Thursday, May 29, 2014

Guest post: Everything changes when you become a mother

It’s a cliché, and I hate clichés. But it’s also a truth. And it beats me over the head on a daily basis.

I never wanted to be the type of person who thinks, let alone says or writes, that there are things that people without children just don’t understand. And I won’t pretend to know what anyone else feels or understands. But I can say with absolute certainty that my own understanding and experience of life has changed immeasurably since I became a mom. And I’m still trying to learn to navigate not just the logistics of life with a baby, but a very new emotional terrain.

My son was born in February after a healthy, uneventful pregnancy. At three months old, he is thriving – sleeping well, eating heartily, and smiling and cooing in ways that melt my heart anew every day. My husband and I try not to make assumptions about the future, but like all parents, we have high hopes for him. And we look forward to every day that we will spend together as a family, watching him grow and learn and discover the world.

Yet today I am sitting on the living room couch sobbing while my baby naps peacefully in the other room. Why? I am no longer painfully sleep-deprived, no longer terrified that he and I will never master the art of breastfeeding and that he will not gain weight and grow. My hormones seem to be back in check and I have largely adjusted to being back at work and away from him, although it is still hard to leave each morning. I am sitting here in tears because I just read a blog post written by someone I don’t know, someone whose story I came across when it was shared by one of my friends on Facebook. It was about a woman who just lost her little boy to cancer. And I am feeling another mother’s pain.

I can’t imagine what it feels like to lose a child. I couldn’t before I had my own baby, but now whenever I encounter such losses, all I can think about is how, once upon a time, that child’s mother had high hopes for her baby, had her heart melted by each smile and coo. Which is not to say that I would not have cried at the same story before I had my son, or that people without children would not shed tears over it. But the feelings behind my tears – the fiery, gut-tearing pain that churns within me when my mind even dances near the edges of the real question that arises with every story of loss: What if it were my baby being taken from me? – are awful and new.

So with my newfound understanding of motherhood, and the attendant capacity to imagine maternal grief, I face a new challenge. Since medical school, I have wanted to be a pediatric oncologist and treat children with cancer. I adore children, I love working with families, and I am fascinated by the science behind the diseases that afflict them. Back in medical school, one of my classmates confessed that she would have become a pediatrician if she hadn’t already become a mother. “I can’t,” she said, shaking her head and looking pained at the thought of caring for sick children. “I just can’t.”

I did not have children at the time, and although wondered how I might be affected once I started a family, I thought that perhaps I would gain some degree of immunity by entering the field before my own children arrived. When I began my pediatrics residency, I certainly felt sad when children were sick, and extremely sad when they died. But I was able to let go of that sadness and move on.

Then, during my second year of training, my own baby arrived. And after my brief maternity leave, I returned to work on the pediatric oncology ward, a place that had always gripped and excited me. And suddenly everything changed.

I still loved the strictly medical side of things: working up a new diagnosis, puzzling over the best ways to manage the side effects of chemotherapy. But the family meeting to discuss a little boy’s grim prognosis nearly sent me into a fit of sobs. I had to look away and sing songs in my head just to get through it. All I wanted to do was to cry with this mother. For this mother.

Which leaves me in a confusing state. Everything that I have always felt about caring for children, I feel much more strongly now. The uplifting and the soul-crushing both resonate in ways I could never have anticipated. Will this effect wane with time, or intensify? Will it render me better able to care for my patients and their families, or become a barrier to pursuing and surviving the emotions of this career about which I once felt so sure?

It’s hard to know anything for certain, other than, finally, what it feels like to be a mom.


Becky MacDonell-Yilmaz is a second-year pediatrics resident at Hasbro Children's Hospital/Brown University and mom to a three-month-old son. She blogs at The Growth Curve .

8 comments:

  1. I can't say whether you will or won't be able to move into oncology. I'm a hospice doc, and it's the younger people who are mourned by their parents that get me more than anything else. If you do this, you will need to find a coping mechanism that doesn't require you to look away. It's hard, hard work to remain present for patients and families when our own grief and pain is palpable. It is possible.

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  2. My first was born in my final year of Med Peds residency, and I don't think it made it harder to deal with loss and tragedy in my patients. It certainly made me more empathetic. But then again, my mom is super stoic, and I think some of that has rubbed off on me, for better or worse. I echo Jay above though. You have to find a coping mechanism or your work will be unbearable. My guess is that the paralyzing grief you feel with poor outcomes for kids will decrease in intensity over time. It's a survival mechanism and you will distance yourself from it to protect your sanity.

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  3. I can totally relate! I changed my mind of becoming a pediatrician when I got pregnant. Right now I am a pathology resident and happy with my choice. Good luck in your residency and hope you will find a good life-long coping mechanism

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  4. This happened to me when my daughter was first born, and then it got better again (not totally back to the way it was, but better.)
    I'm a pediatric genetics fellow and largely interested in lethal metabolic diseases. Dealing with neonatal death in particular is typically a weekly event. After my daughter was born, (14 months ago) I felt so sensitive to anything bad happening to children that I was worried I would have to quit. It was unbearable at first -- watching a kid who was obviously bald from chemo cross the street made me feel like crying -- but as I said, it became tolerable. I'm at the point now where I still go home and cry sometimes, but it's controllable and I feel like that "mommy bond" makes me a better, more compassionate, more dedicated doctor. Good luck!

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  6. What a great post. Your pain is palpable.

    When I rotated on peds path I had to present weekly at tumor conference. Lots of nephroblastoma and neuroblastoma. I palpated my daughter's abdomen in the tub for months.

    When I was preggo with C and J I was lucky enough to have compassionate residents that took the stillborns and traded me for Whipples. They thought they were lucky. If only they knew.

    It never gets better. It only get more tolerable. I don't know if that's bad or good. It just is.

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  7. I'll echo that it never got better or easier for me. I would have considered a fellowship in peds anesthesia but as a mother I just can't do it.

    One of my worst memories of residency is taking a screaming girl with metastatic cancer to the OR for a tumor resection, wheeling her away from her parents, listening to her ask not to die. I think it would have shaken up anyone but as a parent it almost killed me. I've had other experiences with kids as well where I feel the pain as a parent and go home, hug my kids, and cry.

    There is a huge emotional toll when you're a doctor, and I think that some people deal with it better than others. The question to answer is whether it is something you feel like can be compatible with a pedi heme/onc career. One of my family members does pedi heme/onc (has been an attending for 25 years) and he goes to a lot of funerals. He also saves a lot of kids. It is hard though.

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  8. All of us have patients die. All of us need to develop a way of coping with that pain and grief - really coping with it, not stuffing it down or ignoring it. If we shut ourselves off from our own pain, we will also shut ourselves off from the pain and grief our patients experience. When that happens, we become the cold, unfeeling docs who don't listen and we act in ways that make our patients feel dismissed and unheard.

    I don't do peds, so becoming a parent didn't change my reaction to my work. My father's death and my mother's descent into dementia have been much more challenging. Now I see patients every day who look like my mother might look in five years, and I see people my age going through what I went through when my father died. I come home and cry. I go to synagogue and chant the mourner's prayer. I sing. I talk to friends. I go on vacations and weekends away. I work hard to stay connected to the loving people in my life for balance and perspective. And the days when it's really hard - when the pediatric oncologist I meet says "I don't know how you do that work" - those days I tell myself that this is important work, and I try to take pride in doing it well, even though it hurts.

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