I have to be honest about something that is a great source of personal shame: I am really, really bad at taking time off of work.

Despite working at a company with unlimited PTO, the last time I took a weeklong vacation was about a year ago, making me a walking cliche of the American who never goes on holiday. You could argue that the reason is cultural, that the Protestant work ethic has me in a chokehold. But I think the root cause is much simpler: For something allegedly relaxing and fun, vacations require a lot of planning and even more money. The price of flights is up, hotel rooms aren’t cheap, you need to factor in the cost of meals, and even that corny souvenir shot glass isn’t going to pay for itself. 

Hannah Sampson, who writes about travel for the Washington Post, says one answer is to take a staycation. “It’s taking the time to do things you normally wouldn’t do in your regular life and put on hold all of the burdensome things that you would do in your daily life,” she told Vox. “You’re enabling yourself to discover something that you might have taken for granted.” 

Plus, she says, a staycation can be “really fun and rewarding while also being budget-friendly and hopefully allowing you to put money aside for the bigger trip that you want to take sometime.”

So how do you make the most of a staycation? And how do you keep your typical day-to-day life from creeping in? We discuss that and more on the latest episode of Explain It to Me, Vox’s weekly call-in podcast.

Below is an excerpt of my conversation with Sampson, edited for length and clarity. You can listen to the full episode on Apple Podcasts, Spotify, or wherever you get your podcasts. If you’d like to submit a question, send an email to askvox@vox.com or call 1-800-618-8545.

It sounds like the key to a successful staycation is all about mindset. How do you achieve that mindset shift?

The way to really get into the staycation zone is planning and preparing and getting yourself hyped for what you’re going to do. This is something that I love about going on vacation and it applies to staying home too. 

Read reviews for places that you might want to go. If you’ve picked a restaurant, look at the menu and start to drool over what you’re going to eat. Think about your favorite bookstores or paths or discover a new corner of your neighborhood that you want to explore in advance. The anticipation of that experience will give you that vacation high. 

It’s so hard though, because you’re around the house. How do you make your home feel a little more special?

I think we all got too much practice on this during the pandemic, but there are a lot of things you can do to change the vibes of your house. I have a candle that’s national park-scented, so it’s piney. In my house, we do a lot of things like use audio to set the mood. I have small kids, so we’ll play audio of a ride at Disney World or just ambient sound from a park that we like. 

During the pandemic, my husband and I meant to spend our anniversary at the beach where we got married, but I was pregnant. We couldn’t travel. So we found a webcam that showed the sunset on that beach and we got takeout. It was really sad, but we watched the sunset.

It’s sad, but it’s also quite sweet. It’s like, “We’ll bring the beach to us.”

Exactly. And it was a beautiful sunset.

For me, one of the challenges of a staycation — and for all vacations, if I’m honest — is not letting real life creep in. And that’s beyond taking time to do administrative tasks around the house. That Slack goes off. I get that email. A news alert goes out and I’m just like, “Well, what if I just take a little gander?” How do you keep from letting that happen?

Unplugging is so hard. You could have a couple of small kids and teach them to tell you to get off your phone, which mine have learned to do. My husband actually has a Brick device, which locks your phone for you. The discipline is real there. 

It takes work to force yourself out of that constant need of scrolling through TikTok or just seeing what’s up at work. You don’t need to be on there. If there’s an emergency, they know how to reach you at work. So trust that process. Be super in the moment with whatever you’re doing because you need that mental break, even if you haven’t gone somewhere. 

You need to make the most of the time that you have, especially if you’re taking vacation time and spending it at home. Vacation time is a precious resource that you should be using to the best of your ability. 

Medicine has come a long way. We are living longer than ever, we have eradicated diseases that once seemed like a certain death sentence, and new improvements  are constantly being made to our quality of life. But despite all the advances, there’s a huge gap in women’s health. “I think there’s such an interconnectedness between society, culture, medicine, and science,” Dr. Elizabeth Comen told Vox. She’s a medical oncologist who specializes in breast cancer and an associate professor at NYU Langone. She says medicine often mirrors what’s happening in society at large. “For many societies across the globe, women did not have equal agency or power over their bodies, and that’s really reflected in the history of medicine.”

It’s reflected in medicine’s present, too. The share of women with heart disease in the United States is rising, there’s a cultural backlash and skepticism surrounding birth control, and almost half Americans are turning to social media influencers (many of whom aren’t credentialed) for medical information. 

Why is there such a disconnect when it comes to health care for women? And what will it take for it to end? We find out on this week’s episode of Vox’s weekly call-in podcast, Explain It to Me.

Below is an excerpt of my conversation with Evans, edited for length and clarity. You can listen to the full episode on Apple Podcasts, Spotify, or wherever you get your podcasts. If you’d like to submit a question, send an email to askvox@vox.com or call 1-800-618-8545.

We are at this point where we know more about our bodies than we ever have before. Sometimes you go to the doctor, and it feels like they’re still catching up on some pretty basic aspects of women’s health. Why does it feel that way?

Because it’s true. It takes a long time for medical science to catch up with the glaring gaps in our healthcare system. The gaps are not just about the obvious women’s health issues. We focus a lot on breast cancer. We focus a lot on reproductive function or our gynecological needs. But the gaps exist head to toe from our neurologic care, our gastroenterology care, how our hearts function, how our immune system functions, how our joints function. The gaps are real, and the experiences are real.

Can you walk me through some of the history? What did it look like to study women’s health before the 20th century? What were we dealing with?

When we think about modern medicine today and these specialties of urology, gastroenterology, they really didn’t exist before the 1900s at all; those are relatively new concepts. For much of the history of medicine, at least in the Western world, the idea was that, at best, we were small men and, at worst, there were many ridiculous diagnoses like hysteria and a long legacy of dismissing women’s medical needs because we were largely not taken care of by women. Those women that were caregivers in the history of medicine, whether it was the midwives or other types of healers, were largely pushed out of medicine as it became codified, and the idea of medical science really came to rise in the late 19th century.

So, I’m guessing that they weren’t really talking about menopause at the time, let alone perimenopause.

Perimenopause wasn’t even discussed. That’s a relatively new term and new part of our lexicon when it comes to lay discussion and the public at large. With respect to menopause, one of the famous physicians, Roger Wilson, wrote a book [called] Feminine Forever and referred to women going through menopause as vapid cows. He was the one that advocated in the 1960s and 1970s for women to be on hormone replacement therapy. But understand that, in the 1850s, it’s not like people really were wildly aware of what estrogen, and testosterone, and progesterone did. These are all relatively new ideas — the concept of hormones and how they can travel in our body. And again, we have a long way to go.

I read that women were rarely included in clinical trials until the National Institutes of Health mandated it in 1993. I find that so surprising. Why were women missing there? 

Well, these studies were not designed with women in mind. Some of the massive cardiology studies for drugs that we use day in and day out were done on thousands of men and not women. There is so much to that history, including the animal models on which many of these drugs were developed. In order to develop a drug, often, they are developed on mouse models first. It wasn’t until 2016 that you were even required to state the sex of the mice that you were studying. In many of these instances, female mice were not even included in drug development.

Oh my gosh — even the mice? How were these hormones marketed to people when hormone replacement therapy first became a thing?

It depends on which advertisements that you look at. If you look at advertisements of women in the 1950s, ’60s and ’70s, a lot of women were being prescribed anti-anxiety medicine. “Can’t manage your household at home? Don’t want to take care of your kids? Here’s what will sedate you and at least make you able to prepare breakfast for your husband.” It’s really shocking, and yet, not that surprising. If you look at Instagram today, are we really that far off from what gets marketed to women? Women sink billions of dollars probably into sham supplements and sham treatments, because they don’t feel cared for when they go to the doctor. And what fills that space? A lot of people trying to market things that have no proven evidence.

I think it’s really interesting that, at one point, hormone replacement therapy was this big thing, because I feel like growing up in the ’90s and 2000s, hearing women who are older than me speak, they were kind of anti-hormones. How did the pendulum swing that way?

Well, the pendulum has swung in wildly different directions. At first, it was: Every woman needs to be on it. And there were wildly successful sales. Then, there was the women’s health study that exaggerated the risk of breast cancer. Understandably, women were terrified. They were told by the media and by reputable scientists that these risks were significantly high and that they could not be on it, and we didn’t leave them with any alternatives. Now, we’ve become much more granular about what we know and what we don’t know, but I still think we’re far behind on the science. There’s still a lot that we need to learn, but, fortunately, an understanding of the prior studies and what their limitations are has come to light.

There are all these gaps in trust and treatment. There’s going to be a fair amount of snake oil out there, but are there ways that this moment is actually driving better treatment for women?

I’m so grateful that we’re talking about it, but I am terrified of what I see from influencers on Instagram. People can fake their knowledge. There’s so much fake imagery and information that is out there. I wish that we could invest this in quality science, which is long and laborious and painful at times but gives us the quality answers that we need. Every day, I see the consequences of fake information online, whether it’s an incredible loss of financial resources or just wasting money so that you could buy a nice pair of shoes. That would make you feel better than the ridiculous thing online that’s over promising and under delivering. The fear mongering is out of control.

What do you think it will take to trust their doctors again, rather than turning to the treatments they’re being sold online that might be dangerous? What will it take for them to feel good about the interactions they’re having at the doctor’s office? 

I think it’s going to be really challenging. We can’t blame patients, because we’ve done them a disservice. Medicine has fragmented the care of many patients — not just women, but men as well. We have to build a health care system that allows for time to be with patients and really hold space for them. I think that’s where the trust is really going to be built, because, at the end of the day, despite all the technology that’s available, medicine is about human to human care. That is what everybody wants to be treated as: a human to be seen and heard in the ways that you can’t just reduce a body to biology.