Thursday, November 27, 2014

An extra cup at the Thanksgiving table

As a pediatrician-mama, I find that Thanksgiving is -- to use a timely cliche -- easy as pie. I don't have to search my mind for even the shortest moment to access my gratitude place: My child is alive and healthy (*gods, do not be tempted by this statement*). The ocean of gratitude I feel for this has no bottom. I am aware of it dozens of times in the course of my day taking care of sick children: How lucky my partner and I are. How tenuous and temporary and fragile our luck is. How we can claim no credit for this fortune. There are many, many other things I am grateful for, but even if all those other things evaporated, this one thing, this everything, would still fill me up on Thanksgiving day and every day.

Yesterday, as a pre-Thanksgiving treat, my partner came and picked me up from work so we could pick my daughter up together from school. It was a gray, cold day and little specks of icy rain were making it hard to keep my eyes open as I waited just outside the entrance of the hospital. I'm on Jeopardy call all weekend but if I'm not called in, I get to have four days with my family in front of our slightly creepy ventless gas fireplace. (Where does all that CO and CO2 go? Whatever -- pass the pumpkin pie!) So I closed my eyes and sent a surge of warmth towards each of my co-residents, wishing for their well-being and the well-being of their families. Sure, it started from a place of self interest and humor, but then it felt good and right to be sending them little non-denominational blessings in honor of the holiday. There is a special place in my heart forever for the people I am training with -- a certain affection and protective instinct and a huge folder of moments in which these people have awed and inspired me, sometimes unexpectedly.

Then my mind turned to all the families I have cared for who are without a child this Thanksgiving. The babies who never made it into the word, the babies who stayed for only a few hours or days, the babies who left this world after a long struggle in the NICU, the babies who arrived to our ED in the early hours of the morning already cold and pulseless, the children whose otherwise healthy lives were shortened by cancer or trauma, the children with chronic illness who were in and out of the hospital for months or years before a cold or stomach bug proved to be more than they or we could fight. Then I thought of all the children whose lives have been shortened by war or preventable or treatable disease or famine or -- this week especially -- by racism or homophobia or genocide or hate-motivated injustice of any kind. I thought of their parents and the huge, gaping unfairness of what they were given by luck, or the universe, or God, or just random chance, depending on what you believe. I wondered how they go on with things like Thanksgiving. Would I be able to? In Judaism, when someone dies, the thing you say to the people who love them is: zachur li'vracha. My their memory be a blessing. And so, my eyes closed against the rain, I sent this out to all the parents who have lost children: May the memory of your children be a blessing and may there still be things to be grateful for.

On the Jewish holiday of Passover, we leave a cup of wine out on the table for the prophet Elijah. The teaching is that Elijah will one day come as an unknown guest and you want to be ready to welcome him. This year at my Thanksgiving table, I'm going to leave out a cup for all the parents who have lost children, that they may know they and their children are not forgotten. That they should feel welcome back into the rhythm of ritual and community, whenever they are ready. Also, that we may never take our good fortune for granted. And that we may fight in whatever way we can to prevent parents from losing children needlessly.

Happy thanksgiving to you and yours today, from one mama to another! And a special shout out to all the mamas who are taking call today so that others can be with their families -- Thanksgiving is whenever you get home!

-Also posted at whatbeginswithm.wordpress.com

Thursday, November 20, 2014

Vacation sans bebe

I read a few articles recently about Americans and vacationing. Of the only 25% of Americans who have paid vacation days, they have an average of 3.2 days left unused each year (OECD, 2013).

Unused vacation days. Not us!!! We use them all up. Zo travelled with us for the first close to 2 years of his life. However, once he was weaned and could no longer be lulled into a breast milk-induced-coma, we began planning trips without him. Many thanks to my parents and in-laws. And thanks to my cousin for letting us use her timeshare to enjoy fabulous, affordable vacations.

Here is my chronicle of our delectable and delightful second Vacation Sans Bebe, New Orleans style. I will focus on the food because New Orleans has to have some of the most amazing, creamy, luscious, sinful, gluttonous food around and there is just too much to write about (the wonderful people, the outstanding architecture, the cultures, the alcohol).

Best brunch ever - I can’t tell you how much O and I love an excellent brunch. My Sorority Sister B and her husband R who work for a major oil company in Louisiana met us at Slim Goodies. The french toast below was the best I have ever had; crispy French bread crust, fluffy middle, dusted with powdered sugar, and drizzled with syrup! Paired with mimosas that you prepare yourself (orange juice from Slim Goodies and prosecco from a neighboring restaurant they have an arrangement with), it was amazing!

(scrambled eggs, french toast, and large mimosa from Slim Goodies)


Best lunch - oooooh oooooh oooooooh. Gumbo and crawfish at Cafe Reconcile. Amazing nonprofit organization that trains local teenagers and young adults for careers in the restaurant business. Wonderful staff. Delicious food. The crawfish sauce was so complex yet not overwhelming. The grits were soft but had some substance to them and were perfectly seasoned.

(crawfish on grits, from Cafe Reconcile)

And the tie for best dinner - Bacchanal Wines and Houstons.

Bacchanal had to be one of the most fun experiences. We took a taxi into the Ninth Ward past factories and train tracks and end up in a cute neighborhood. You see a line on the corner entering a house with a big fenced in yard. You enter what may have previously been a living room, but has been converted into a wine and cheese shop. You purchase a bottle of wine, get a cheese plate (we unfortunately didn’t order one and the line was too long by the time we wanted some cheese), and go find a table. There are at least 100 people sitting and standing around. There is a live band playing in the courtyard. It is magical.

My husband and I failed on our first attempts to find a table, finally separating while he waited in the 20 person long food line and me making googly-eyes at folks with finished wine glasses taking up space. Finally, a very nice retired couple took pity on my and told me to pull up an empty chair. We sat at a candlelit table talking and drinking until they left.

And then the CHICKEN arrived.

Notice how I put that sentence on its own line. I had confit chicken that literally melted in my mouth with bok choy and a yummy carb I can’t remember. I did a little research on what confit means; it is to cook meat in oil at a low temperature (it’s not fried, it like melts away, oh goodness, soo yummy). That chicken was soo freaking good I am hungry just writing about it; the skin was crispy and perfectly salted and the chicken literally fell off of the bone and just melted in my mouth. O had a grilled tilapia that was equally divine. For dessert we had dark chocolate drizzled with olive oil and sea salt with even more wine.

(courtyard at Bacchanal Wine, image from http://fleurdelicious-nola.com accessed 11/1/2014)

Beignets - and on our last night in NOLA, we toured the city, stopping in shops. Eating. Drinking alcohol-containing beverages in plastic cups while walking (crazy that you can do that legally in NOLA). We ended the night on the banks of the Mississippi eating beignets from Cafe DuMonde with B and R. We heard approaching music as a first-line band leading a wedding party approached. As is the customary, we all stood up and joined in dancing and singing “As the Saints go Marching in” under the twinkling night sky.

Here’s to the best vacation sans bebe, NOLA, we love you bebe!


(Voodoo Tour, St. Louis Cemetery #1)



Our recommendations for excellent food in NOLA:

Slim Goodies, Cafe Reconcile (weekday breakfast and lunch only, nonprofit that does job development and career training for teenagers and young adults in the Garden District), Cafe DuMonde, Houstons, and Bacchanal Wines (get there early and just go ahead and get the darn cheese plate!).

Of note, I have no conflicts or disclosures, we went everywhere based on recommendations from friends and paid for everything ourselves. All pictures were taken by me and O unless otherwise mentioned and cited.

References:

An Assessment of Paid Time Off in the U.S. Implications for employees, companies, and the economy. Accessed Oct 16 2014.

Center for Economic Policy Research. No-vacation nation revisited. 2014. Accessed Oct 16 2014.

Work-life balance. Accessed Oct 16 2014.

Monday, November 17, 2014

MiM Mail: Middle of career life crisis

I feel like I am in the middle of a career-life-crisis.

I am a mother to an almost-3-year-old, and a 9 month old. I am an OB/Gyn. And, I love being both.

After residency, I joined a large private practice. Even after I had my son, I was fairly happy with my schedule. I worked about 3 1/2 days a week in the office, one day on call per week, and one weekend on call per month. But, I thought it was a pretty good life for an OB-Gyn. I sometimes missed holidays, wedding anniversaries, and important family events, but realized that those things came with the territory. After all, babies don't take holidays from coming into this world.

About two years ago, we moved to our home state to be closer to family. In doing so, I changed career paths. I now work as an OB hospitalist, doing about seven 24-hour shifts per month. It's a different role than I ever thought I would have. I see patients in the hospital that have no physician and take care of OB emergencies when their on call physician cannot make it to the hospital in time. In short, I still get to deliver babies and help women in emergent obstetrical issues, which is very rewarding. And, I get to have a lot of time with my children. Now, for example, when we sign up for a 2 week swimming class, I only miss a couple classes, whereas before, I would have only made it to one class. I get to go to the park, the zoo, the mall carousel, and all the daily little things that a lot of mothers in medicine have to miss out on.

I feel guilty even saying this, but when I first transitioned to this job, I definitely had to adjust to being at home so much. I felt guilty at times, because there were definitely moments when I (and my son, for that matter) felt bored. I would call my sisters and ask what they do each day with their kids. But, now, we have gotten into our groove. We have play dates, learning activities, favorite fun spots, and of course, naptime. So, before I know it, the day has passed and we are on to the next. And, just when motherhood starts wearing me out, it is time for me to go to work the next day. And, actually, it is a nice break to get away and have some career time. My 3 year old son asks every morning if I am a doctor or a mom. With this job, most days I spend "being a mom", and only some days do I spend "being a doctor".

So, what's the problem? One of the reasons I went into OB/Gyn was the hospital-office balance. I loved forming long-lasting relationships with patients that continued throughout life stages, multiple pregnancies, and through difficult diagnoses. There is something about delivering someone's baby that bonds you to them. You become important to them. It almost feels like you should be invited to sit at their table for Thanksgiving dinner. And, now, I don't have that relationship. So, I keep looking at job opportunities and wondering if I should return to private practice so that I can have relationships with my patients like I had before. The thing is, that if I make that career jump back to traditional OB/Gyn private practice, I will be giving up a lot of time that I have with my kids. So, I worry that I would end up in a "grass is not always greener" situation. I'm not as familiar with the business aspects of medicine, but to the best of my knowledge, it is difficult to keep a practice afloat (paying overhead, salaries, benefits, malpractice) in the OB/Gyn world and work only part time, so full-time it would be.

I know you guys can't decide my future. The truth is, that getting it all in writing is actually helping me process it all. But, any advice would be nice. Is it possible to have a part-time OB/Gyn practice? Should I just count myself blessed that I get so much time with my kids, even though my particular position as an OB/Gyn is not quite as fulfilling as it once was? How do I not feel guilty thinking all these thoughts?

Sincerely,
Confused mommy doc

Sunday, November 16, 2014

McDonalds dilemma

For a long time, I was not willing to take any time for myself. When I had a day off, I would keep the kids home and spend the day watching them, dragging them along with me to errands and doctors appointment, and not taking any time to relax.

Recently, due to my high stress level, I've decided to compromise. When I have a day off, I keep my youngest home in the morning, then bring her to daycare for the afternoon, when she would be napping anyway. (My older daughter is in school)

Initially, this didn't work very well. She would scream and cry during the drive to daycare and be inconsolable when I left.  To the point where I would practically be crying when I left.

The daycare wasn't crazy about this arrangement either. They said it was very disruptive to have her come in and be so upset.

Finally, I had what I thought was brilliant idea. There's a McDonald's on the way to daycare, so I would stop by the McDonald's and get her a happy meal to take with her. I did remove the toy for later, but she got to have the rest of it.

And you know what? It really worked. She was so excited to bring her little happy meal to school with her, and after a couple of trials of this, she was no longer upset about my leaving.

Of course, it's never that simple.

Apparently, there are a couple of kids in the class who cry inconsolably when my daughter is eating her McDonald's happy meal because they are so jealous. The teachers have tried to arrange things so that my daughter won't share a table with them, but it makes me feel bad every time I hear about it.

It's sort of silly because it's not any kind of amazing meal. It's a few chicken nuggets, apple slices, milk, and a handful of french fries.  She doesn't even get a dessert, which many other kids have.  I mean, I have literally seen kids there eating Dunkin' Donuts donuts for breakfast.

The daycare hasn't said a word to me about it or implied that I shouldn't do this anymore. But I still feel a little bit guilty. But maybe I shouldn't worry so much about other people's kids and worry more about my own.

Friday, November 14, 2014

How Do You Discipline Your Kids- In Public?

Genmedmom here.

Last week, on my usual Thursday off, I was on kids' dropoff and pickup duty, and I had a very difficult time with pickup.

Both kids are in preschool: Babygirl, almost age 3, loves her Bright Horizons daycare/ preschool, and Babyboy, age 4, is becoming more fond of his public Special Ed preschool program, as his teacher has really connected with him. Getting them up/ fed/ dressed/ out the door is always a bit of a challenge, but manageable.

Pickups, however, are getting dangerous. And not just for me, but also for my mother, who is most often on pickup duty.

Given the timing of school dismissal, we need to pick up Babyboy first, and then swing by Babygirl's school. Since you can't leave a four-year-old in a car by themselves, he has to come in with us to retrieve his sister. For the past month or so, once inside, Babyboy finds something he wants to play with in her classroom, and won't leave. He gets obsessed with completing whatever project he's invented, like lining up the construction toys or building something with Legos. I get it, he's autistic, and tends to have these sort of OCD-like moments. If you try to stop him before he's done with whatever it is he's determined to do, he throws himself on the floor in a tantrum. A loud violent tantrum. Even when he doesn't engage in something in the classroom, when it's time to leave, he gets wild, and runs away down the hallways, laughing at me when I call to him.

Babygirl is also now commonly protesting leaving, and has thrown herself on the floor, or also run away, giggling.

All of this is totally disruptive. Not only for the kids in her classroom, but for everyone in the whole school, as my kids scream and shriek and wreak havoc. Heads pop out of doorways, teachers checking on us, kids asking what's going on. If I yell, I'm just contributing to the mayhem.

Last week was the worst for me. It was him running away, and her tantruming. We were in the hallway, me kneeling on the floor trying to dress Babygirl to go outside, as she rolled around screeching, fighting me. I gave up on forcing her into rain gear (it was pouring) and hoisted her up, flailing and screaming. Meanwhile, Babyboy was running up and down the hallways, throwing himself on the carpet and rolling around, laughing defiantly. I had to chase down my son, grab his arm, and struggle out of the building. This was while carrying Babygirl, her lunchbox, raincoat, and backback.

I lost the backpack somewhere (and didn't realize until we got home), probably when I opened the heavy door. I had to let go of Babyboy in order to open it, and as soon as I did, Babyboy bolted out, across the driveway, and into the parking lot. In the rain.

There were no cars coming at that moment, thank God. But I yelled and yelled: Get back here! You hold mommy's hand in the parking lot! It was a safety issue. I had to get him and us out of the driveway and the parking area, and into the car. I yelled, I threatened, but he would not cooperate. Then Babygirl hurled herself down and I had to wrestle her back up, while attempting to run after a defiantly giggling Babyboy. The more I yelled, the worse he got. I caught him, and fairly dragged him to the car.

Finally, I jammed Babygirl into her seat and buckled her in- safe at least! And threatened to do the same for Babyboy. He got in his seat.

I was fairly shaking by the time I got into my seat. My throat hurt from yelling so much. It was so embarassing... What do the teachers think? What do other parents think?

"You both were very bad today," I admonished. I wasn't sure what else to do. They're in the car, so can't do a time-out. I'm not sure a delayed time-out would be helpful. I think spanking solves nothing, and would look awful in public as well!

They've been much the same for my mother all this week. So me, my husband, and mother have talked about this. We're struck with the difference between the kids when they're together, and when they're apart. One-on-one, they're little angels. Barring hunger or naptime, when it's just one by themselves, they're model citizens.

And, occasionally, they're OK together. I've taken both kids to restaurants, just me and them, and they've been wonderful. Random elderly women have complimented us: "Good as gold!" "So nice to see such good behavior!"

We can't figure out why Babygirl's school pickup has become such a trigger for terrible behavior. Sibling rivalry, like, they're competing for attention? Normal toddler/ preschooler defiance, like,as their sense of self forms and they're establishing independence?

We have consulted with a child psychologist in the past, and we will again. But I know there's alot of experience out there. Anyone else sometimes struggle to control their kids in public? What sort of discipline tactics work?

Genmedmom

Thursday, November 13, 2014

Guest post: United we stand, divided we fall

Editor's note: MiM contributor juliaink came across this blog post and thought it would make a good guest post here. The author was gracious in sharing it with us.


I was going to write about how new parents need to come together to create a “united front” when it comes to how they’re going to raise their baby, but because of a great thread I’m following on Facebook, my focus is beginning to soften and is more inclusive. There is a need for new parents to really hash out all the key points on how you intend to raise your children – before the baby arrives. If there are any big differences in your parenting styles, it would be best to know before your little person comes into the world to shine a spotlight on them! And if there are challenges between the generations, and there almost always are, it’s important for the couple to unite together for the sake of their own relationship. If a particular issue with a grandparent comes up, their child should speak directly to them about it – not the in-law child. This is just basic information that you’ve probably already figured out as a couple, but has special importance when you become new parents.

Having acknowledged all of this, the thread I’m following on Facebook talks about how grandmothers might experience postpartum mood disorders as their own daughters become pregnant and give birth. This was nothing I’d ever considered before, but makes complete sense to me upon hearing it. What a woman experiences during her birth will remain with her for always, her whole life. As a woman’s own daughter begins her journey toward motherhood these emotions and feelings from so long ago might begin to resurface. This can cause strain in the mother/daughter relationship as the soon-to-be grandmother revisits her own experience. If it was negative or traumatic for her, than there will be challenges that come along with this remembered event. If there were no real issues at her birth, there can still be some challenges or feelings of judgement if her daughter decides to do things differently from the way she did in her early years of mothering.

The same can be said for fathers and grandfathers. We live in a very different time with new research and lots of ideas about best practices during pregnancy, birth and parenting that just simply did not exist when our own mothers and fathers were on their journey. It’s no wonder that we have plenty of families having discussions with soundbites like this:

“When we were having babies, we just did it! What are you so worried about?”

“Well, that’s not the way we did it when you were a baby, and you turned out just fine, didn’t you?”

The health care system I work for has a fairly new class called “Grandparents Today” and it’s geared toward softening these conversations between the generations. It’s taught by a retired L&D nurse of 35 years on the floor who also happens to be a grandmother herself, so this is peer-to-peer education. The class brings to light all of the current information we have on how to keep babies safe when sleeping, why there is such an emphasis on breastfeeding, how and why it makes such good sense to wear your babies and have them skin-to-skin as much as possible, etc. The grandparents who take this class absolutely love it! They come back to their own children and school them about these best practices and everyone lands on the same page – at least about the things that are taught in the class.

I’d like to propose these two generations take this opportunity of bringing the newest family member on board as a chance to unite the whole family around raising this little person to adulthood. It’s a ton of work to do this job well – if you’re lucky enough to have your parents nearby and can count on them to assist with the day-to-day care of your newborn, this can be a lifesaver for you and your relationship. But even if they’re far away, relying on the wisdom that they possess – just from having more years on this earth than you – can be so helpful.

When talking with them about your challenges, try hard not to compare your situation to theirs. Yes, you might be going back to work full-time and they stayed home, but every parent works – just in different locations! Include your father in this new stage of his life without resentment – it was a different time and he was not encouraged to take part in parenting the same way you are today. If your mother never breastfed you, remember that as she’s learning right along with you, her words don’t mean to be unsupportive, she just might be feeling a little guilty about not doing this when it was her turn.

Having a new baby means stretching, growing and making room for this little person. Everyone examines who they are in relationship to this new life and it brings up stuff for each member of the family, some of it good and some of it not so good. Don’t assume anything in communication with one another. If the words you hear sting, instead of getting defensive, pause and try to imagine where their hurt might be coming from. Ask lots of questions. Look for understanding and common ground.

Having a baby does not have to be something that divides a family – it can be something that brings you all together. Being aware of these multi-generational challenges can be one way that you get closer to your own parents. Isn’t that something worth fighting for?

When you had your baby, did issues arise between you and your own parents? How did you handle them? Did the baby bring you closer together or drive you farther apart?


-Barb Buckner Suárez, a childbirth educator
Originally posted at Birth Happens

Monday, November 10, 2014

MiM Mail: Residency limit for leave and having children

First of all, thank you for this amazing blog that provides me with so much inspiration. It's so nice to hear from other women at all stages of training on their struggles and triumphs.

I'm specifically looking for anyone out there who had a baby during an anesthesia residency program. I'm hoping to have #2 while still in residency, but the ABA states that no one can take more than 20 days of leave per year during residency without making up the time. I know, based on my first little one (had during med school), that I will need at least 8 weeks, ideally 10. But I'm also poised to do a fellowship! Has anyone gone through this and found a loophole? Or convinced a fellowship program to let them start a month or two late? I feel that if we wait until I'm an attending, the age gap between our little ones will be too big (7 years).

Thanks in advance for your help!

Thursday, November 6, 2014

The New Four Fs

Last year, I spent a couple of months doubled over with post-prandial pain after dinner. We’re talking pain that would sometimes incapacitate me, having to lie down while my husband tended to the kids and got them ready for bed. I’ve been lucky to be generally healthy so this was a fairly disturbing turn of events—was I now starting to fall apart physically as I neared 40?

It turned out to be a gallstone. A single but determined gallstone: too large to pass, too much of a drama queen to peacefully co-exist in my right upper quadrant. Of course, I remembered that mnemonic from medical school about the Four Fs of risk factors for cholesterol gallstones: Fat, Female, Fertile, Forty. This did not improve my “downhill” meme. As a 23-year old medical student, hearing that mnemonic involving 40 was downright depressing. That was my future: declining bone mass, fertility, metabolism and physical health. Awesome!

Back to those fun months of pain, I was given a referral to see a surgeon. I made a joke about the Four Fs and my meeting multiple risk factors. He shot me down, “Those are not true.” Hmmm. Apparently I never got the updated gallstone mnemonic memo.

Having recently crashed the “now 40” party, I have decided that I will ascribe to a new 4 Fs system going forward:

Fit, Fearless, Fabulous, Forty.

Fit. I am fitter than I have been in years. Sure, I don’t have the time or will to work out daily like in college and medical school (and probably that was a little pathologic anyway), but I have been consistently exercising about three times a week. I rarely have enough time (or will – time is not the only barrier) to do more than 30 minutes at a time, but I’m really proud of sticking to a routine even if I am traveling. My body is not built for running long or hard but it can do 2-3 miles if gently prodded without disintegrating into a rubble of bone fragments. As a family, we’ve taken to going to the nearby high school track on the weekend so the kids can ride bikes, run, or play while I do my laps. I have no lofty aspirations of marathons or anything of that high-achieving jazz but to stay committed to regular exercise for stress relief, brain preservation, and of course all of the physical benefits.

Fearless. I have had plenty of fear and anxiety in my life. Do they like me? What if I say the wrong thing? Who is that man on the bike path? What if I get pregnant? What if I don’t get pregnant? Why didn’t my husband call me at the agreed-upon time during his deployment? Etc etc. My goal now is to be more mentally strong. Easier said than done, but I think understanding myself better, having more internal security in who I am is the key – and that’s happening as I get older. I’m not trying to morph into a daredevil risk-taker (although, I did recently swing on a rope, suspended in the air by a cable, into a large aerial web of rope and climbed spider-style onto the adjoining tree platform – THAT was fun), but to doubt myself less, believe more. That brings me to the next F.

Fabulous. Fabulous is not just how you look but also a state of mind. It’s feeling amazing and worth it. I have outfits that make me feel fabulous. I have work that I engage in (particularly involving education, research and leadership) that I know I have talents for and thus makes me feel fabulous. Being able to make my family (children and husband included) individually and collectively feel loved and important = more fabulousness. No one can feel fabulous all the time, but doing things that make me feel this way as much as possible is my goal.

Forty. Forty is nowhere near downhill. I feel like I am at my height as a mother, as a contributing member of society, as a partner, as a physician, as a human. I would not want to trade places with my 20-year old or 30-year old selves, even if she did have higher bone mass, faster metabolism and better skin. I have come so far! (Products also help, skin-wise.)

So those are my new Four Fs. What would be yours?

Tuesday, November 4, 2014

Go vote!

Last week I got off early and took my 'lil bit with me to vote (aka "bote" according to her).  This is the second time in her little life that she's come with me to our local library to get her "Merican flag" sticker.  Now that she's almost 4 we had a little lesson on the drive over about how girls and people with brown skin like us didn't get to vote a long time ago.  She was adoringly APPALLED!  She said that the people who don't let girls and brown people "bote" were not acting "nicely." I agreed.  So, today, for all us moms in medicine who are walking paths blazed by amazing women before us - HAPPY VOTING DAY!!

Monday, November 3, 2014

MiM Mail: Types of practices and family life

Hello fellow Mothers in Medicine!

I am a senior resident in a medical subspecialty, about to graduate next year, and am in need of frank advice on different types of practices and having a full family life. I have a child under the age of 1, and plan on having a second child within the next few years. My specialty allows for some flexibility, and I think that either solo practice, small private practice, or hospital employment are all viable options. Ideally, I would like to work part time while my children are young. I am hoping to gain some perspectives on others experiences with the varying different practice types, what worked well for young families and what presented challenges. Thank you in advance for sharing your experiences and thoughts!

Wednesday, October 29, 2014

Guest post: It takes a village . . .

...and my village includes a housecleaner, a nanny, a back-up part-time nanny for on-call days, an amazingly flexible husband who works from home and one amazing non-medical friend I've made in this new city. Plus, in really important crunch times, a family willing to fly across the country for weeks at a time to care for my family so I can focus on studying. I come from a family whose resources definitely did not allow for hiring nannies or housecleaners, so I always feel a little self-conscious about it and hesitate to seek help, even when I know it’s needed.

Before medical school, and even during the first two years, I could usually balance the work of school with the work of home. Between studying for Step 1 and then starting 3rd year, with two young children, I realized something had to give! I finally accepted the fact that extra help was necessary, for my sanity and for my success in medicine. While I don't mind cleaning the tub or mopping the floor, I would rather spend that time playing with my children, hanging out with my husband, trying to maintain some relationship with my friends and family, and of course, reading, reading, reading for school!

Since I've relinquished control of keeping up with the cleaning, and since my husband has taken over the cooking (mostly), I'm amazed how much time and mental energy I've been able to devote to school. I'm also pleasantly surprised at how much this extra time to study has boosted my confidence on the wards and subsequently my performance. Meanwhile, at home, I'm actually more likely to tidy up and clean a bit every day, since I don't feel so overwhelmed with the amount of cleaning to be done. This makes my husband, a neat freak by nature, extremely happy. Historically, every woman who could afford to hired people to help manage the house, so why do we try to be superwomen today?

I'm interested to hear how other mothers in medicine have found ways to expand their village of support and if they noticed a difference in their professional lives. I’m also interested to hear if you received any negative responses from your family about hiring help?

Ley is a medical student with two children under age 5. She lives on the west coast and remembers enjoying running, cycling and camping before medical school happened; she hopes to return to those hobbies sometime in the next decade.

Monday, October 27, 2014

MiM Mail: Advice for a MiM-to-be

Dear MiMs,

I have to start by saying that I love that this exists, and I truly appreciate every post on here. I'm a senior in college currently in the process of applying to medical schools all over the country. I have a loving, wonderfully supportive boyfriend on track to becoming a nurse next year. I'll call him J. (Side note: he's not bothered by having a "lesser" career than me, he doesn't see it that way. Being a nurse allows him to pursue other passions that he wouldn't have time for as a doctor.) We have been together for years, and are planning on getting married and having kids down the road, but not just yet (we're young!!!). J will likely go back to our hometown for the year after graduation, and while I hope to end up at school there as well, I may be anywhere. J plans to move to wherever I am, once I'm settled in, though we may be apart for quite a while. I get a lot of advice from people with no experience in this arena, so I figured it was time to ask some who actually know what they're talking about... Is it crazy to get married in med school? Assuming an ideal world, when is the best time in med school/residency to have kids? Is there a best time? Right now I want to be a pediatrician, but many people (often well-intended, but lacking expertise) recommend dermatology, pathology, anesthesiology, etc., for better hours. For all I know, I'll love those when I try them, but my heart is set on peds right now. Has anyone sacrificed the preferred career option in favor of more time with kids? I know I'll want lots of time with mine, but I don't want to feel like I'm not living up to my potential. The work/home balance seems to be a constant and changing thing, but I'm willing to figure it out!

I hear criticism from all angles about my desire to be a mother and a physician, as well as my interest in primary care, and I would love some encouragement. J is supportive, but still a 21-year-old guy, so he's not always the most helpful... No need to sweep the bad parts of MiM-ing under the rug, just point me in the right direction to find a handful of great parts!

Thanks for being such an inspiration to this MiM-to-be!

E

Friday, October 24, 2014

Incentivizing Grades

I really don't think incentivizing is a word, but you know what I mean.

My daughter made it through the first quarter of middle school, and she's doing quite well. But I can tell that things aren't coming quite as effortlessly as they were for her in lower school. She seems to have an external locus of control about studying and grades - her friends that study just "know how to do it and I don't." I'm working on changing her worldview here - giving her more of a sense of control. I'm not really worried about her grades so much as her learning that effort brings results. Natural talent can only take you so far. I'm reminded of David Brooks' 2009 opinion article about 10,000 hours.

I get that organization is a learning curve when you go from having primarily one teacher to having a complex schedule that changes every day with seven different teachers. My daughter is very organized and is slowly learning to be tech savvy; the school posts most of the assignments and tests online.

Her dad and stepmom and I have recently been having discussions around putting incentives around grades - just to make her a little more motivated. She gets lost sometimes in back episodes of Glee on Netflix - a recently discovered obsession. I worry about putting incentives on grades but the more parents I talk to I realize that this is common. Some even put incentives on practicing sports and music. I'm primarily bumping into monetary incentives - like $20 an A at the end of each semester.

One mom told me, "I go to work because I get paid. Why shouldn't my kid get something for his/her effort?" I'm not sure I'd like my work quite as much if I didn't get monetary compensation but I do love what I do. And I've got to pay mortgage and bills and student loans somehow.

Any advice or thoughts on this subject would be very much appreciated. My feelings are all over the map.

Thursday, October 23, 2014

Taking calls

I love my iPhone.  I take it with me everywhere I go: into meetings, into patient rooms, into the bathroom. (I don't use it in the bathroom, I swear.) 

Part of the reason I am so unwilling to separate from my phone for even a minute is that my phone is the only contact number that the daycare and the school have to reach me.

I assume when I get a call from daycare that whatever they are calling about must be vitally important. I'm immediately filled with terror until I answer the phone and discover that:

--my daughter was bitten by another kid

--my daughter bit another kid

--my daughter has a tummy ache

--my daughter is out of clean pants

--CONJUNCTIVITIS 

But it doesn't matter that the content of basically 100% of these calls has always been non-urgent. If I get the call, I feel like I have to drop whatever else I am doing and answer it.  So I excuse myself from the patient I am with or the meeting, and I take the phone call.  Then I apologize profusely when I return.

I'm sure in the days before cell phones, the daycare would be less likely to call me, knowing they would have to go through a receptionist or page me. But it is what it is.  

I suppose I could not take the calls if I am with a patient. But I'm pretty sure that I would be so distracted, I would be completely worthless. I mean, what if it's not just that they're out of pants? What if something is really wrong?

Monday, October 20, 2014

MiM Mail: Respond to the itch?

Dear Mothers in Medicine,

I am a 29 year old single mother of 2 boys, ages 7 and 3. I'm not in medicine as of yet, but about 6 months ago started getting the itch that my calling is to be a Family Practitioner. I'm so glad to have found your site, as I am torn between following my dreams and putting my childrens' needs first. I wonder if anyone has advice - is there any way to do both?

I live near Cleveland, Ohio and moving isn't really an option (to my knowledge) since I am divorced and share the children with the ex 50/50 (I have them every other week). It also might be good to know that my 7 year old has ADHD. Some people consider this to not even be a true condition, I understand, but my child is severe and cannot even attend school without receiving his medication twice daily. I am really the only one who understands him and can give him the love he needs unconditionally. So I am definitely a huge part of his healthy well being. My younger son needs me too, of course, but is very close with his father. So I worry less about my younger son.

Currently I am a Sign Language Interpreter. For the past 11 years, 90% of my work has involved medical settings. So, I've had the opportunity to shadow just about every aspect of the medical field. It has been an amazing experience! And that's where the hunger to become a physician myself began.

I noticed that for just about any other foreign language you can find a doctor with whom to communicate directly, if you look hard enough. In Ohio, however, there apparently are no physicians fluent in American Sign Language whatsoever. Because of my passion for the deaf community, this saddens me. Even with extremely skilled interpreters facilitating doctor/patient communication, I truly feel that some (possibly cruicial) nuances of the language are lost in translation. I want to close that gap in patient care. We really are behind the times in this, as a society.

Other reasons I long to enter medical school: I have a strong passion for the sciences, math, and especially solving mysteries. What better mysteries to solve than those which could save or better someone's life? I was standing outside a patient room in a dermatology office and happened to overhear the conversation between the attending physician and one of the residents there. I immediately saw myself on both sides of the conversation - first as the resident, sharing the information I had gathered from the patient with my attending and gaining confidence in my abilities to correctly diagnose and treat each issue, taking into account the special circumstances of each individual patient. But I could also see myself as the attending physician. I know I would love using the leading questions to help new doctors grow and learn in their profession. I can see myself there, as if it is as close as tomorrow.

Now, I don't know if my background will be a hindrance, as I was home schooled, and only have my Associate's degree so far. I pressed forward and earned my degree from a local community college despite my family's protests. My family is very grass roots and took offense to me wanting to go farther in my education than anyone else in the family ever has. But I did it. I am a very determined individual, so I know I could get through medical school. Afterwards, I would strive to be the very best of physicians by always being willing and ready to learn everything I can - never being satisfied with my current knowledge.

So I guess what it all boils down to is this: Would it be possible for me to be a medical student and a good mother to my two children? I know my life will never feel complete if I don't reach my full potential educationally/vocationally, but I don't want to ignore my childrens' needs either, as my parents did. They should come first.

At first glance it might be easy to say, "Well, its too much if you have children. You'd never see them," and that might be the bottom line. But currently, my income is barely enough to survive. Being a med student would actually increase the funds I have to use throughout the year substantially as compared to working all that I can currently.

So I'm just looking for options and advice. Is there a way in Cleveland to be a part-time med student, perhaps? Or set your own schedule somewhat, since I have every other week without the children?

Thank you so very much for your time and consideration. I truly value any gems of insight you can provide.

Sincerely,

Torn