through the work that I do. And that’s different for every client, depending on what’s going on.

But then that will allow for the natural progression into the prefrontal cortex and the work to do there.

Trauma-Informed Coaching: Creating Safe Spaces for Physicians

Dr. Cindy: So, there’s a difference between needing a therapist for past trauma, and there’s also something called a trauma-informed framework that is definitely utilized in coaching.

Is that what you are describing right now? Is that trauma informed or I might be. I might not be informed correctly. Describe that to me.

Dr. Horrell: Yeah, and I do say that I’m trauma informed, and I’m glad you brought this up. I think a lot of this comes from the clients I’ve encountered in my own path.

I also like to normalize trauma because none of us make it out of this life without some form of trauma. Maybe little “t” trauma could be big “T” trauma. Some of us could have more than others.

We’ll all experience it at some point if we work in medicine. If you work in emergency medicine, you’re going to experience secondary trauma, and I think that’s really important for my field to be talking about.

But to be trauma-informed, when I’m using that phrase I’m trying to convey to people I’m aware of what trauma is. I’m aware of how it shows up in your life, and I’m aware of what it looks like.

I’m also saying that I am a safe and confidential space for you to share from your life. I’m not conveying that I’m a trauma therapist, but I do think I have the experience and the skill to coach you in this present moment and into the future facing scenarios that are going on.

So, I do believe it’s a place I excel, as well. And I think that that’s one part because of my own life experiences and the other part, because I’m an ER physician and then those things kind of marry together to create the coach that I am. Because there’s not much you can say to me after a decade in emergency medicine that would surprise me.

I think that creates this environment that I have for my clients that allow them to be able to feel safe. Their nervous systems can cool down. They’re able to share and that transformational work can begin.

Dr. Cindy: I love that. I like how you describe that you are a safe place and I thank you for clarifying to me what trauma-informed means.

Exactly. So I appreciate that.

Dr. Horrell: I think that it’s important to know because it’s something that’s thrown around a lot and I like, yes, how I see it, how I use it, and why I say it.

How to Find Possibility in Hard Seasons: Reframing Challenges

Dr. Cindy: You’ve, said that within each challenge lies a seed of possibility.

For the listener today who’s feeling stuck and challenged, what would you say to help her find that seed in her current situation?

Dr. Horrell: I would say come see me and we’ll find a lot of good seeds together. But outside that, the first thing that anybody can do is to just slow way down.

Take a break. In the ways that you can start taking things off your plate, take some time off.

You know, maybe you don’t do a family vacation. Maybe you need some space or some days off. And I know that that’s really hard for some people, but that is such imperative work for you and your family.

I would say get some sleep. That is huge.

Then begin the process of trying to find those seeds in that place and look at things with a broader lens, considering all possible scenarios, and be honest with yourself, but approach it with a lot of self-compassion. So maybe discuss it with someone. Who will listen to you and can reflect back, or if that’s not an option, write it out and ask yourself some questions.

But let yourself get really curious, even if it seems crazy or out there, because curiosity has an excellent nose for seeds, a possibility, and it can lead to just really incredible fruits. But again, you have to get to that space where you can see those seeds.

Dr. Cindy: Which means if you’re in a moment where you’re really challenged.

I like that you said maybe you don’t take that family vacation. Those are stressful depending on how many kids you have or how big of a family you’re taking with you.

It means having self-compassion and focusing on yourself and slowing down and identifying the seeds. I’m hearing you.

I so appreciate everything you’ve talked about today, that everything is so rich and has so much deep meaning.

Final Reflections + How to Connect with Dr. Horrell

Dr. Cindy: How can people connect with you?

Dr. Horrell: I would love to talk to anyone who wants to reach out and chat. You can follow me on Instagram at @CultivatingSplendorCoaching. Or check out my website at
cultivatingsplendor.com.

On my website, there’s a contact tab and you can contact me through my website if you’re interested in knowing more about the work I do or want to reach out and just ask some questions.

Dr. Cindy: Okay, lovely. And I will put those in the show notes so you can just read through the show notes and click, and it’ll go straight to your contacts.

Perfect. And just one last question, like a reflection for everybody. If you could leave physician moms with one question to sit with after this episode, what would that be?

Dr. Horrell: In the context of our conversation today, it would be, are you embodying the person you want to be? And if not, what is keeping you from claiming that for yourself?

I would encourage you not to waste this one beautiful life you have been given. You are a gift as you are right now, and the work you do demands that you be generous to yourself, that you are self-compassionate with yourself and that you allow for it.

Dr. Cindy: Thank you for that. You gave me chills.

Dr. Horrell: Well, I really think that that is my mission now, is to just help others see the light that’s in themselves that often that has dimmed or they can’t see.

It is my joy in life to be able to reflect that back to others.

Dr. Cindy: Mm-hmm. Well, that definitely comes through and I really appreciate you coming to the show today. Thank you.

Dr. Horrell: Well, thank you so much for having me.

Guest links:

Instagram:

@CultivatingSplendorCoaching

Website:

Cultivating Splendor