Managing Expectations

When I opened the email from KC saying that we were doing a topic week on “work- home balance” I laughed out loud. That particular day, I had failed miserably at achieving any kind of balance in my life. Poor scheduling had put me, once again, working through lunch, not giving me time to eat. I was not on call, so when I went in to tell my labor patient I would not be able to be at her delivery, she broke out into tears, begging me to stay. Home only briefly, I then had to run out to a friends Christmas party that I had promised to attend. A crying child had to be peeled off my leg, “Mommy don’t leave!” as I sneaked out the door. Arriving at said party late without a side dish, I realized I had forgot that it was pot luck. I mingled briefly, feeling guilty the whole time, then headed back home, to tuck in kids and finish editing a journal article that I had gotten at least 10 e-mails on that day (MUST FINISH ASAP!). Crashing into bed much later that night, I apologized to stay-at-home dad/husband for the week of extended hours. His answer was quite profound, “You really need to learn to manage your expectations .”

Luckily that day was the exception and not the rule. I think most days I do a fair job of finding balance. His advice was good though, communication and managing my own expectations for how much I can do is key. I am not superwoman, neither do I want to be.

So, in addition to his suggestion; here are some examples of how I try on most days to implement balance.

1. Schedule exercise. I am sure that one of the things that keeps me sane is that I exercise 3-5 times a week. I work out my frustrations on the treadmill and lap pool instead of my coworkers. I don't however routinely train for races, because this takes too much time. I would like to do a triathlon in the next couple years, but I want to plan ahead for a time when I won't have other projects looming.
2. As soon as you can possibly afford it, hire a housekeeper. This is not a luxury. I put this off way too long.
3. Communication. My husband and I have our phones synced with our home calendar, so any event goes immediately on the schedule. We’ve also started a weekly “team meeting” where we talk through our schedule and expectations for the week. You can also come up with code words for naughty things to put on calendar :)
   
4. Schedule. As my practice has gotten busier I have had to become more strict with my scheduling, for my own sanity. Previously, I would do surgeries or schedule patients during my lunch hour “if it was more convenient for the patient” or “if there were extenuating circumstances”, however these situations became more frequent over the years as my practice got busier. A few months ago, I ended up with surgery scheduled at lunch every day for 2 weeks straight. I re-evaluated my schedule. I realized that eating lunch and sitting down for 15-20 minutes a day was a necessity for my sanity.
5. Prioritizing socialization. I think this is where I feel like I fail the most. I manage to over-commit myself socially and at the same time, still have trouble keeping up with my friends.
6. Spend at least one day a week with the kids with no other distractions. In our house, this day is usually Saturday. Our kids are not overly scheduled. They will occasionally want to participate in activities, but not usually year round. I try to spend one day a week home with the kids, just hanging out and having fun.
   

Now as far as residency is concerned, balance is not always possible. Maybe for some of the residencies that don't require as much call, it may be more possible, but for OB/Surgery/Ortho residencies, its all about survival. You work, and when you 're home, you spend every moment with your kids that you can. That's all I remember, it was a giant blur. It was worth it, though, to be able to do what I loved, but those were years of sacrifice. When it was time to practice I chose a family friendly location and made it work.

My main source of balance comes from the fact that I have such an amazing stay-at-home dad/husband. (I wrote a full post on this in the past, for those commenters who were requesting more information on the topic). This year, in addition to the new baby, he has started a part-time business from home, which has presented its own challenges for us to find balance. Overall, he still does the majority of shopping and childcare. Our relationship is stronger than ever, and I respect/love/adore him more and more every year. I do feel the weight at times of being the sole provider, and I think this leads to overextending myself with my work schedule.

The key becomes realizing that the nature of medicine means that you won't have balance every single day, and that's OK, but you must have some sense of balance overall.