Tuesday, December 14, 2010

No balance on the crazy train

I must admit, work- life balance is something I lack.

To be honest balance was a problem for me before marriage and children- well before earning my MD and before I took on the responsibility of caring for extremely sick patients.

I can remember in high school rushing home from basketball practice to work on the lay-out for the school newspaper. With copy and photos spread across the dining room table I would stay up all night long until it was perfect. In college I would sometimes sleep in the laboratory in order to run experiments, even on the weekends. Because of the fear that my work would not be good enough this super human dedication provided comfort that at least I would not fall short in effort. My extreme personality served me well in residency and fellowship, and I excelled.

This is my nature, and honestly this behavior had some consequences. Over the years I learned to accommodate or “tone down” these tendencies. In personal relationships, I realized my expecting perfection was alienating (and annoying). I learned that diversification was necessary to achieve balance, so I included exercise and relaxation in my schedule. Over the past few years I recognize that these changes are working for me. I find that I am happier and more effective through letting go, and exercise continues to be a good outlet for stress.

Fast forward to now, and although a recovering perfectionist I constantly battle feeling overwhelmed and exhausted. Right now I am not working, at home with my 6 week old son. I am determined to use my return to work as a fresh start. I have been soul searching trying to figure out what changes I need to make. This is difficult. One obvious problem- I am not working at all and still feel exhausted and overwhelmed. Not unusual for a new mom, and expected based on the irregular sleeping schedule. But as I review my spiral notebook full of lists I have created…… feeling frustrated that I am unable to make much progress on the multitude of tasks…. I wonder if this is hopeless. It is a similar feeling that I experience when working, with so much to do and unable to achieve the momentum to get to the bottom of the list.

Seriously I need help. From others I know that the first step to work life balance is learning to say no….. but why is this difficult for me? My problem is not saying no (I can be really tough when necessary), my problem is being able to discern what tasks are valuable and which are not.

Tasks that are not fun or productive but nonetheless necessary: Just because it feels like drudgery does not mean that it can be skipped.

Tasks that cannot be left undone (someone else must be found to cover): I would rather not do it, but is it worth the trouble to finding someone else? Maybe I should just get it finished already.

Tasks that are opportunities with potential strong upside: These are the easiest to say no to (many of my male colleagues would jump at the chance) but why must I pass on opportunities that I have earned?

With reflection and soul searching I realize my old tendencies are possibly still at play here. That an underlying personal expectation for perfection and fear that my work would will not be good enough still plagues me. I am afraid it is true, and despite significant personal and professional achievement I still rely on external measures of success. I now believe that this is at the heart of the matter. I hope this is the beginning of my next personal transformation…… but still at a loss for how to overcome this hurdle.

I figure that I am not alone- for the ability to withstand numerous years of training and tolerate long hours must commonly be motivated by similar ‘dysfunction’. What is the secret to better discernment? Any advice from those who already figured out how to disembark the crazy train, or from others riding along with me?


  1. 1) Set boundaries - in terms of time (limit work to 40 hours if you really want sanity).
    2) Say no. Say no to anything that you don't HAVE to do, or anything that you don't enjoy.
    3) Think about your baby. Change for your baby's sake.

    You can have meaningful work and meaningful practice, but it takes practice to find that balance.
    Also check out the book Womenomics by Katy Kay and Claire Shipman.

  2. Is perfection worth misery? What is the value of striving for perfection if what that really means is that you are determined to be disappointed, hypercritical and dissatisfied?

    Make the choice to hop off the crazy train. If not for you, for your child.

  3. JC - is there a female nephrologist in your area that you know? If so, she's willing to have lunch and talk.

    I recommend the book, THe One Life Solution, by Dr. Henry Cloud. Excellent book reminding us that we all have the same 24 hours a day, but it comes down to making realistic hard choices that are different from the way we were trained in medicine. It explores how to have the work life balance that everyone desires. Was wonderful for me.

    Life is too short to be completely crazy. It's ok - motherhood throws a wrench in life, but that is a good thing. It makes you stop and re-evaluate where you want to spend your time and it is OK to decide that parts of you outside of medicine might be more important.

  4. JC, I totally understand your frustration. Here's my take, for whatever it's worth.

    The perfectionism is a personality trait. I don't think you will ever be able to get rid of it, but I think you can modify it - which it sounds like you've already done to some degree. The more confidence you have in yourself and your skills, the more you'll be able to suppress this.

    It is a type of dysfunction. I have a similar dysfunction - pathologic competitiveness. So I understand where you're coming from.

    What I would do (again, for what it's worth) is to first sit down and set out your big overarching goals; two or three, not twelve. Write them down if you have to. Do this before you go back to work. Prioritize them as to how important they are to you. (For example, you may want to be chairman of your department. That would be a big, overarching goal.)

    Then, use these goals as a measuring stick for tasks. Whenever a task comes up, ask yourself, "How relevant is this to achieving my goals?" If it's very relevant, give it a high priority. If it's not relevant at all, bag it.

    Try not to let the little details get to you. If the house is cluttered, don't let it stress you out.

    It's a lifelong battle, my friend. But I tell you, it helps a lot to direct it if you know where you want the crazy train to go.

    Good luck!

  5. 1) Repeat the mantra, "Good enough is good enough." Particularly for things that don't really matter (job paperwork, etc).
    2) Hire people to do all the tasks that aren't really rewarding at home Cooking is fun, but hire a chef so you can do it when you have time but it's not another task. We hire people to do cleaning, yard work, repairs, shopping, errands, etc. And don't feel guilty about it! Think of all the stimulus you are providing the economy.
    3) Create a story for your job life (I am the...). Then for every opportunity offered, you can ask, does it fit into my story. Even better, ask yourself what you should be doing to complete your story and go ask for those opportunities (which will likely be better than the ones you are offered anyway).
    4)Celebrate the times you fall short of perfection. Invite people over even when your house isn't perfect, and see how much fun you and they have anyway. Bring store bought cookies to school function ( a few years off...). But you can put them on a platter to look homemade. :-) Make a support group of perfectionists and hold each other to not being perfect.


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