At some point, the life you carefully constructed starts to feel misaligned.The work that once energized you now drains you. The relationships that felt stable suddenly feel tight. The version of yourself you have spent decades becoming no longer fits the shape of your days. And when that unraveling begins, we are quick to label it a midlife crisis, as if something has gone wrong or something needs to be fixed.But what if nothing is wrong at all?In this conversation, astrologer and spiritual teacher Liv Toepfer reframes what so many people experience in midlife not as a breakdown, but as a predictable point of awakening. A moment written into the architecture of the soul. One that arrives whether you are ready for it or not, often quietly at first, and then all at once.Liv explains how astrology reveals specific life thresholds, times when the psyche, nervous system, and soul begin asking deeper questions. Chief among them is what many astrologers refer to as Neptune meets Neptune, also known as the Neptune square Neptune. This midlife astrology transit often occurs in the early 40s and is associated with spiritual awakening, identity dissolution, and a reorientation toward meaning and truth. Illusions fall away. Careers shift. Relationships strain or end. Old coping strategies stop working. The external markers of success no longer satisfy the internal call.This is not chaos. It is initiation.Astrology, as Liv shares, is not about prediction or bypassing responsibility. It is a language. A way of understanding why now and how to work with change instead of fighting it. From Saturn return in early adulthood to North Node purpose and nodal cycles in midlife, astrology transits offer a broader context for growth that many people feel but cannot yet name.#astrology #podcast #doctor #healer #spiritual We also explore how the body participates in these awakenings. The nervous system responds before the mind has language. Energy shifts show up as fatigue, restlessness, emotional sensitivity, or the sense that something wants to move but you do not yet know what. Breath, presence, and self trust become anchors when certainty dissolves.From the perspective of Priya Rao, MD, a cardiologist and physician working at the intersection of medicine and consciousness, this conversation bridges astrology, nervous system regulation, and healing beyond symptoms. It reflects the Open Heart lens where modern medicine and spirituality are not opposing forces, but complementary ways of understanding the human experience.If you have ever wondered why everything seems to be shifting at once, why success suddenly feels empty, or why your inner voice is getting louder, this may not be a crisis. It may be your soul asking you to listen more closely.About our guest:Liv Toepfer is an astrologer, spiritual teacher, and guide for conscious transition. After more than two decades as a high level event producer, burnout became the doorway that led her into yoga, meditation, astrology, and energy work. Today, she supports others through life’s pivotal thresholds with grounded wisdom, clarity, and deep respect for the intelligence of the body and soul.Connect with Liv:Email: liv@itsavibe.earthWebsite: www.itsavibe.earthInstagram: @thevibetribetxInstagram: @livbydesign✨ Subscribe to Open Heart with Priya Rao, MD to hear more conversations where modern medicine and spirituality meet where we remember that healing is as much about consciousness as it is about care.Follow Priya & Open Heart:Instagram: Instagram.com/openheartthepodWebsite: https://openheartpodcast.com/Priya Instagram: https://www.instagram.com/dr.kothapalliLinkedIn: https://www.linkedin.com/in/pkothapallimd/© 2025 Priya Rao Media LLC. All rights reserved.

There are moments in medicine that don’t fit inside the chart. Moments where a patient’s suffering can’t be explained by labs or imaging, and the usual tools fall quiet. For some physicians, that silence becomes the beginning of a different kind of listening. Today, psychiatrist Dr. Judy Tsafrir sits with me to explore what happens when astrology, intuition, and clinical practice begin to speak to one another — not in contradiction, but in a deeper coherence. This conversation moves slowly and honestly through the questions physicians aren’t trained to ask, yet inevitably face: What is a soul wound? What makes a crisis arrive on time? And what does healing require when the mind isn’t the only thing in pain?00:00 Introduction to Sacred Psychiatry01:04 A Life-Changing Consultation with an Astrologer02:39 Embracing Astrology and Esoteric Practices05:48 The Journey of Self-Discovery and Healing07:54 Integrating Spirituality into Medical Practice14:37 The Importance of Energy and Diet in Healing30:39 Astrological Shifts and Spiritual Awakening38:49 Introduction to Chiron in Astrology39:11 The Myth of Chiron41:17 Chiron's Wound and Prometheus43:40 Chiron Return and Life Transitions44:52 Astrological Cycles and Midlife Crisis45:38 The Power of Authenticity48:37 Spiritual Practices in Medicine52:09 The Shift to Air Signs and Quantum Reality55:05 Physician Suicide and Mental Health59:15 Life After Death and Spiritual Experiences01:01:56 Living with an Open Heart01:07:02 Final Thoughts and ReflectionsJudy speaks from a place few clinicians are willing to name: the recognition that a patient’s suffering is often entangled with spiritual injury, archetypal patterns, and timing that feels strangely precise. She describes the moment astrology found her — during a season of profound personal crisis — and how the natal chart, the Chiron wound, and midlife transits became a map she couldn’t dismiss. Not because they were mystical, but because they were useful. Because they helped her make sense of what medicine alone couldn’t reach.But this conversation is not abstract. It’s grounded in the real costs of being a physician today — the moral injury, the exhaustion, the quiet grief of watching the system fracture while trying to remain human inside of it. Judy speaks with clarity about physician suicide, about the inner split that comes from abandoning one’s own truth for the illusion of safety, and why authenticity becomes a survival skill rather than a spiritual luxury.We explore diet, energy, intuition, trauma, spiritual awakening, consciousness, and the long arc of healing that moves through the body as much as the psyche. Judy shares how she weaves astrology into her clinical work without losing scientific integrity, and why the future of medicine may require a shift toward an “air sign consciousness” — one that values subtlety, resonance, and quantum patterns as essential dimensions of health.If the ideas in this episode move something in you, stay with it. Let it breathe. These are the kinds of truths that don’t demand belief — only curiosity. And if you find resonance here, subscribe, share, or join us for the next conversation inside Open Heart, where science meets soul and the interior life is taken seriously.🔗 CONNECT WITH JUDY TSAFRIR, MDWebsite: https://www.judytsafrirmd.com/Instagram: https://www.instagram.com/sacred_psychiatry/reels/?hl=am-et@sacred_psychiatryTikTok: https://www.tiktok.com/@sacred_psychiatry@sacred_psychiatryLinkedIn: https://www.linkedin.com/in/judytsafrirmd/Book — Sacred Psychiatry:https://www.amazon.com/Sacred-Psychiatry-Transpersonal-Transform-Consciousness/dp/B0CB9G8699Subscribe to Open Heart with Priya Rao, MD to hear more conversations where modern medicine and spirituality meet — where we remember that healing is as much about consciousness as it is about care.Follow Priya & Open Heart:Instagram.com/openheartthepod

There are places in medicine where the stakes are unmistakable, where a single decision or breath becomes the turning point in a story still unfolding. The cardiac ICU is one of those places. It asks for precision, intuition, and a level of humanity that is rarely taught. This conversation opens that world with honesty and depth through someone who carries both clinical mastery and grounded purpose.

Chapters

00:00 The Hidden World of Critical Care Cardiology
01:52 Inside the CICU: Teamwork and Humanity
03:40 Systems Change and the Deferred Dream
05:35 Courage, Identity, and Trusting Yourself
07:21 Vulnerability as Power in Medicine
10:48 The Immigrant Story and Human Truths
12:04 Lessons from Cardiac Arrest and Resilience
14:17 Team Harmony and Leadership in Crisis
17:59 Breaking Groupthink in Medicine
19:31 Women in Cardiology and Belonging
21:24 Psychological Safety in the Cath Lab
24:17 Creating Energetic Safety in Clinical Spaces
26:36 The Power of Intention and Positive Words
29:40 Patients and the Second Lease on Life
32:59 Compassion, Guilt, and Caring for the Healer
41:45 Purpose, Self Promotion, and Finding Your Path
43:46 Trust, Energy, and the Unseen Layers of Connection
55:26 Final Reflections and Finding Your People

Dr. Rosy Thachil, MD, MBA, FACC is a critical care cardiologist and healthcare leader whose work reflects the complexity of modern cardiac care. She understands that healing is clinical, emotional, and deeply human. Her lens invites us to look at medicine not only as a system but as a place where presence and authenticity truly matter.

Rosy shares what it means to care for the sickest cardiac patients and how trust forms among interdisciplinary teams during the most intense moments. She describes how the CICU reveals both the strength and fragility of being human. Her experiences highlight the connection between technical skill and compassionate care, a balance that defines true holistic cardiology.

She also speaks about her deferred dream of earning an MBA and how stepping outside the expected path gave her a new language for leadership and systems change. Her journey shows how courage grows when we let go of groupthink and develop confidence in our own direction. Rosy reflects on vulnerability as an essential part of connection and how it can soften even the most difficult clinical conversations.

Her immigrant story adds another layer to this reflection. Rosy speaks about belonging, identity, and the early messages that shape how many of us learn to protect our deeper truths. Together, we discuss mentorship, representation, and the experience of women in cardiology where visibility still matters. Priya shares her own path as a structural interventional cardiologist and the resilience required to walk into rooms where few women stand.

This conversation lives where medicine and humanity meet, where the heart is understood through both physiology and connection. It is a reminder that healing is a blend of knowledge, intuition, emotional intelligence, and presence. For anyone in healthcare or anyone seeking clarity in their own life, this dialogue offers grounding and a return to what is real.

Guest
Rosy Thachil, MD, MBA, FACC
Website: https://ThachilMD.com
Instagram: https://www.instagram.com/rosythachilmd

Subscribe to Open Heart with Priya Rao, MD to explore conversations where science meets soul and healing is understood as both consciousness and care.

Follow Priya and Open Heart
Instagram: https://www.instagram.com/dr.kothapalli
Instagram: https://www.instagram.com/openheartthepod

© 2025 Priya Rao Media LLC. All rights reserved.