Showing posts with label work-life balance. Show all posts
Showing posts with label work-life balance. Show all posts

Monday, July 20, 2015

A Little Gift To Take To Work

We just returned from a week's family vacation. The kids have been off from school, and Hubby has been off from work, so, we've all been together 24/7.

I have afternoon clinic on Mondays, and we dilly-dallied away the early Monday morning.

Finally, reluctantly, I packed my lunch bag, kissed Hubby and the kids goodbye, and set off on foot for the train.

My three-and-a-half-year-old daughter called out to me from an upstairs window: "Mommy! Mommy! MOMMY!"

I looked up from the driveway and yelled back, "Yes, honey?"

"Will you do me a favor, after work?" She says "favor" like "fay-vow" and "work" like "wowk".

"Of course, Honey! What is it you'd like?"

With adorable preschooler excitement, she stammered out, as loudly as she could: "Will you- will you- will you... I mean, after work, will you... please just come home?"

Monday, June 29, 2015

Moving and credentialing are like oil and water

The last 3 months my husband O has been packing while I have been working on getting credentialed. His boxes are brown and filled with books and mine are checkie-boxes that I slowly work through. His boxes move us toward relocating while mine push us further and further away from our goal of saving money ($731 for DEA license, $130 for DC Controlled Substances License, the list goes on and on) but closer to my first job as a Pediatric Attending Physician.

The only one of us who has had fun packing is our almost 4 year old. His favorite activities include: throwing empty boxes, making forts out of boxes, and sliding on boxes. One day O and I heard a loud crash as he and his friends decided to pack his room; they did a pretty good job of placing all of his toys in a large box and then they proceeded to drag it into the hallway so he could move. It was endearing for about an hour until he began rummaging through it to get toys that he now decided he just had to have.

I am writing now so that I can take a break from packing another box of dishes. Packing dishes has helped me realize that we have a ton of dishes we don’t even use. I am purging these unused items because I refuse to pack them and I’ll be happier with less clutter. We have made so many trips to our local donation center I cannot even count them and each time I wonder where all of this stuff came from, while controlling my desire to “just hold on” to that thing I haven’t used in months but that I absolutely “need” (like the expensive Dr. Brown’s baby bottles, they are totally keepers!).

The last 3 months have shown me that working, while doing on-line orientation modules and handling credentialing just don’t mix. There isn’t enough time in the day. Thankfully, credentialing is all done and in less than 3 weeks I will be a full-fledged Attending Pediatrician! Unfortunately our movers come in 3 days and I now can’t seem to motivate myself to press on and I have no more credentialing to use as my excuse. It’s game time. Relocation here we come! But for now I’m just going to sleep.

Tuesday, June 23, 2015

Girls Don’t Cry

I have been following the response to Sir Tim Hunt’s incredibly sexist comments on women in science and thinking about how it relates to a working mother in medicine. If you haven’t heard of Tim Hunt, he is a Nobel prize winner who made headlines earlier this month for saying “…three things happen when [girls] are in the lab…You fall in love with then, they fall in love with you and when you criticize them, they cry” at a lunch for women journalists and scientists in Seoul.

Not surprisingly, the response has been overwhelming.  Some of my favorite tweets:


and…

and my all-time favorite…















But all joking aside, sexism still exists in science and medicine.  And as a working mom I’m very sensitive to issues of sexism, ambition, and differences between men and women.

This may be because I am constantly pulled in two directions (career versus family) and wonder if my ambition is ever questioned. On the one hand, I don’t want to draw attention to the fact that I am very much pulled in these two directions and must balance work and life.  But on the other hand, I do want to draw attention to this struggle to help support other women and help others understand decisions working moms need to make.

The fact is that I make very conscious decisions that incorporate both my work ambitions and my motherly ambitions. No, these decisions do not involve being distractingly sexy or crying in the lab but they do involve taking a slower and, sometimes, more convoluted paths.

I have rejected significantly higher leadership positions because they would squash my flexible schedule, I consciously avoid travel, and I am not willing to move my entire family for my career. To some of my male colleagues, these decisions may seem crazy, but, for me, these decisions are very calculated. 

I’m very conscious of burnout and hope to keep a level of balance that helps me work full time, find satisfaction in what I do, and keep me on an ongoing trajectory so that when I am no longer in the weeds of motherhood, I will still have interesting and meaningful career opportunities.

That being said, there are times when keeping the reins on my career is hard. I wonder whether I am being left in the dust when I see male colleagues make different choices and move up the ranks faster than me. And as a working mom, I never want to compromise other women by having my ambition questioned. 

But even with these doubts, I am incredibly proud of the difficult career decisions that I and every working mother have to make.  I know I will only have a short time with my kids at home and I want to cherish that time.  I’m sure there will be time in the future to turbo charge my career if I want.


In terms of Tim Hunt, I’m not sure if #distractinglysexy and #crybaby necessarily come up as issues for my career but ambition, choices, and timing certainly do. I think if we keep open dialogues and try to respect for each person’s decisions then I think we can push the conversation.  What do you think?

Tuesday, June 16, 2015

MIM Intro: Doctor Professor Mom


Hello, I am Doctor Professor Mom.  No, that’s not my real name but it’s a name that makes me really proud.  My oldest son coined it a few months ago when he learned that I am not only a doctor but I am also a professor and I am also a mom.  He seemed genuinely proud when he coined the name and, of course, I was equally proud both at his creativity and at some of my accomplishments.

Even as a Doctor Professor Mom, it’s hard to feel accomplished.  Maybe it’s something about academic medicine where I feel pulled in a million different directions. I teach; I do research; I see patients – it’s easy to feel like a jack of all trades and master of none.  Add on a busy family life and mastery is not in my cards.  But academic medicine has given me incredible flexibility, variety, and satisfaction.  Plus, I get to proudly say I am a doctor and a professor.

Of course my proudest accomplishment is not that I am a doctor or a professor but that I am a mom to three boisterous, energetic, and absolutely wonderful sons.  They are ten, eight, and six (gasp - how did they get so old).  After ten years of motherhood I have a lot to reflect on in managing a household with two equally ambitious working parents and ever changing challenges of parenting. 

I became interested in writing about my experience as a doctor and mother after my first son was born.  I spent 18 months crying every day when I went to work and decided (with the incredible support of my husband) to leave my job and stay home.  Then I struggled trying to find my identity as a stay-at-home mom (I wrote about this experience in an essay called Dr. Mom).  I returned to work and decided to focus on research and a career in academic medicine.  For me, it was an excellent choice.  That being said, the struggles of being a working mom, finding meaning and satisfaction in your work, and all the other challenges of life never go away even when you feel like you’ve found the perfect job.

When I wrote Dr. Mom in 2007, so many women contacted me and thanked me for sharing my story.  I promised myself I would write more, but, not surprisingly, life got busy.  I’m thrilled to have a place to write, to be a part of a community of women in medicine and hope that something I write will resonate with someone else. 

Tuesday, March 10, 2015

Career poll: if you weren't a doctor, what would you be?

Since beginning my clinical rotations as a medical student, I have been exposed to so many interesting, dynamic jobs within health care that I never knew existed such as Recreational Therapy, Occupational/Physical Therapy, Respiratory Therapy, Doula, Midwife, Lactation Consultant, Clinical Social Worker, the list goes on and on.


As someone who regularly follows MiM guest posts and who talks to many premedical students, I always find it interesting that exposure to other fields in medicine is so lacking. There are so many different ways to become a health care provider and though Doctors are among the highest in the hierarchy, without a diverse group of providers we not only fail to provide the best service to our patients, but we often fail to address core issues that determine health outcomes. 

With that said, for the physicians around:
  • if you weren’t a doctor what medical professional would you be or would you choose a completely different field?


And for those in training:
  • what other careers in medicine have you researched, considered, or shadowed in? What did you think?


My answers:

  • If I hadn’t become a doctor, I would be a Recreational Therapist with a focus on alternative methods such as massage and reiki or a Doula/Health Coach/Life Coach/Interior Decorator
  • Prior to my training, I didn’t really spend time shadowing Nurse Practitioners or Physician Assistants but should have. I will be entering academic community pediatrics in an urban setting and the overwhelming majority of my mentors and folks whose careers inspire me are Pediatricians. However, if I was interested in more community or rural medicine, pursuing a career as a  Nurse Practitioner or Physician Assistant would have been a possible alternate route to providing primary care with much less debt and better work-life balance.

Friday, January 2, 2015

Princess Service

“Your Princess Service has arrived.” At the end of my holiday shift, those words uttered from the lips of my Dream Guy, were like music to my ears.

I just completed a 6 day holiday shift working what our residency program has deemed WARS (working at reduced staff). You work up to 6 shifts in a row and get either the week of Christmas or New Years off in addition to your 3 weeks of vacation. I gladly got one of my favorite inpatient services with the Division Chief that I most admire. However, after morning 3 of waking at 5am to arrive for sign out by 6am, I was tired, my feet hurt, and I was forgetting what sunlight felt like on my face.

Three years into residency, our family knows to plan for rough stints like this and to have extremely low expectations for how our house will look (though I am so ashamed about how cluttered our bedroom is and bemoan its state daily with apologies). My in laws came into town on day 1 and are staying for 4 days after.

My day of work ends with O calling and making some silly joke about my “Princess Service”. The staff members here call being picked up or dropped off from work “Princess Service” and O has added it to his lexicon. I don’t think he quite knows that it is one of the highlights of my day.

I have arrived home daily to Zo playing on the floor with his grandmother with blocks or making Playdoh cookies, a glass of wine waiting for me, and delicious vegetarian fare cooked by my in laws or my husband. By around 8pm I can be found in my pajamas nodding off on the couch while someone else does the dishes. I somehow make it through story time and have been in bed by 9:30 or so every night. O and I watch our new favorite on-line miniseries, this month it’s American Horror Story, and I pass out.

WARS has ended and I begin the next part of the end of this year, applying for my medical license in the 2 states that we would love to end up in, and preparing for my next interviews.

Here’s to all of the Princess-Mommy-Doctors out there. I hope during this holiday season you feel the joy I feel each time I hear “Your Princess Service has arrived.”

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.

Saturday, September 20, 2014

Birthday Call: from zero to 60 and then somewhere in the middle in mere hours

40 minutes into my commute to work, I had a pseudo-melt down. As I sang “Happy Birthday” over the phone to my three-year-old, I lost it. I realized that I hadn’t kissed him on his birthday, I’d forgotten my lunch and during a 28 hour call the cafeteria food begins to make me nauseous, and that I was exceedingly anxious about all of the changes our lives will encounter over the next few months.

Needless to say, I’m in the call room after a deluge of discharges, awaiting our next transfer, feeling the urge to write and release this tension.

My Little Zo is three today. Three years ago, on this day, I birthed a fabulous little human being into the world. He’s helped me grow in countless ways. I’ve learned to let go. I’ve learned to give my all in the moment and then pass things off to someone else (to hubby O, to my parents/in-laws, to the wonderful ladies at daycare, to his Pediatrician). I’ve learned that keeping your own kid alive and occupied means breaking lots of rules (my infant slept on his belly after weeks of sleepless nights, my 2 year old ate yogurt and spinach smoothies or oatmeal for dinner on picky-eating nights) and that I am so much more capable than I ever thought imaginable. I’ve realized what’s important (playing legos and dinosaurs before bedtime and leaving my notes until he’s gone to bed, sleep, couple time, giving my all at work and not worrying about my child since he’s taken care of at all times).

In less than a year, I’ll be an Attending and yet another goal will have been achieved. I have had a few successful telephone interviews and I have my first in-person interview in October with a community health system affiliated with my medical school. This morning when I was sobbing, a great friend, KJ, who is now a Pediatrician in private practice gave me her pep-talk. We have these at least once every few months. She tells me about all of the little and big victories she has in her life after residency. She has weekends off and time to be with her boyfriend and her dog. She tells me about her quirky colleagues and her amazing patients. She tells me how different things will be in a few short months.

So, on Little Zo’s third birthday, I went from zero (dragging myself out of bed after an exhausting month on inpatient service during asthma season), to 60 (sobbing in the Starbucks parking lot), to somewhere in the middle. I am thankful for three years of motherhood. Thankful that Zo is vibrant, healthy, active, super-smart, and super-sweet (when he’s not biting or hitting). Thankful for only 3 more days on inpatient service before 2 months of elective and that I've been able to do great work this month and keep folks' babies alive and healthy! Thankful for friends like KJ who understand the struggles of residency-based medical practice. Sad that I wasn’t at home snuggling Zo and our visiting family members. And hopeful of life after residency.

Happy birthday to my little roaring dinosaur - Mommy loves you!

Tuesday, September 2, 2014

What's your idea of fun?

Our health centers are “medical homes” now, so I have to come to accept (but not necessarily embrace) my allotted turn or assignment to work, i.e. see pediatric patients, on an occasional Saturday. Periodically, I am able to trade these away, so they end up being few and far between. After a full day of patient care on a recent Saturday on a recent 3-day holiday weekend, my family (me included) were out to dinner and a colleague happened to be picking up dinner at the restaurant where we were dining. She came over to make small talk, and I mentioned I'd just come from working the whole day.

My young son then chimes in with, “But mom, for you, work is fun, so it’s not so bad.”

And that got me thinking about whether or not it is fun. Of course, there are all kinds of fun. Family fun is our recent amusement/water park trip, swimming in any lake, ocean, or gorge together, and family movie night. My individual "fun" is going on a long run, doing the Sunday NY Times crossword puzzle, or simply sleeping late.

But the perception that work is fun has got me thinking. Indeed, a lot of pediatrics and teaching is, when my patients giggle and the toddlers talk and my students are inspired and inspiring. And my work is gratifying. It feels meaningful. But at times it is heart-wrenching. I’m intrigued that “fun” is how I portray my work to my children, or that this is how they perceive my orientation towards what takes me from them day to day. That this one word (fun) has encapsulated their mom’s chosen career path.

Monday, September 1, 2014

Self advocacy - why is it so hard?

It’s funny how a few things collide, to suddenly make life crystal clear. It’s job application time for me, and I was lucky enough to receive three offers, strangely enough covering the gamut of work life balance from no after hours to full on subspecialty. After much deliberation, I chose the job that would best complement all my roles – mother, wife, doctor, furry friends owner, health advocate wannabe – you all know the list. I recognised I was burnt out, and at risk of leaving medicine altogether if I didn’t make an active decision to change my hours and where I was headed. Both my husband and I are in high level, full time roles, something I never felt comfortable with for the children. Here was my opportunity to make a change more in line with what I wanted for my family. I’m a firm believer in if-something-isn’t-right-fix-it, don’t just wish or whinge! Fast forward one week - past all the happiness at finally making a decision, the peace that the decision was right for me and mine, excitement of starting a new job, the daydreams and plans to incorporate fitness, walk the furry friends, spend more time with hubby and children - to today. I’m catapulted from a state of contented decision-making bliss into Guilt – guilt I now know is ‘doctor guilt’ (thank you Emily). It deserves a capital G, don’t you think, for the central place it often plays in women’s lives? So what happened?

Well a couple of things. Firstly, taking this new, wonderful job involves resigning from my current job, something that I’ve never had to do before (I’m yet to do this, because I’m waiting on a formal contract). It also means leaving a path I’d always thought I’d follow, and jumping into a reasonably unknown area for me. After making my decision, I had a conversation with the boss of the subspecialty I’d originally planned to follow, creating doubt in my mind that I’d made the correct choice. She wanted me to take her job offer, and I felt like I was letting her down in choosing not to. It was also ‘known’. After the ‘doctor guilt’ came self recrimination – in resigning, I am jumping ship, baling out, leaving colleagues in the lurch. In reality, my position is actually supernumerary at present, so in actual fact, no-one is left in the lurch, but my soon to be old hospital won’t remember that. I’m now the person I never thought I’d be – the one who leaves a post early.

This really forced me to choose what was important to me. I sat down and thought long and hard about my values, what I considered ethical, the life I wanted for my family, the sort of mother I wanted to be, and whether that married with my current workload (no surprises the answer is no). I pictured myself in each of the three jobs, and tried to see how I felt, what my reactions were. I read widely, trying to build a picture of my future career options. I came across an article about women failing to speak up when sexually harassed and why we are all so ingrained to be ‘good girls’, to not create waves, keep everyone else happy. I had many long chats with close medical friends, trusted senior colleagues, and my husband, who all agreed I should take this job. People who, like me, would never ordinarily leave a post early. I was told leaving a post early is common, people do it all the time. Not me though. Never me. In an ideal world, I would ask to start the new job when this one finishes, in five months time. That’s the path of least resistance.

But spending another week, let alone another month, in my current position is too long. My family needs to make a change now. As well as that, moving now saves me time at the end – possibly nearly a year of time (due to retrospectively counting some of this year, something that probably won’t happen if I don’t move until next year). The next five months in my current job is surplus to my training needs. So, for the first time in my life, I’ve chosen to do what is right for me. I’m going to take the community based, no after hours or on call job, and I’m going to start in 4 weeks. All I have to do now, is tell them. Resign. Although I’ve decided, I still question it, and probably will, until my contract arrives, and I have to make the decision final.

So I guess two questions. Has anyone else ever left a post early? Taken a leap of faith? Any advice on whether it turned out ok in the end? Fingers crossed.

Wednesday, August 13, 2014

Taking Care Of Ourselves

Genmedmom here.

A patient of mine recently asked me how my kids are, and what cute things were they doing nowadays? I'm very open about my family with all of my patients. They've seen me huge and pregnant, and they've seen my colleagues during my maternity leaves. My kids' photos hang in my exam room. We often trade parenting experiences as part of the visit.

So, I was not at all put off by her asking about my kids. Her visit was over anyways, and we were only making small talk as we wrapped it up. I described how Babyboy is a little engineer, always building and figuring things out, and that Babygirl is full of sass and song, teasting and challenging and singing all day long. She laughed and said a few things about her kids, how they were all grown up, how she missed their little days, but didn't miss how hard it had been.

"Make sure you take care of yourself," she said, suddenly not laughing anymore. It was a bit abrupt, this serious turn of mood.

"I mean you need to take the time for care for you, because you need to replenish your strength, to be able to care for your kids. Exercise, salon time, friends time, it's really important. You need to do that." She was beseeching me.

"Uh, okay, yes, I know what you mean, absolutely..." We were moving towards the door.

She stopped, and said, quietly: "No, really, I can see how tired you are. You're really, really tired. Remember to take care of you. I need you to, too!" Here she smiled, and the door opened and she was gone, leaving me unusually flustered, standing there for a few seconds, wondering what next.

I know I carried on with my clinic, and then went home, and did the dinner/ bathtime/ bedtime routine with my kids. I know I crammed in some mail opening, bill pay, and reading. I know that sleep was likely disrupted by something... If not one of the kids (usually Babygirl) then the cats, or this nagging cough I've had. I know I am really, really tired.

Now, I have alot of help from a wonderful husband and my untiring mother. I do get to exercise twice a week. I write, which is therapeutic. Hubby and I sit down for dinner every night that he's not traveling, and we have family dinners every week. I don't shop much, or see friends that often, and I can't remember the last time I went to a salon.

I honestly can't tell if I'm taking care of myself enough or not. I think I am. But if patients see me as exhausted, drained, that's not good. I'm not sure how much more time I can carve out for "down time" things, and I'm not sure I feel that strongly about making that happen.

What do others do to take care of themselves? How much down time do you need?

Friday, August 8, 2014

(Don't) Hide your kids!

The first year after my daughter was born, my end of year evaluations digressed into a lot of talk about whether or not I was mommy tracking myself.  The criticism was not about my work ethic or my skills. Apparently, there was an extensive discussion about how overly preoccupied I seemed to be about my daughter.  I mentioned her too often.  The suggestion of part-time residency came up and the sentiment was that I would no longer reach my full potential.  These meetings are supposed to be confidential-ish but I was told afterwards that perhaps I should try to hide my kid.

The instructions to hide my daughter came from a good place.  It came from an attending who had my best interest in mind.  He mentioned that in this world even though I was working just as hard, family issues were going to be looked down upon.  I would be stereotyped.  People aren't used to mom surgeons, especially not as residents.  He told me a story about sneaking off from work as a fellow to pick up his sick son by making up some elaborate story to hide the reason that he had to leave.  “It is more respectable to meet friends for beer than try and pick up your child from daycare,”  he told me.  My response…I would talk about my child incessantly!

So, I did.  I figured, if the world wasn't ready for women to be both surgeons and moms, than I would help to make them ready.  The end result is that I feel this has brought me a lot closer to the other hospital staff who are sometimes more open about recognizing the importance of family.  Being closer to the hospital staff makes my job easier.  I chat with the nurses, scrub techs, office managers about our families.  I feel like it gives me a sense of legitimacy and realness which means we are all on the same team.  Also, an unexpected result was that I became the “mama hen” of the residents.  There are a few more junior residents with kids or husbands and the associated stress.  I try to keep an open door policy for them.  And we have real and frank conversations about how hard this can be.  The supportiveness of being able to have this dialog goes both ways!  Also, I find that many of my attendings take an interest in my family life as well as my surgical development.

This past year’s evaluations had no mention of mommy tracking.  In fact, I was made chief resident.  Last night, as I sat finishing up work in the chief’s office while my baby girl bounced around watching Dora and coloring, I felt I made the right decision.  She knows all the names of the other chiefs and incorporates them into her world.  She loves coming to the office and is well known throughout the department.  She chats with me at night about her day and asks about my day.  She tells me she wants to be a doctor like me when she grows up (well, a doctor and a cowgirl of course).  I’ll never hide this beautiful girl!

Wednesday, July 23, 2014

Say What?!? Time to find a job!

It’s that time of the year. Career preparation time. I am applying for community pediatric jobs in the D-M-V (Washington DC-Virginia-Maryland) area and it feels surreal. Medical school in the area was extremely enjoyable and our family hopes to return and lay some roots (is it weird to really want to be on House Hunters?!?).

What didn’t happen:
- I didn’t get Chief Resident. I was pretty bummed out for several weeks, but I think it’s for the best. My mentors reminded me that I pretty much have all of the skills I would have been able to obtain (leadership, administrative) and if I am totally honest with myself acting as an Inpatient Attending for several weeks and crazy hours is not my cup-of-tea! I’m all about outpatient medicine and am ready to have regular hours, my own patients, and more time with my family. No pseudo-residency-with- poor pay increase for me.

What has happened:
- started talking to my Academic Advisors about my interests in community pediatrics
- had a few outstanding people offer to serve as references (Clinic Director, Chair of our Peds Heme-Onc Department, Mentor, etc . . .)
- written and revised my cover letter
- written and revised my Curriculum Vitae (CV)
- gotten considerable feedback from my Clinic Director, Academic Advisor, family and friends including an amazing sorority sister who's a Lawyer who cut my cover letter up so much that I basically rewrote it and it's soo much better
- started regularly visiting the PracticeLink and Pedsjobs websites
- registered for the AAP National Conference in San Diego in October

What I still have to do:
- finish reading “Lean In” (loving this book, so enlightening and inspiring. I’m all about leaning in!)
- send out my cover letter and CV to personal contacts in the area letting them know I’m ready to “discuss employment opportunities” (loving the sound of that)
- actually find some jobs to apply to
- go to the AAP Conference’s career fair and professional development sessions and dazzle some program/practice reps and learn about interviewing and contracts
- finish the last 11 months of residency
- start work as a Pediatric Attending Physician (woo-hoo!)

Alright practicing physicians - any suggestions? Anything you see missing in my list above? In applying for jobs after Residency what mistakes did you make? What do you wish you’d done differently?

Thursday, July 3, 2014

Play dates: Mothers in Medicine Style

Most of the Mothers in Medicine contributors, including myself, write anonymously. I write about my husband O and my son Zo knowing that folks who know me can figure out pretty quickly who I am. I write as if my boss is reading my posts, though I have never actually told her, but just in case, I write as if she may read them, nothing too embarrassing. I write to share and get feedback from folks near and far who understand my struggles and my triumphs in ways that my non-physician family never truly will. I have been writing for MiM since I was a Medical Student and over the years I have started telling folks beyond my family to check out my posts including some trusted work colleagues.

Over the years, I have felt like I have come to personally know many of our regular contributors and even a few of our regular commenters. I hope that someday there will be a big Mothers in Medicine Conference or maybe just a gathering at a bigger annual professional conference. When I read Cutter’s posts I said, hmmmm, I think we work in the same hospital! Flash forward to several months later (and many thanks to KC) and Cutter and I had our first MiM meet up at a local museum. Her daughter is super duper cute and Zo was smitten at first glance. He quickly followed her to the slide and then he began chasing her around the exhibits.

Play dates are always good times to reflect on the joys and vent about the struggles of motherhood, but when the other parent is a MiM, it is especially cathartic. Cutter is amazing. Chief Resident, Super Mom/Wife, super hair braider (from Youtube videos nonetheless). We spent hours talking and it was so nice to have someone who understands the doctoring and the mothering because it makes for a really unique life.

I have had a few other play dates with women Doctors including several with a beloved Attending who has young children. These times are equally amazing. She has the wisdom of being several years out of residency and fellowship. The first time I asked her and her kids out for a play date, she gladly accepted. We met up at another local museum and the next time at a park. Each time there was a lot of her being a cheerleader, saying “You’ll get through this.”

Play dates with stay-at-home mothers usually involve looks of pity and many exclamations of “I can’t believe you work that much.” Play dates with 9 to 5 working non-physician mothers usually involve less pity, but still many “I can’t believe you work that much” looks. There was none of that at our MiM playdate and I liked it!



Here’s to many future play dates, MiM style!

Tuesday, June 3, 2014

What Does "Lean In" Mean? Whatever You Want It To.

Genmedmom here. You'd think that as a doctor and a mother and a blogger with a focus on work-life balance, that I'd have been psyched to read Sheryl Sandberg's Lean In. Truthfully, I dreaded reading it.

I figured I'd have to read it sooner or later, given what I do, and I wasn't looking forward to it at all. From the bits and pieces I'd heard about it, I assumed that it must be a pushy, finger-wagging manifesto designed to make me feel more guilty that I already felt.

But I felt guilty NOT reading it. So one day, when I ordered a bunch of books on Autism (our son is autistic) and a few Barbara Brown Taylor essay collections, I also ordered Lean In. It sat on my bedside table for about a month. The other books got read (I read a lot), but Sheryl's smiling face looked up at me night after night, book closed, waiting.

Finally, one night, after the kids were down and charts were done and my brain needed some book reading for an hour or so, I realized I had nothing else to read but smiling Sheryl. I very reluctantly opened it...

And she had me at the second paragraph of the introduction.

She describes how she gained seventy pounds in her first pregnancy, and suffered from brutal nausea the whole time; how she struggled with simply walking, and realized that Google needed to have pregnancy parking close to the building, for all pregnant employees. So she made it happen. Wow.

Flashback to my pregnancies, where I gained, yes, seventy pounds, and felt awful, and struggled with simply walking... Like many employees of my big city hospital, I park at a garage about a mile away, and walk in. For my first pregnancy, my manager gave me a handful of parking passes that I used in the last ten days. That was great, but it was the last ten days, and there weren't any for my second pregnancy. I remember waddling painfully to and fro...

The point of her sharing the anecdote is to illustrate that she didn't realize how helpful pregnancy parking would be until she experienced it for herself. She wondered how no one brought it up before:

"The other pregnant women must have suffered in silence, not wanting to ask for special treatment. Or maybe they lacked the confidence and seniority to demand that the problem be fixed. Having one pregnant woman at the top- even one who looked like a whale- made the difference".

The book continues in this style, outlining the significant challenges women face in today's workplace, dotted with personal anecdotes and shared stories, humor, and problem-solving suggestions. There's plenty of data, but it's not boring. I was surprised at the praise, validation and encouragement for women at all angles of leaning in, including those who work part-time or stay at home. There is very little by way of exhortation; actually, I had to search for anything:

"I have written this book to encourage women to dream big, forge a path through the obstacles, and achieve their full potential. I am hoping that each woman will set her own goals and reach for them with gusto."

I actually enjoyed this book, and strongly recommend it to any woman considering a career in anything.

So, why did I dread reading it? Why did a book described everywhere as "an inspiring call to action" sit gathering dust on my bedside table for a month?

Well, as an internist who works part-time and mother of two young children, I've been exhorted, invalidated, even attacked. So, I assumed Sandberg's book would be another attack. It's not every day, but I'm sure I'm not the only part-time physician who has encountered this, the face-scrunching and "So, how does THAT work?" or a "Don't your patients get frustrated that you're not fully available?" kind of thing.

The attack most famous came from a senior female physician. I remember how sick I felt when I read anesthesiologist Karen Sibert's Op-Ed "Don't Quit This Day Job" in the New York Times (June 2011). In this essay, she doesn't just frown upon women working part-time in medicine: she crushes them. Worse, she crushes the aspirations of those considering medicine as a career:

"I recently spoke with a college student who asked me if anesthesiology is a good field for women. She didn’t want to hear that my days are unpredictable because serious operations can take a long time and emergency surgery often needs to be done at night. What she really wanted to know was if my working life was consistent with her rosy vision of limited work hours and raising children. I doubt that she welcomed my parting advice: If you want to be a doctor, be a doctor....You can’t have it all."

The death blow, however, was to people like me,

"Patients need doctors to take care of them. Medicine shouldn’t be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life’s work."

The... what do you call this? It wasn't an implication or an accusation, it was a sound dismissal of MY life's work. I have a small panel of patients, commensurate to my four clinical sessions per week. I work in a warm, nurturing environment, in a group practice of all part-time female internists. We have excellent clinical support staff. We enjoy great flexibility in our hours. We also are also regularly evaluated and rated by our patients, as well as our hospital, on various criteria ranging from patient satisfaction surveys to outcomes data comparisons between practices, and we perform extremely well.

I also have two small children, ages two and three, a working husband who is a wonderful partner, and family close by. I'm almost always home for dinner, and enjoy most weekends with my family. Yes, we carry pagers and are on call for ourselves Monday through Friday, with weekend calls shared, and there are occasional calls at less opportune times (bathtime, bedtime..). And, with the advent of the patient portal, where patients can communicate with providers online (kind of like email), they can send me a message basically anytime. But overall, clashes between work and family are few and far between.

My gut sense is that what I have going works. Most of my patients are working women, and I'm open and chatty about being a working mom (can you tell?). My kids' photos are up in my exam room, regularly updated, and patients eagerly ask about them, just as I inquire about their families. We trade stories. I receive solidly positive feedback from patients and colleagues alike. (I feel weird putting it on paper, all this positivity, but isn't that what we women do, is downplay our achievements?)

THIS is my "leaning in". I do not aspire to be a department chair, to publish in the peer-reviewed literature (though I have), or to have my own office with puffy leather chairs. I have made the considerable achievements of graduating from medical school, surviving residency, and thriving in a highly regarded primary care practice. I want to be a good doctor and a good mother (and to write about it!) I believe that you CAN have all this, because I do.

That is the beauty of the message from Sheryl Sandberg: "leaning in" isn't a one-size-fits-all formula. As in the quote above, she hopes that women set their own goals and reach for them.

Sandberg also talks about how women need to help other women achieve their goals. I agree with that, and it starts with pregnancy parking! It also includes calmly ignoring even senior female docs like Karen Sibert when they try to force a one-size-fits-all, my-way-or-the-highway approach onto a career path as variable and malleable as medicine. Sandberg discusses the phenomenon of senior women not only being unhelpful, but even hindering the progress of the up-and-coming women:

"Critics have scoffed at me for trusting that once women are in power, that they will help one another, since that has not always been the case. I'm willing to take that bet. The first wave of women who ascended to leadership positions were few and far between, and to survive, many focused more on fitting in than on helping others. The current wave of female leadership in increasingly willing to speak up. The more women attain positions of power, the less pressure there will be to conform, and the more they will do for other women."

So, read the book, and either make your way up, or reach a hand down. Set goals and "lean in" any way you choose, because only you know what is right for you, and if it's right for you, it's all right.

And I'm interested to hear what others think of smiling Sheryl's book.