"These are attributes of physicians that serve them well professionally," said the presenter,* flashing a list onto the giant screen:
- perennial caretaker
- emotional remoteness
The family medicine conference attendees nodded and murmured in recognition, and he continued, "And these are the attributes of physicians that are liabilities in family life." He flipped to the next power-point slide:
- perennial caretaker
- emotional remoteness **
As the audience burst into appreciative, rueful laughter, I was struck by how neatly my domestic difficulties had just been explained.
I've often noticed that the very qualities that enable me to do a good job at the clinic frustrate my efforts at caring for my family and our home.
My days at work are organized exactly as I like them, from the length of patients' appointments to their medication lists to the position of the stapler on my desk. I interview patients, I examine them and I write prescriptions, requisitions and orders. I don't determine what walks in the door, but I manage every aspect of the problem once it's presented to me.
My life at home is an unpredictable, distracted mess. Much as I'd like to slot in a toddler bum wipe at 10:15 and keep the school backpacks stowed in the hallway closet, urgent requests and displaced things greet me at every turn. I may be the one guiding the day in a general sense, but the thousand details are determined by three messy, spontaneous children.
The satisfaction of measuring performance by objective standards at work cannot be achieved in the same way at home. I can pick up the faintest of heart murmurs, I can suture a laceration beautifully, I run my clinics on time, but how do you grade yourself on raising a daughter well?
At the clinic, I take on challenging work, complete it, and turn to the next diagnostic puzzle. But at home, I repeat menial tasks thousands of times, while others undo them.
Like most physicians, I thrive on competition. It's always motivated me, and winning is powerful affirmation. But motherhood is a different beast from the MCAT, pharmacology prizes and residency applications. No one's going to come out on top, and comparing yourself to other mothers is futile and dangerous ground. The competitive mother after gold stars is the one no one wants to be around.
The only item on the list to which I can't relate is emotional remoteness at home. My problem is the opposite. Because I am so emotionally controlled at work - probably because I hear the very moving stories of refugees every day - I tend to let any restraint slip away when I walk in the front door in the evening. I can be extremely irritable, though no one at work would ever believe it. Once, when I was being particularly foul, Pete gently suggested, "I think you should try to treat us like you would your patients."
I want to be a great doctor, and even more, a great mother. But if the qualities of one can be the undoing of the other, no wonder it feels such a struggle some days.
*Dr. Paul Farnan, St. Paul's Hospital CME, November 2008