Wednesday, December 15, 2010

MiM Mailbag: Resident mom barely keeping head above water

When I heard about the latest topic week on work-life balance, I became excited to participate and finally submit a post. I've been a long-time reader and often refer new mamas in medicine to the site. I’ve spoken at a Resident Physician Parenting Workshop for the last two years and was a member of a recent Task Force that authored a document called Medicine and Motherhood: Can We Talk? I'm a mother to a joyful (but sleep depriving) 2-year-old, spouse to a wonderful MD/PhD student, and very happy to be finishing a family medicine residency here in Canada shortly. I thought I could write something witty, something useful, or share some secret for success… but all I can do is shout out for HELP!!!

I'm looking for help because, well, this teetering balancing act of physician, mother, spouse, friend, and committee member is about to fall apart!

I've cut back on committees and extracurriculars and even did a career switch (internal medicine to family medicine) in attempt to regain some equilibrium. I have in-laws that are happy to help, use money from my line of credit to have cleaners every other week, and have a fabulous daycare. And yet, I'm still barely keeping my head above water.

Hubby and I barely see each other -- this month I'm working nights in Emerg and he's on 1:4 call for the general surgery service. I think we spent less than 8 hours awake in each other’s company this week.
I never seem to have time to study or read around cases. Hubby feels like he's barely prepared for days in the OR and for exams. I feel like I could be a better doctor if only there was more time or energy.
And this beautiful child, well, he doesn't like to sleep much. And although my brain screams "No Way!", my heart is ready for another baby (or two).

How do you other MiM make it work? Everyone else seems to do it "better" than us -- they study more, are more well prepared in the OR, their dinners are home-made, and their kids are sleeping longer.
Said only very slightly tongue-in-cheek...

-Resident

9 comments:

  1. Oh how I feel for you!
    Reading your post is an echo of the thoughts in my head. I'm doing an ob/gyn residency (no where near finishing), with a 5 year old angel and yearning for: more time, more kids, more of a relationship with my husband.
    Wish I could offer advice, but I also look forward to hearing from other MIM members who have walked these paths before.
    Hang in there - sounds like the end is in sight and that life-raft may be on the horizon. :)

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  2. "I’ve spoken at a Resident Physician Parenting Workshop for the last two years and was a member of a recent Task Force that authored a document called Medicine and Motherhood: Can We Talk?"

    Your life is a book, not a chapter. You don't have to do everything at once. Residency should largely be about becoming clinically competent. Even though I know you will hate this advice, give up your committees until you are done with residency. Pick them up when you have more time. They will still be there. And you'll be amazed at how much more time you have for your family.

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  3. I am right there with you ,In Australia, and the one thing I've learnt lately is that its not true that everyone else is doing better.
    When I have burst into tears recently at teaching under the pressure of it all, my colleague who also has a baby allergic to sleep told me about how difficult she and her doctor husband find it. And I was certain she had it all under control.
    It doesn't make it much easier, but it kind of helps to know that ANYONE would find it tough.
    Cut back on work/committees etc where you can, and try and do things that feed your soul.
    And I think there really will be a light at the end of the tunnel, REading Dr Whoo's post yesterday made me realise...she is a couple of years down the track. Eventually our kids will sleep
    and when they wake up at the crack of dawn they'll be able to get their own breakfast.

    EVERYTHING feels worse when your sleep deprived.

    Hang in there.
    Thanks for your post

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  4. Resident~ Let me echo the above sentiments. Residency. Sucks. Hardcore sucks. But! It is finite. When you get out into the "real world" you and your husband can seek out jobs that wil be more conducive to seeing one another more than 8 hours per week.

    Residency is about putting one foot in front of the other, learning what you need to know to be a clinically competent physician. Becoming a good physician takes years, becoming a *great* physician takes decades. I see the perfectionism in you, let it settle a bit and know that you don't have to be and do it all *right now.*

    I totally agree that you should drop all the "extra committee stuff" and concentrate on your family and your studies for now. Let take out, chicken nuggets, or Kraft Mac and Cheese be ok for dinner some nights, or if having homecooked meals are high priority, take a Sunday afternoon, cook ahead and freeze portons to thaw. And trust me, those who seem to do things "better?" Have their own crosses to bear, you just may not see them.

    As for the not sleeping child...I don't know your particular situation, but sometimes doing what is easy is not always "textbook right." With my first, I was the sleep Nazi, and got less sleep for it. With my second, I was more laid back, and yes, many nights his 3 year old self still makes his way to our bed, but we all sleep (when I am not on call, that is) and I highly doubt he will do it when he is 16.

    So in conclusion to this novel, do what you need to do to get through residency, it gets easier, I promise. Wait until you and your husband are our of residency before adding more to your plate (or family). It will be here before you know it...hang in there, you will make it. :)

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  5. I'll echo that residency was hell. Having two kids during residency was, for me, a hair short of insanity. Luckily, I am regaining my sanity.

    I agree to completely cut back on everything you can except family and training for now. And if you do decide to grow your family at this time, make sure you are prepared that it is pretty tough and you need to have support in place.

    Don't compare! Looking around and feeling like you are falling short is part of the struggle of residency and motherhood - I guarantee everyone around you is busting at the seams just like you. I know I was! But everyone "thought" I was superwoman, in fact I was told this often, and I think this perception just reinforced my own faulty self-image of what I could manage to do until I reached my own breaking point.

    Good luck! Use those in-laws and try to take time for yourself and your marriage when you can. You will get sleep again when kid is a little older, but if you have another you won't sleep for a long time.

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  6. Where are you at in your training exactly -- are you finishing this June? if so, then the end is in sight, and this too shall pass. But you still have to get through the next six months!

    To me the three things that stand out are your committee stuff, your toddler's lack of sleeping, and, oh yes, that minor aside that YOUR PARTNER IS A SURGERY RESIDENT. Holy Hannah! that by itself is enough to put many moms over the edge, let alone if they are actually trying to work full time as well, let alone if they also have a wonky call schedule!

    I would cut yourself some serious slack. Don't compare yourself to anyone -- but if you do (we all do), make sure it's to HIS colleagues, not yours -- are any of them in a similar situation? They are the ones to look at.

    For a radical idea, is it possible to go parttime for any of your remaining months of training? Some of our residents have done that. Works well for rotations like ER, anesthesia, family medicine, OB (ie. spread your call over 2 months). We have had some of our residents do that. Or take a month or two of complete leave, just to recenter themselves a bit etc. It delays your certification slightly but you know what, five years from now you won't even notice that. Think about working towards the fall CCFP exam instead.

    Personally I have my doubts if you can improve toddler sleep while everything else is chaotic, but it's just a guess. Staying consistent is super key and that's very hard when you're treading water, in my experience. It depends how motivated you both are to really do this.

    Oh and get OFF the committees. They will be there when you're ready again (and you will be!).

    If you're still in your first year of residency, why not go ahead and get pregnant - take some part time months, no more night call once you're 32 weeks (at least in Ontario) -- then take the full year off and get your head organized. That might be a great way to regain balance if you can do that.

    Good luck, and don't be too hard on yourself. That surgical residency is a killer. Hang in there!

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  7. First off, thank you all so much for your wonderful, thoughtful feedback. It's incredibly touching to have so many people offer support and suggestions. The underlying theme came across loud & clear and HH said it so concretely:

    ****Even though I know you will hate this advice, give up your committees until you are done with residency. Pick them up when you have more time. They will still be there ***

    HH - Thank you. I don't hate this advice. Not at all. Actually, I love it so much. In a time in which we try and fit so much into a day it's nice to be reminded how important the clinical medicine is in residency.

    Risking coming across like a crazy person that takes internet comments from people I haven't met too seriously... I've been wanting to resign from our board of directors for ages, but haven't had the guts to do it (actually tried to not come back this term, but was guilt-ed into returning -- mental note, must learn to say no). I resigned last night, and it feels SO, SO GOOD. It's like a massive weight has been taken off my shoulders and a whole extra area of brain space has been liberated! Hooray for me having gone from 3 to ZERO evening meetings each month!!!

    Anon - Good luck!! I can only imagine how busy your days are in a surgical residency. I feel your sleep deprivation :)

    Bekkles - Thanks for sharing your experiences. It's quite revealing to have those images of perfection in other people revised. The many other posts in which balance has been hard for other MIM to achieve have all been so helpful to me to hear.

    Dr. Whoo - Thanks for your thoughts. I appreciate the sleep advice - it sounds a lot like our approach thus far (and I'm thinking that with (still hypothetical) number 2 I'm chucking the sleep books out the window and trying a different approach!). Also -- Mac and Cheese KD sounds mighty yummy right now!

    Gizabeth - I'm starting to see a pattern with those of you who survived residency :) Focusing on the important things... it seems so intuitive as I write it, I'm almost embarrassed to not be doing it!. This advice feels so right to me -- now I just need to put it into practice. You also identified the issue of being superwoman (to others) and being barely held together by threads (my reality)... I was talking to another MIM about this today at work and admitting to her that I needed to give up my committee work and that I am NOT superwoman felt so liberating in it's self!

    Susan - Nice to see another Canadian on the board!
    I agree - Toddler sleep and chaotic lives are not a good mix - I blame 80% of our sleep issues on call. Our son falls asleep wonderfully during the months when we are both at home and not taking call. Two stories, potty, and straight to bed. Heaven. Months with call? It's awful - I think he's confused when only 1 parent is home (or with shift work, when the other shows up at random times!). The worst nights are post-call - tired parents and a toddler to who is desperate to spend time with us and so tries to stay up to midnight for more parental time. Oh, the guilt!

    Luckily I only have 8 months of residency left and so should finished without being pregnant (well, maybe just a *little* pregnant at graduation!) or a new one. I also think having time to get settled as staff is key, before going off on another leave so little one #2 will likely wait awhile.


    The posts this week have been so helpful. I really appreciate all the time you each spent writing back to my post.

    -Resident mama

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  8. Congratulations on resigning your Board thingy!! that is a great step. It's amazing how even small things like that make a difference.

    I've been getting bugged by someone to take over an admin type position this April --something that always turns over in April, it's year end or whatever -- and was interested, but concerned about adding on something right now. Last night it occurred to me if I could get them to delay it til the fall, when my littlest (of three) will start part-time daycare, it would be SO MUCH easier. I emailed them today to put that out there and have had a very enthusiastic response so far. A friend of mine thought I was a genius for even thinking of that, she said she totally would have just said "yes" and then spent six months regretting she ever heard about it. It's funny how thinking outside the box a bit can make huge differences...

    I guess that's why I mentioned the part-time residency thing. It is very against our culture to do that, but it has made HUGE differences in the lives of a few of our residents and I think it's always worth floating around. You just never know who you'll find that thinks that is reasonable, or even genius! And sometimes it's the "old guys" whose wives did everything and recognize how impossible it can be for us, vs. the "younger ones" who Did It Themselves and so Why Aren't We? At least that's my experience! :)

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  9. I'm also Canadian and did my Family Medicine residency at UBC. I had my first child at the beginning of second year, and returned to residency part-time after five months of leave. I worked mornings and picked up my daughter from daycare after lunch.

    I did take pains to complete all my rotations with call schedules in the early part of my residency and left all rotations potentially conducive to part-time work for after maternity leave.

    And after 6 or 8 months of part-time work, I was so eager to complete my training that I returned full-time for the remaining few months.

    It can be done.

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