No big surprise, but…I’m still tired

I’m currently mid staycation with my daughter, and I disobeyed my own advice.  I overplanned.  As a result I set myself up for constant disappointment because, I AM TIRED.  I’m now re-grouping and re-thinking.  Just getting done what I can, hanging out with my girl and enjoying her warm little hugs - realizing it doesn’t matter if we make it to every museum and live kids music performance and puppet show imaginable.  She just wants to hang out and read Rainbow Fairy books.  I have the same bleary eyed overwhelmed tiredness of residency staycations, and it’s a little bit of a revelation.

Attending life is full of new challenges.  I have called patients and set up appointments and reviewed pathology this entire break.  I can’t emotionally separate from what is going on.  There are many good changes - I do have increased control over my schedule, autonomy, and there is a more personal sense of fulfillment.  But, I am still so tired.  I feel constantly behind at home and at work - there is always more to do.  Part of the reason we’re having a staycation is just I didn’t have the energy or time to plan a proper vacation.

So, I’m writing this post as proof that from this moment on I will close my laptop and try to unplug.  And in a few days I will be back, hopefully energized just a bit so that I can keep moving.

Over exposed

The space that once gave me comfort has become a source of constant pain.  I am a breast surgeon and just  months ago my mother died of breast cancer. At my hospital. 

Before she died, I felt blessed to be here, and to be available for her.  My clinic adjacent to the medical oncology clinic, I checked our shared board and could track her through her day.  I would pop in between patients to go to her appointments.  If I missed one I walked 3 feet from my own workroom to the medical oncology workroom to chat with her doctor, my colleague.  When clinic was over or I had a cancelation, I could walk down the hall to infusion and sit with her. I would stop at the coffee shop on my walk over to grab a cookie or snack for us to share.  We would watch the Today show or some Lifetime movie while gossiping about any and everything.  These were my sacred spaces.  The places where I could be a part of healing, not just for my own patients but for my mom.  A chance to be there for her. She has always been there for me, more than I could ever express.  Even during that final admission, I could run to the cafeteria going the back way, I could tell all my family where to park, I helped navigate this monstrosity of a hospital, escorting everyone where they needed to be.  Her team was my team and it gave me a feeling of purpose, and brought her a sense of comfort.  For that I will always be grateful.  But now I sit on the other side of this comfort.  I walk on coals on the stone path from the parking lot to my office.  Each of her last 4 days began with this walk.  Every place is a trigger, every person I work with is both mine and hers.  

The list is endless. Faculty meeting takes me up the elevator to her hospice room.  I've now just stopped going, clinic always runs a "little late" and regrettably I'm unable to attend.  The long walk down the main corridor to the OR or the wards or the ER, represent a piece of her final journey.  I peek through the open door of the ER as I walk by, as if one time Ill see her there, in her pink pajamas on the night she arrived for that final admission.  Each walk through the ICU I feel my walk to her room, sometimes I feel the weight of my daughters hand as we head to visit Grandma.  I follow my chief on rounds and pray that today, I won't have to see a patient in the very same space - one day I do, and I am undone.  Each day I operate I lay before her, in the same operative room where she once lay, in a moment of hope.  The hope I have for my own patients.  Praying that their post operative story will be different than hers, longer and less filled with pain and fear.  

Soon I will walk down the same corridor for a biopsy of my own, in the same room, the same hall, the same side, the same spot.

Mandatory meeting...CHILDCARE PROVIDED

I have posted before about how much I love my job.  I am honored to work with so many amazing people.  Quite recently a revolutionary change has occurred for our late departmental meetings…childcare is provided (as well as dinner).  Such a simple offering means SO much. These special surgeon kid playtimes are now one of the highlights of my daughter’s social calendar!

Below I have posted (with permission) the beautiful and inspiring blog post of our amazing Clerkship Coordinator after the first childcare night. I am so proud of us.  I am so proud of who my daughter (the 6 year old described below) is becoming.  I am proud of this department, of my profession and the future that we are creating for our girls as Mothers in Medicine…

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From the blog of JP -

When I was a kid, about 25 years ago, I overheard my mother repeating a riddle that had been told to her. In short, a young boy and his father were in a car accident. The father died immediately upon impact. The boy was rushed to the hospital. Once in the OR, the surgeon stands over the boy and simply declares, "I cannot operate on this child. He is my son." So the riddle goes, if the father was killed in the accident, how on Earth is this possible? Keep in mind, the riddle is at least 25 years old.

I listened as folks stumbled over themselves with the most absurd answers, "The dad hadn’t really died." "The surgeon was the boy’s step-father!" "The father was not his biological one and the surgeon must have been the boy’s sperm donor." The answers came and went and when the person finally threw their hands up in defeat, the person telling the riddle simply replied, "It was the Mom! The boy's mother was the surgeon!" Gasped responses immediately followed; these gasps were made as if to imply extreme bewilderment that a woman, A MOTHER, could be a surgeon. Nonetheless, the folks on the receiving end of the riddle felt embarrassed for not offering the most overlooked obvious answer even if they could not fathom a female with a scalpel.

Fast forward 25 years, I just spent my evening at work doing arts and crafts with two children of surgeon faculty members so that said parents could engage in an after-hours faculty meeting.  I brought all of my craft items from home so the young girls could make various winter holiday crafts. At one point I noticed one of the girls (6 in age) was making a gingerbread man. I quickly praised her on her great artistry, "Hey! That’s a great gingerbread man!" I pointed out. "That's not a gingerbread man!" she quickly declared. I was caught completely off guard. Y'all. I'm telling you. It was a gingerbread man!  Before I could ask her what it was (since I was so offensively incorrect), she proudly exclaimed, "It’s a gingerbread GIRL!" Immediately, a grin washed over my face. I'd only met this child within the hour. Our time was consumed with learning each other's nicknames, teacher's names and favorite colors. Feminism 101 had yet to make it to our arts and crafts agenda. I wanted to high five her. I wanted to spin around in circles and dance giddily in only the way excited 6 year old girls do. But instead, I nodded, and told her it was the most amazing gingerbread girl I'd ever seen.

Within the next hour, the other little girl (8 in age) casually announced that she was creating a top hat for her snow woman. SNOW WOMAN! Did I hear her correctly? Snow woman!! Yes! And she'd said so, so nonchalantly. It's as if Frosty the Snowman wasn't the first... the only...the standard! “Every snowwoman needs a top hat!” I replied.

If I'd told that 25 year old riddle, now, to both of these young girls, they would have quickly and without hesitation answered that the boy's surgeon was obviously his mother. I am confident of this.

It was in that moment, and for the rest of the evening, I stood proud; proud of the progress women had made in the last 25-30 years. Proud to have been able to witness, in my lifetime, such dramatic change, albeit long overdue and with still so much progress yet to be had. I was proud to be a female working in surgery education. I was proud to work for a team with so many female surgeons. I was proud to work under the leadership of a successful woman, whom not only was a General Surgeon, but also the Program Director of the General Surgery Residency program.  I was proud to work for and with a group of smart and successful women who greatly value their profession and equally, their role as a mother. I was proud that these young girls were exemplifying everything I’d known to be true as a child, but always felt so disconnected with. Perception was no longer reality. The reality had finally become perception! These mothers, these brilliant successful female surgeons, they are paving the way for the next generation of gingerbread girls and snow women to achieve greatness.

This is how we lift each other up. We create an environment in which we welcome one another's children so that we and they grow enlightened, encouraged, educated, inspired and excited by possibilities. We embrace the difficult balance. My God, the balance is difficult. We dispose of the box that which we were placed in and we become assertive in our ideas of becoming both brilliant and successful professionals as well as invested mothers. And it doesn't just begin and end with women, my friends. We must embrace our professional fathers as well! We are only as good as our counterparts. Our strengths are magnified when we surround ourselves with other strong, confident and supportive human beings.

I am grateful to be able to contribute to their (our) mission.

Some day I knew I would write this post.

Last year I posted about trying to cope with my moms breast cancer recurrence.  Four years ago my mother was diagnosed with Stage I breast cancer.  Less than three years after her diagnosis she recurred as Stage 4.  She did not make the 5 year survival mark.  If you look up Stage 1 Breast cancer on the American Cancer Society website, you will find this quote: "The 5-year relative survival rate for women with stage 0 or stage I breast cancer is close to 100%." Irony.

This last year has been spent with me trying desperately to treasure every moment while also trying to stop a boulder.  I have made appointments, had family strategy meetings, endlessly researched and relentlessly picked the brain of her oncologist.  I have tried to make moments out of every pause.  I would often sneak away from my clinic to sit in the infusion room.  We would watch soap operas and chat about bits of everything while I would chart.  My mom worked from home for the last year, and I would occasionally spend my administrative time in her home office. We would gossip and look at shoes online while trying to work.  These moments are some of the most cherished, just the two of us.  Our family tried to band together.  We reinstated family Sunday dinners.  We all visited as much as we could manage.  We organized family outings.  We took advantage of all the grandparents days at the local museums and kids theaters.  But many days were post chemo days or too much pain days, and on those days we just talked and sat.

Thanks to our move, my daughter got a full year of Grandma time. A year I pray she is old enough to remember and cherish.  I will fight to make sure she doesn't forget.  Their love for each other was magical.

My daughter was with us in the hospital intermittently up until my mothers death.  On that final trip she saw something in our urgency to get back.  She asked me, "Mommy, did Grandma's cancer get stronger than the chemotherapy?"  In her pure and innocent love, she drew a final picture of Grandma holding all of our hands, each of us smiling.  At our daughters request, we buried that picture with my mother.  She said, this way we would always be with Grandma.  I am continually in awe of the simple wisdom of children.

I have seen many people die.  I have cried with families in the hospital.  I have sat vigil in the unit trying to will patients back from the precipice.  I saw the scans, I knew this was coming.  But, there was no preparing for this feeling, for this moment.  I have never felt this.  I have no words for it.  As I move past the initial shock I am just trying to exist in this new reality.  I am trying to be normal because it's been a month and now people expect me to function and be "back." But I am still in phase 1 and I have no idea what to do.  I am constantly searching for something...a memory, a piece of her jewelry, a picture, a video, anything to fill this chasm.  I have filled my house with old purses and pictures and clothes and plates and spices and cakes she made from her freezer and each thing is like a single speck of sand. I talked to her every day.  I texted her between cases.  I dropped by to see her on the way home.  What do I do with all of these things I would have told her, what do I do with all of these words that are words only for her.  Who do I give them to, where do I put them.  I re-read every e-mail from her.  I started at the present and just kept reading until the e-mails ran out.  This little journey just confirmed why she is so important to me.  There were encouragements from every moment - before big operations that I was nervous about during residency, before interviews, presentations at conferences, client pitches from my finance days.  She called me before EVERY SINGLE test in medical school.  Somehow she never forgot a single one and she would call me on the morning of the test, making sure to wake up early (she was on central time and I was on eastern) in order to catch me before I left my room.  She was my cheerleader.  She believed in me unfailingly and with such purity it was impossible to not just believe her and strive to be what she saw in me.

I will end with this.  I have been so moved by the outpouring of love in the final days of my mothers life and since her death.  It has come from friends old and new.  Friends who I haven't talked to in years but have reached out to me in a way that erases those years.  New friends and colleagues have been there, supporting me in ways I didn't even realize I needed.  Women I don't even know in Facebook mommy groups have sincerely reached out because they too have experienced the loss of a parent.  These women have been a wall for me to lean against when I felt I couldn't stand.  I am so grateful and thankful for this love.

Love is what feels most like my mother.

Three weeks in

I am three weeks into being an attending and I am writing this to all of those starting intern year (like I was when I started reading this blog), and to all of you in the middle of a long residency and questioning if you can make it through. I am writing this to put your sacrifices into perspective - all the missed recitals and mothers day lunches, the shitty clinic clothes you wear because you can't afford anything else, the many times you leave your spouse to sleep alone at night while you're on call --- I am just three weeks in, but it sure feels really worth it right now.  All I feel right now is joy (Well joy and a fair amount of fear and anxiety!! but mostly joy).  

It feels unbelievable to finally be at this point.  It has been such a long road.  I know being an attending presents lots of new challenges which I am learning about every day.  I know I may not feel so exuberant years from now.  But right now, I'm enjoying it.  I feel thankful to be in a job that I truly love, working with people I respect and feel honored to work with.  I love my patients and feel energized after clinic or a day in the OR.  I also feel very supported by the other faculty.  I feel like that bright eyed, brand new medical student 12 years ago who wanted to "help people." 

Last night, after kindergarten registration, I stared at my worn out sleeping daughter and I was proud of this model of motherhood I have provided for her.  I was proud of our new house, her new house, the house she will grow up in -  I hope one day it will be as dear to her as the house I grew up in just 10 minutes away.  My residency baby - she made me a mother in medicine.  She made me a better person, a better doctor - and every moment of this struggle feels very worth it right now. 

Claim your space!

Equal pay, sit at the table, ask for what you're worth!

All of the above are often part of the dialog concerning women in the workplace.  Women ask for less, do not request promotions/raises, do not sit at the table.  As a big Sheryl Sandberg fan these mantras have been my mentoring rhetoric for years, starting from my own brief time in investment banking when these concepts were instilled into me through a womens group at our firm.  So, when negotiating my first contract - I asked for more and I got it, I asked for time and I got it.  I made sure to ASK ... I felt well trained.

However, just moments ago, I was chatting with one of our attendings and he was congratulating me on my job (I'm very happily staying at the place where I am doing my fellowship) and he asked why I hadn't moved into the vacant office yet. There is one vacant office in the department.  It is clearly going to be my office.  Its the small one near the bathroom that all the junior faculty get until they move up the ranks.  I walk by it longingly every day and go sit in my loud cubicle and try to work while sitting next to all the administrators constantly answering phones.  I fantasize about this office...mine in only a few short months.  Just this morning as I walked in from the garage, I was making mental plans of which pieces of my daughters art work I need to get framed to put up in my new office. I envision my name on the door.  But, NEVER had it occurred to me to "just move in."  This thought was just second nature to my male attending, meanwhile I'm sitting in the background and waiting for my turn. Maybe I'm making a mountain out of a mole hill, but I do think that we have to never stop striving to be seen and recognized and heard.  I see it in myself all the time.  I feel it. I often have to remind myself that I worked hard for this job and every job.  I walk around suppressing my impostor syndrome on an daily basis.  But, today I realized I can't be complacent.  I have to keep claiming my space.

Not the last...the first

I am thankful for many things as I reflect on a tumultuous year.

I am thankful that a program that didn't even exist yet became available to me last year enabling me to move back to my hometown for fellowship.  I didn't know that only months after I accepted the position I would discover that my mother's breast cancer would come back all over her body.

I am thankful for a supportive fellowship program - colleagues, mentors and my mothers doctors all in one.  I am thankful that they are on my team, and on her team.

I am thankful that my daughter can go to "grandma's house" multiple times a week.  I am grateful that they are buddies now - both at a loss if they haven't seen each other for more than a day.  I am so grateful for this time.

I am grateful that my husband who has been stifled in his career by the location of my residency is now managing a large group and doing a job he loves.  This move has been good for all of us.

I am grateful for impromptu dinners with my siblings, my best friends, who I haven't been able to hang out with for years.

Most of all I am thankful that when I feel tears well up as I realize that this Thanksgiving and this Christmas may be my last with my mom, I can instead focus on the fact that it is really the first -  The first Christmas my sweet baby girl gets to spend with Grandma.  The first Christmas that I have been able to spend with my entire family in 13 years.  I am thankful for first - with a mustard seed of hope that this will be the first of many.

I am thankful for family and the sweet gift of each day we get to spend together.

Mothers

This blog is about mothers in medicine, but most centrally it is about mothers.  I considered many times over the past few weeks telling KC that I was going to resign from writing.  But, I would stop myself because I so love this community of women.  I felt I didn't have much to give.  I'm drowning a bit right now.  To catch you up, I've started a new, amazing, super supportive fellowship.  I feel like I have my life back after 7 years of residency servitude.  I've passed the first part of my boards.  I have some exciting job prospects that may be materializing soon.  My daughter is in a wonderful school and thriving, and my husband just landed his dream job.  I get to hang out with my siblings on a regular basis.  I'm writing grants with my baby sis (so amazing).  But most importantly, and most poignantly, my mom has treatment resistant aggressive metastatic breast cancer.  On the bright side I get to see her nearly everyday, her doctors are my colleagues and we have far from exhausted every option.  But on the other side - I feel like I am drowning.

My mind is constantly thinking about my mom.  I constantly fight to push some medical knowledge out of my head while using other parts of my medical knowledge to help.  I feel quite ineffective at this.  I strive to bring her grandbaby to her side every day because my baby girl is a beacon of joy in the midst of this.  To busy myself I cook and clean and organize - thankful for my siblings and my dad as we all share these tasks together.  I yearn to just lay in bed and talk to my mom for hours, but I am so unstill.

At work I try to bury my constant thoughts so that I can excel, so that they see me as an asset.  Most days it seems to work okay, other days - like the day we realized it had spread to the liver on therapy - its hard for me to stand.

There is a centrality of mothers in a childs life.  This is the beauty of this blog and certain groups on facebook.  We realize that we have two awesomely important jobs.  Well now my mind is on the one who was so central in my life and how I can't envision a life without her.

So, I don't have lots of MiM specific insight or questions.  Just that this blog is about mothers.  So, I thought I'd talk about mine.

My mom quit her Economics PhD program when I was a baby.  My dad had to travel for work, so she chose her family.  She was a stay at home mom until I was about 12.  Then she started doing economics work for the state and selling real-estate.  It wasn't until I had my own child that I realize that she must never have slept or ate when we were little!  3 active kids in a million activities and she essentially worked two jobs.  Despite that she seemed just as present then as when she stayed at home.  She has always found a way to always make us feel that she is right there.  I never really had teenage angst with my mom.  She has always been my best friend and my cheerleader.  She never made me feel like I was anything short of the best and she is crazy proud of any and everything we do.  She told so many of her physicians that I was a surgeon that I'm pretty sure they flagged her chart.  She rescued me from my post partum depression.  She is the one who made it okay for me to get help.  She taught me that I could do anything, that I could be fierce and accomplished and made me feel like I deserve it.

So now, I can't bear the thought that my sweet baby girl (who wants to do everything with grandma) might forget her.  If I'm ever blessed to have another child I can't bear the thought of that child never meeting her.  My siblings are younger, they have weddings and pregnancies in future that she will likely never see.  I always thought that choosing oncology as a career was my calling, because with cancer people have time to prepare, unlike the immediate finality of trauma for example.  But, now that we're in the middle of this "time to prepare," I can tell you it sucks.  It is hard to make the most of it/treasure every minute/make happy laughing videos and everything you see on Hallmark movies.  My mom is tired and worn down from chemo right now.  She needs rest and pain medication - not a montage.  What we really want is the time before this all started.

Thats all for now.  Make life count.

Would I do it again?

No.

I’ve thought about this a lot over the past few weeks.  Residency is ending.  It’s been 7 yrs coming. There have been many ups and downs.  The end is exciting and stressful.  The costs at the end are nearly insurmountable - thousands upon thousands of dollars for boards, licensing and moving.  The worry that you don’t know enough.  The sadness about leaving this family and the excited anxiety about starting the next step.   As I reflect upon this journey, I recognize that it has been amazing.  It is an unbelievable honor to take care of patients. I love what I do.  I love being a surgeon.  I will be starting a fellowship next year back in my hometown and I couldn’t be happier about going home and training in a field that I love.  I’m excited about my research.  I love my future colleagues!  I don’t regret my choice and I love my field and my patients.  However, I also admit that 7 yrs has wreaked havoc on my life, my family, my husband, my child, my health, and my bank account.  The direction of medicine worries me.  I think the business of medicine is crowding out the practice of medicine.  But, I realize that no field is perfect.  I understand that.  But there are other ways to live a life. Other ways that would give me a different sense of control.  There are other ways to have challenging work that is not so hard emotionally, technically and physically EVERY DAY.  Medicine is not just challenging, it is hard.

So, as I reflect upon these years in the few moments of silence and meditation, I think to myself, would I do this again.  I think it’s important to reiterate that I actually don’t have regrets about my choice and I don’t dislike my job, I LOVE it in fact.  My husband is still here, right by my side.  My daughter is a fireball of wonderfulness who loves hearing about my day.  I’ve missed many family functions and have not been there for my siblings and parents in the way I wish I could have been all the time, but they still love me and I have found ways to still be present.  But when I really ask myself, knowing everything I know - Would I leave my job in finance and go to medical school and choose to be a physician?   I think the answer may be no.  What is your answer?

Go vote!

Last week I got off early and took my 'lil bit with me to vote (aka "bote" according to her).  This is the second time in her little life that she's come with me to our local library to get her "Merican flag" sticker.  Now that she's almost 4 we had a little lesson on the drive over about how girls and people with brown skin like us didn't get to vote a long time ago.  She was adoringly APPALLED!  She said that the people who don't let girls and brown people "bote" were not acting "nicely." I agreed.  So, today, for all us moms in medicine who are walking paths blazed by amazing women before us - HAPPY VOTING DAY!!

(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!

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!

Mothers in Medicine

I haven't written poetry in many years.  This is what resulted from my last call:

Mothers in Medicine
We self-medicate with colors and sound
Suppressing every trace
until it's gone
Only to emerge the next time when we are
Destroyed

Creating new nightmares
Flashes of faces
Of skin
Of cords
Of inside
Of babies
Breeding deeper and deeper layers of hypervigilance
For our own
children


Then we step through the threshold, into the light



Cross posted at www.myrecoveryroom.com

Question: Maternity leave

Lately every night I'm on call I seem to be the magnet for pregnant patients - trauma, acute abdomens, appys, choleys - you name it.  During my last call as we talked about my pregnancy magnet, it lead to a discussion about having babies during residency.  We happened to be a diverse group of providers with a diverse and international training background. The take away from the discussion was basically that in the US we don't value new moms, dads or babies.  Those who had trained elsewhere (in surgery) seemed to feel that it was just natural to expect residents to take 4 months, 6 months, or 1 year off (mom or dad).  Meanwhile we all told stories of post c-section residents NSAIDing their way through full operative days 4 weeks after giving birth.  We talked about how broken your body can feel so soon after giving birth, both mentally and physically.  We talked about those itty bitty 6-week old babies in daycare.

So, for those of you who have trained elsewhere in the world:

What is the attitude towards new moms and dads in other countries with more flexible and lengthy maternity leave policies? 

Are residents looked down upon for taking leave (like they often are in the US)?  

Does a culture of more family centric leave create a more equitable distribution of gender roles in the home and the workplace? 

I'm just wondering...

Daddy time!

My daughter has the most beautiful relationship with her daddy.  They have their own little songs they sing together, bedtime rituals, games only they understand.  She’s his little buddy and I love to watch her chat with him in her little 3 year old way about her day or her thoughts.  I’m currently on a very long night float rotation and my little one is having a hard time keeping her sleep schedule.  Many nights my husband declares that she is going to bed at 8pm on the dot.  I often find her snuggled up with my hubby in bed after they’ve stayed up late watching “one more Dora” or having a jam session in his studio.  There is so much beauty in their father daughter relationship.  It is deep and substantial and real.  I hope their strong bond continues as she gets older and helps her to continue to be strong and self assured.   My husband and I love raising this beautiful girl together.

A few weeks ago I was talking to a fellow resident (and mom of 2) about the typical mommy guilt involved with being a resident and spending time away from your kids.  She’s struggling about choosing a specialty and worried about the damage a more rigorous specialty would cause to her kids.  Somehow we got to the topic of her husband having to comb hair and she mentioned that her daughter actually prefers her daddy’s more gentle approach to her mom’s attempts at taming her hair.  And then we starting talking about all the daddy daughter bonds both of our daughters have and reflected that without their busy mamas, our daughters may not have had the opportunity to form these strong attachments.

My daughter is proud of my work at “the doctor house.”  The time I spend with her is my most treasured and I think our relationship is amazing.  How awesome is it that she also has just as enriching and fulfilling a relationship with her daddy.  And, I’m not suggesting that dads never form close relationships with their daughters in all other work-life situations.  However, just think of how many women you know who report troubled or complicated or loose ties to their fathers.  Maybe our girls would have formed all these same attachments no matter what careers we had.  But, on those days of horrible mommy guilt, it’s nice to think of my baby girl and my hubby dancing, singing and rocking out to their own song.

cross posted at www.myrecoveryroom.com

How motherhood changed my medicine

Better late than never.  Here is my post from topic week on how medicine has changed me...

I've been trying to think of what to write about for this topic week.  How has medicine changed me? I found myself at a loss.  I have been on this journey for SO LONG.  Medicine has grown with me more than changed me.  Then I thought to the one singular occurrence in my life that has changed me the most ... hands down motherhood has palpably and incomprehensibly changed me more than I could have ever imagined.  As a result, after reflecting on how medicine has changed me I really felt compelled to write about how motherhood has changed my medicine.

Here are my thoughts:

- Motherhood has given me an honest compassion that is different than the compassion I had before.  I find it hard to explain, but it is simpler and more organic.

- Motherhood has given me a more zen-like patience with which to approach the craziness and chaos of medicine and residency.

- NICU nurses like moms more than surgery residents ;)  I used this to my advantage and as a result, loved taking care of my NICU babies.

- My priorities have shifted.  My goals are similar, but now they must fit into a different version of me.

- I can't do it all and I know it.  However I will still try.

- I prioritize my time at home and at work with crazy efficiency.  I definitely think the constant balancing act has helped me in being a chief.

- I love sharing my life with my daughter, therefore while at work I am even more motivated to make it count for something, to "help people" as she tells me, to heal, to learn, to affect change.  She has inspired my medicine in ways that make every struggle of motherhood well worth the gain in every aspect of who I am.

Happy New Year.  Here's to motherhood and medicine.

BEST WEEK EVER!

I've been on vacation this past week.  Since I had nothing pre-planned I decided to make it a stay-cation.  It was much needed, as all vacations are.  This time, I didn't have my typical residency feeling of wanting to emotionally implode prior to the vacation starting.  I was just happy and ready to have some time off as I transition to another rotation.

My husband has demanded all week that I have "me time" and salon time and manicure time, etc.  But, for this vacation all I wanted to do was hang out with my precious girl.  I was literally giddy with excitement planning activities for us to do.  Now that she is almost 3, she is so curious and at a perfect age to do things.  I had prepped her for our week of "adventures" and she was just as excited as I was.  She kept telling people that she wasn't going to school because she was going to hang out with mommy.  Well, we hung out, and with one day to go I can say hands down that this has been the BEST WEEK EVER!!

We went to museums, the library (about 1 million times, its our "spot!"), different parks, we had picnics and did crafts at home - it was AWESOME!  But the even better part about our awesome week of adventures, is that, the thought of going back to work on Monday doesn't make me want to vomit.  The call night before my vacation started we had a few emergent-ish, difficult-ish cases that I felt comfortable with.  The morning after my call, one of my former med students from an earlier rotation, called me aside to help him think through a patient situation.  This call marked the end of my chiefdom at the knife and gun club hospital that we rotate through and I truly feel like I have surgically and clinically matured since I was here a year ago.  It was a great call to mark the start of my vacation.  

Today, at the science museum I ran into a former chief at our program.  He finished the year before I started but was technically in the building on my first day of intern year.  He ran into the group of new interns as he was saying his final goodbyes. He was all smiles as he left the building on his final day of a long surgical residency.  I was right at the door as he was walking out.  He gave me a hug and said "Welcome!" Then he chuckled and left.  I had never seen him again until today.  I re-introduced myself and we did some shop talk as our kids played in the aerospace exhibit.  He was still all smiles and at the end he said, "its long but its so worth it!"

So to summarize, I just had the best week ever, just being a mom.  I am really happy with my career.  And, to top it off, I've witnessed proof of the light at the end of the tunnel.

Happy Saturday!

A Tribute

My program has survived a ridiculous and trying week of great loss.  Sunday, our former Chairman, a giant in the field of surgery, died.  His family was by his side.  He has lived a life full of amazing accomplishments.  He has touched the lives of many patients, taught many residents who have gone on to accomplish great things of their own.  His death was shocking for many of us, others already knew he wasn't well the past few weeks.  He is a presence in our department that will be sorely missed.  Dr. S, your legacy will live on forever.

Early Monday morning we heard that one of our young budding surgical oncologist died.  He died overseas as a visiting scholar - a huge honor that he was so excited about.  He was only 42 years old - the always beaming father of three beautiful little girls.  His death was completely random and sudden.  This was a crushing blow.  My second year I spent nearly my entire oncology rotation doing breast cases with this attending.  Listening to all three of Shaquille O'Neal's albums (yes I said THREE!!) and he knew all the words.  Again, let me repeat -  He knew ALL the words.  We bantered over our Eagles/Cowboys rivalry.  Last year when the Eagles beat the Cowboys I wallpapered his office with "Fly, Eagles, Fly" posters.  One year I operated with him after the Cowboys beat the Eagles and he wore his Cowboys hat and lanyard and brought cowboys paraphernalia into the OR just to taunt me.  He swore by the wall of 4-0's in his mastectomy closure, a move I've probably complained about but will likely follow someday in by own breast onc practice, which I plan to specialize in.  I talked to him briefly about my career plans, we were waiting to sit down and plan this year.  I haven't operated with him in the last couple of years but I have an Eagles hat waiting and specially made just for this purpose.  700 patients.  There has been immense outpouring of love and disbelief from his patients.  So many lives saved.  I pray that his girls will always know that their father's life was lived with purpose and meaning.  People can live 100 years and not touch a fraction of the women and men who have been cured, supported and cared for him.  I hope they will always remember the times they did have with their father.  I want them to know that he bragged about them constantly, that he lit up every moment he spoke about them, that he inspired us to see how the love of parenting and doctoring could go hand in hand.  He put them first.  You were his heart - his girls and his beautiful wife.  He was so proud of all of you.  Dr. A, our hearts are breaking, you will be greatly missed.  

The Last Bu-bu

WE DID IT!!!  When I started breast feeding I was determined and optimistic!  But, as I persisted I got discouraged more times than I could remember.  There were latching problems, cracked nipples, thrush and the pumping!  PUMPING SUCKS!!!!  I celebrated when we hit the one year mark and I stopped pumping.  My plan was to allow my baby girl to self wean.  Well, she wasn't interested.  I stopped pumping but kept making LOTS of milk, so we persisted with morning and nighttime feeds.  When my baby girl was a year and a half I left the lab and went back to surgical residency hours.  My initial stint on transplant kept me at work around the clock and I felt for sure that my milk would dry up.  Miraculously it didn't and "bu-bu" time became a special time with me and my baby girl in the midst of all the chaos.  Well, the time has finally come.  Baby girl is losing interest, I've basically stopped making milk and my baby girl is a smart, amazing, beautiful big toddler now.  She hasn't had bu-bu in a week.  I put her to sleep by telling her princess stories or stories about my "doc-tur house" while she lays her head on my chest.  I'm a bit sad our "bu-bu" time is over but amazing grateful for the two and a half years we had of this amazing connection.  I'm incredibly proud of our accomplishment that survived even the insanity of residency and as always I am crazy in love with my beautiful child.  I can't wait for all the new memories we will make together.

Now off to pick some strawberries!  Happy Saturday!

Cutter's extra random top 10 list of imperfection!

1. I've allowed my daughter to watch 4 hours of consecutive Dora while I half sleep on the couch post call (unfortunately this one has happened more than once!)

2. The tired mama: In the middle of telling my daughter a princess story to help her go to sleep I heard myself say "prepped and draped in the standard sterile fashion" to which my baby girl responded with "WAKE UP!  More PRINCESS MOMMIE!!!!"

3. A happy meal 

4. Letting baby girl sit in a dirty diaper for about 30 minutes to long because I was just TOO worn out to change it

5. I understand mom jeans now - how else do you rein in all that belly!

6. I can't do it all, which means I struggle to read enough and I'm sometimes late to work - especially when I go to kiss my baby on the way out the door and discover that she has collected a mountain of poop right by her head!

7. Occasionally I wear swim suit bottoms to work as underwear.

8. I'm really bad at dictating in a timely fashion once I get behind.

9. I owe lots of library fines.

10.  My hair looks terrible nearly all the time!