Apparently I’m only worth ¼ of a man

This weekend I attended a surgical conference in a beautiful location.  I had been looking forward to bringing my family with me to enjoy a nice weekend getaway.  I barely got out of the hospital on Friday in order to get there, and as a result I felt totally rushed and nervous about the talk I was supposed to give Saturday morning.  I was slated to give my talk right after the big state of surgery update talk by a surgical big wig.  He talked about the health care reform, the surgeon shortage, the effect of hours restrictions on surgeon proficiency at the end of residency and then he talked about the detrimental effect of the influx of all these pesky women into medical school and now SURGERY!!!! Yes, I’m actually serious.  This dude got up in front of an audience at a major meeting and had a slide that said that four female surgeons were required to equal the productivity of one male surgeon .  Yes, these words were on his slide.  He prefaced the slide with a line about it potentially being controversial, but asserted that it was based in statistics and facts that were not cited at any point in his talk.  One of my mentors was sitting beside me and made an immediate rebuttal in addition to commenting again at the end of his talk.  She made it clear that she was a productive female surgeon and that statements like his are what lead to unfair hiring practices.  I whispered to her that I planned to take one more dig at him when I got up to talk.  And she smiled and told me to “go for it!”

I then got up to do my talk after my introduction by a very prominent female surgeon leader.   Suddenly, all my prior nervousness was gone - I’ve always been good at making waves!  So, I loaded my talk, got behind the podium and calmly mentioned that I was never one to shy away from controversy and that as a former economist I was well aware that statistics can easily be manipulated to support your agenda.  I then mentioned that I would now present the research I completed while pregnant in the lab and more productive than anyone else with me.

It is ridiculous that we continue to fight against these types of stereotypes and misinformation.  The only reassuring thing about the entire situation was that so many people came up to me afterwards in support of what I had said.  Women add value to medicine in so many ways, we are essential.  I don’t have to say much about it.  I’m preaching to the choir here.

ROAR!!!

The Real Deal: My Intern Orientation Part 1

In my idealized vision of Intern Orientation, my first week would be busy, yet amazing. In reality, it was one part separation anxiety hell and one part meeting really cool new colleagues with a dash of partner arguments.

The hell: knowing that I would miss my baby and then really, really, really missing everything about him. Having spent the last 9 months at home with him full-time, gone are the days of sleeping in, play dates with the other stay-at-home mommies, the almost daily home-cooked meals. The first few mornings have involved me trying to ease myself out of bed without waking the baby or my husband only to have the baby pop up and begin screeching as I brush my teeth. I learned after the first day that the only way to make it out of the house on time is to ignore his cries. I have cried on my way to the hospital on more than one occasion. I have questioned why I chose this path. I have felt like a horrible mother, especially since Zo refused to drink more than 0.5oz of expressed milk for 2 days and morphed from a content, happy baby into a fussy fuss-face in the blink of an eye. Half-jokingly, I have contemplated moving to a country without extradition laws to escape the mountains of student loan debt that I have accumulated so that I can stay at home with him comfortably until he begins elementary school.

The cool colleagues: My Co-Interns are awesome. I was very nervous to meet them. I was worried about the clique-ish, fraternity culture of my medical school repeating itself, but the majority of the group seems very committed to providing excellent care and being collegial with one another rather than drinking it up at bars. Though, I know that I will have to make a point to plan some family-friendly events for everyone to participate in. And some wine and cheese socials for those of us who like things more low-key.

The arguments with the partner who I never argue with: The arguments started on the first day. Prior to orientation, my husband had never spent an entire day alone with Zo. Add screaming fussiness, the heat of Southern living, and a baby who refuses to drink expressed milk and you have a recipe for disaster. By Day 3, hubby and I were pretty angry. By then, Zo had begun eating fruits and veggies verociously throughout the day and we had begun mixing breast milk in everything. We devised banana and milk smoothies, rice and beans with splashes of milk for creaminess, I could go on but some of our concoctions made us cringe while the baby lapped it all up.  Additionally, Zo has altered his schedule and now wakes up 6-8 times a night instead of his usual 3-4. So yeah, the arguments about everything from not having enough veggies to me closing the door too loudly resulted in various heated debates and even one “I don’t want to talk anymore, let’s stop talking right now!”

The mid-to-final-verdict: The first few days of Doctor-mommy being away during the day means less daytime milk, many more night time nursing awakenings, and a fussy family. There will be an end, right?!? I’ll post again once the final verdict is in.

Family and distance

When I was about six months pregnant with my first daughter, I got in huge argument with my father. Because he lived so far away me, he wanted to book plane tickets to visit the baby well in advance, and he decided he was going to come on the day before I was due, and stay for a week.

I was not happy. Since it was my first pregnancy, I fully expected to deliver a week late and he'd miss the whole thing. And then be hanging around me while I was very heavily pregnant, and expecting to go out a lot. Plus I didn't really want my family (other than my husband) around when I was actually in labor.

We argued back and forth. Finally, I lied and said that they'd done an ultrasound and changed my due date to a week later. That convinced him.

I ended up delivering on time, but it actually worked out well having him there a week later, since that was when I was at my most sleep-deprived and grateful for the help.

At the same time, my mother traveled great distance to see her first grandchild for the first time. Unfortunately, she came down with a really nasty cold. I was terrified of having her near my newborn with that cold. I imagined the baby spiking a fever and ending up in the ER, and having to get an LP or something. But my mother was not exactly cool with the fact that she'd spent so much money traveling to see the baby, and now she had to stay away from her. She was angry at me for months over that one. (We still haven't decided who was right.)

I don't think I realized before I had kids how important it is to be near family. Other things that were annoying about living thousands of miles from any family members:

1) They didn't visit often

2) When they visited, the trips lasted for freaking ever until I couldn't take it another minute

3) When there was an emergency, we had no back-up we really trusted

4) No free babysitting

5) When one of us was sick, there was nobody around to give us a break aside from each other.

When I graduated from residency, my number one priority was to move closer to family. Right now, we live less than an hour's drive from my in-laws and much closer to my family too. It's not exactly right around the corner, but boy, does it make a huge difference. This time when I went into labor, I had a family member who came that very day to watch Mel. My parents were able to quickly make travel plans after I gave birth, and still arrived before I was discharged from the hospital.

We have family visiting almost every other weekend, which gives us a much needed break. When one of the kids is sick, I can often call my in-laws to come watch them if I know the night before.

I know other people who live in the same town or even the same house as family members. When I was younger, that would have been unacceptable to me, but now I'm jealous of those people. It's amazing how much of a difference having nearby family can make.

Enemy

The clock is not the enemy.
Fatigue is not the enemy.
The hospital is not the enemy.
Consultants are not the enemy.
The lab is not the enemy.
Utilization review is not the enemy.
Your patient is not the enemy.

DISEASE is the enemy.

Go forward with courage ladies.

MiM Mailbag: Leave the financial industry for medicine?

Hello,

I am not yet a medical student or doctor, or a mother for that matter, but I am on the verge of both and am looking for advice! I have been reading your blogs/articles for months and have found so much inspiration and motivation from the amazing women who write and comment.

My situation: I am 29, Canadian, graduated from undergrad in 2006, took a few years to coach alpine ski racing full-time and then got started in the financial industry in 2008. I've worked my way through a couple junior roles and am now an equities trader - reaching my initial goal in 4 years. I'm bored! I have spent the last 6 months trying to determine what I actually want from my career and have  figured out that money is not enough motivation for me to spend my working life hating my job.  Through a very long and thorough process I have come to realize that medicine is the ideal career path for me, for many reasons, and now is the time to pursue it!

The decision is a tough one for everyone, from what I gather from the posts on this and other blogs. The aspects I am struggling with are the same as those of other posters; we are trying (have been for ~6months) to get pregnant - will have a toddler during residency if everything goes as planned, that will be tough. I feel like I am ready to take that challenge on, have a very supportive husband who will make it work. The part that I am struggling with right now, where I need the encouragement to take the big first step back to school, is leaving a job that pays very well (less than 2 years in my current position and at $100k/yr) and going to effectively negative income for the next 6 years...or more.  My current job is one people tend to get into for the money, medicine is not (from my view anyways), there is upside as a physician but its the work and the industry that is so intriguing to me. It's a scary first step for me to take, I know I WANT to and honestly if I were single and not planning to have kids asap I would have left my job months ago. I'm trying to make the right decision, I need to know it is the right one, which is basically impossible. I worry about making this move and regretting 10yrs from now that life is still tough, we have a ton of med-school debt and it could have been so much easier if I had stuck it out in finance for the plentiful income.

Please tell me about your opinion on this; once you have kids, does the value you place on how happy you are in your career fall back? In 10years, would I rather have more money in a boring, unsatisfying job, than be happy with my work but still be struggling to pay down school debts and keep my kids in sports and other activities that I believe are important and of course cost money?

I've heard that priorites really do change alot when kids come into the picture, I am worried that if I don't make this decision now (to leave my career and begin the long/hard path that is medicine) I won't want to uproot once my kids are born and I'll regret not doing something I really wanted. Or, I make the decision to leave my cush job now, and when my kids are a couple years old and I'm spending 24hrs at a hospital in residency that I will regret leaving the boringness for this challenge.

HELP!

MDWannbe

Anti-vaccine Sympathy

Sometimes I will hear other mothers (usually online) freaking out about vaccinations. Here are some of the comments I've heard recently about vaccines:

1) Worried about autism (despite study being discredited)

2) Want to spread vaccines out, not give them all at once

3) Want to skip certain vaccines (usually varicella) since the diseases aren't actually that harmful

4) Want to postpone vaccines

5) Angry and distrustful of doctor for not knowing all inactive ingredients in a vaccine

I read these comments and I just feel frustrated, both as a mother and a doctor. How could these mothers be so stupid? So selfish? Don't they realize these vaccines are safe? Don't they realize the only reason they can even contemplate skipping a vaccine is because the rest of us "risk" our kids? Don't they realize that the kids who can't be vaccinated or do not achieve full immunity are at increased risk because they fail to vaccinate?

Of course, when I'm at the doctor, waiting for my child to get her vaccines, the thoughts in my head are very different:

"OMG, what if she gets a reaction to these vaccines? What if she gets a fever and is awake all night? What if she's cranky for weeks? What if they KILL her?"

"She's so small... maybe we should postpone the vaccines till she's older."

"Why do we have to get so many vaccines at once? This is cruel and inhuman. Maybe we can spread them out?"

"OMG, what if she now becomes autistic??????"

Ultimately, we always get the vaccines. But I do believe most mothers feel that fear when our kids get their shots. That's why I'm sort of resentful of moms who can't man up and go through with it.

MiM Mailbag: Do single moms go to medical school?

Dear Mothers in Medicine,

I have been a VERY long follower of your blog and after reading a few pre-med blog posts find myself wondering if you could give me some advice.

I am a new mother (my baby is 9 months) who has been trying to achieve my dream of medical school for a while. I have a degree in Biology, publications, a TON of research experience (some of which is at an Ivy League school) but because I was an international student, I couldn't guarantee funds for medical school after graduation and hence my application was not accepted. Right away I pursued nursing school as a venue to receive permanent residence in US. I was successful and shortly after graduation resumed studying for the MCAT while working part-time as an RN. Unfortunately, my MCAT score was not good enough to get in (it had been a *few* years since my classes). Being in my late 20s, my OB doctor stated if my husband and I wanted to have children, due to potential complications from some of my health issues, I should achieve pregnancy sooner or later. A year later, we have a baby.

Sadly, my (also in his late 20s) young husband wasn't prepared for a responsibility of having a baby and filed for divorce not too long ago. So, here I am, in what seems like a disastrous situation - a former pre-med hopeful, now a single mom trying to make ends meet with a 9-month-old. I am sure there are worse situations out there, but I am completely bummed as to what I should do. I refuse to give up my dream, but yet, I often wonder do single moms go to medical school? To make matters worse, I reside in a state where my parents don't live and because the divorce is here, my husband is going to restrict my relocation, hence family support will not exist (not physical one in any case).

I often wonder if I should retake the science classes from scratch? I'm afraid to seek guidance of a pre-med counselor because they will just want me to forget it.

Any help/advice would be greatly appreciated. I am trying to explore all my options and not give up hope...

Thank you.

K

Last Day: Part 2

Ok, lets try this again (yes, I'm over posting myself).  I just finally put my daughter to sleep.  Its as if she knows something is up.  She has been adorable all day!  

Today I had a marvelous day with my daughter.  We read books, danced like crazy, had a morning sleepover (which involved playing and jumping around on a comforter and pillows on the floor in her room), slow danced to Miles Davis, belted out some Etta James, played catch in the yard, ate munchkins outside in the Dunkin Donuts parking lot, called family to say "I lu y-ooo" and just basically had an awesome day.  Tomorrow I go back to residency after my two year lab hiatus.

As I held my little munchkin tonight, after breastfeeding her to sleep, I couldn't stop thinking of the meeting with the scheduling chief a little more that two years ago.  During our meeting we discussed the feasibility of me going into the lab.  I remember thinking that if I pulled this off, the little 10 week old peanut inside me would be a year and a half by the time I started back - practically a grown-up.  Well, here we are.  I am the mother of the greatest 18 month old baby that ever lived.  I can't believe I'm already at that year and a half mark.  I look back at myself then and realize that I am UTTERLY CHANGED.  Completely and utterly changed.  She has changed me in every way.  She colors ever decision I make, she is such a huge part of what defines me, what motivates me, what matters.  During my last trip home for my mom's surgery, my husband taught my daughter how to say "Mommy's a doctor"  or more like "Mah-mie uh dahktur."  Tonight as he handed her to me for our bedtime routine he must have given her the sign, because she said it again, in her cute beautiful little voice.  I nearly melted.  I love her SO MUCH.  I pray that through all of this I can be a good mom and a good doctor.

Cutter

Last day

I’ve half drafted about 4-5 entries that still are unfinished in my MiM folder.  I definitely plan to eventually post the ones about my journey as daughter and doctor dealing with my mom’s recent breast cancer diagnosis.  It has been a difficult, emotional, strengthening, family building, strange, roller coaster of an experience.  So far, things are going well.  However, I’m writing just a short entry today.  Today is my last day of “freedom.”

Tomorrow I’m back in the hospital, a resident again after my two year lab hiatus.  I start off as transplant chief.  I am completely terrified and completely excited. My life has changed so much in these two years. My special necklace with a pearl and my daughters name on it just arrived from Etsy yesterday.  I love my beautiful girl so much!!  I hope I’m doing the right thing.  I’m completely motivated to make her proud.  My life these two years has been a roller coaster of emotions.  I’ve gone from loving my anesthesiologist who put in my epidural so much that I was convinced anesthesia was my new calling.  Then I was convinced that I must find a way to be a stay at home mom - otherwise I thought my life would be impossible to balance.  But, now the hormones are fading, the Zoloft is working (prob TMI - but you’ll hear more about that if I ever post the post-partum depression entry I wrote), and I’m amped up to be a surgeon.  Two years of cancer research has given me some clarity.  I feel confident that I want to be a breast surgeon (also one of the entries on file).  So, I have 3 more years to get as much out of all the other amazing types of surgery that I also love.

Wish me luck!

Cutter

Guest post: We are growing up

Tomorrow is my first day of Intern orientation. I have wanted to become a doctor for my entire life and tomorrow I officially work at my top choice hospital. This moment is bittersweet, mostly because it is the beginning of being a working mother and it is the end of my 9 months as a stay at home mother to Lil’ Zo. I am already missing him but I am so excited to begin my career as a Pediatrician. Pause for my Happy Dance!

I have grown so much as a person since becoming a parent. I am very in tune with Zo’s moods and cues; I know hunger before he cries, when he’s tired by the slightest rub of his eyes or ears, and that a certain face and eyebrow raise mean a poop is on the way. I have learned how to simultaneously nurse, compose emails, and catch up with friends.

I have learned how to be less rigid. For one, Zo sleeps on his belly even though I know it is not the current medical advice. As a newborn, Zo refused for weeks to sleep on his back for more than an hour. During one of her visits, my mother suggested that I try letting him take a nap on his belly. I watched him like a hawk for a week and saw he could turn his head left and right during sleeping, then I slept in his room for an additional week, and his sleeping went from 30 minutes to 3 hours, and I gradually made my way back to my shared bed with my husband.

I have learned that baby wearing is like baby chamomile tea; it soothes and lulls him into a state of contented bliss during which I can clean the house, read blogs, and cook dinner (with him on my back). I have learned that a nursing pre-toddler likes to test out acrobatic moves during his brief, but oh-so-efficient nursing sessions. I swear my boy moves and grooves more than I thought possible all while maintaining a proper latch without biting me with his fresh new teeth (he’s amazing!).

Tomorrow I start my life as a seasoned mommy and Pediatric Resident who still has so much to learn. I know that I will be a better, more compassionate physician because of all of the love my precious little one has showered on me since his birth. Now, off to bed where I will sleep and cuddle and nurse him until I am off for work. We are officially growing up.


-Mommabee is a Pediatric Resident in "The South" with a background in public health. She is married to O, a Librarian turned Doctoral Student and is the momma to Lil' Zo (Fall 2011). She enjoys reading, traveling, spending time outdoors, and of course providing excellent patient care.

the off-cycle job hunt

I was recently at ASCO and having dinner with a friend from residency. I asked about his post fellowship job hunt and he shared the details of what sounded like exhaustive process that had finally resulted in a position with a large pharmaceutical company. He asked me what networking I had done - or was planning to- do while at the conference.

Networking?

Yeah, like to get a job.

Uh, I haven’t started thinking about it.

And thus ensued a forty-five minute lecture. How could I have not started this process already? I should have a letter of intent and an updated CV. I should have started cold calling large oncology practices. I should have come to the conference knowing who was going to be here and how I was going to introduce myself. The fact I will be graduating late should have spurned me into starting the search earlier.

I sank lower into my chair and, as he continued to berate my lack of preparedness, accidentally finished the massive slice of chocolate cheesecake we had intended to share. I left the restaurant not knowing if the queasiness in my stomach was from anxiety or a butter bezoar.

Although technically I am about to enter my third and final year of fellowship, because I started late due to my first maternity leave (in residency) and owe this program time for my second leave, I won’t finish until October 1, 2013.  The heme and onc boards are in late October, so I wasn’t planning on starting “a real job” until November 2013. Factor in a possible move, I might not be ready to start work until December 2013.

But I have to start the search now? My friend is an intensely driven and consummate go-getter. Both of his parents are successful academic physicians, his older sisters are also physicians, and I suspect he learned about RVUs and impact factors at the family dinner table. He knows a shocking amount of information about the business end of being a physician – how to get grants, publications, protected time, compensation, promotions, jobs, etc. During residency, fellowship, and now, apparently at the start of my job hunt, he was, and is currently, trying to tell me what-I-should-know in order to be successful.  Although I know the constant “advice” comes from a place of caring (and it does, despite the fact I am making him sound like a jerk), he can drive me a bit insane.

But he might be right. I will be graduating off cycle, perhaps almost six months after other fellows are ready to start working. I want to move back to my hometown, a medium-sized city with its own set of fellows graduating from the local university. There are some cities where the heme/onc job market is saturated and if I wait to start the search, I might not be able to find a job at all. He reminded me of a mutual friend who couldn’t find a position until a community oncologist actually died.

I think in the writing of this post I have convinced myself of what I already suspected to be true – as daunting as it may seem, I should start looking now.

A real job. Like a grown-up. Who doesn't procrastinate.

MiM Mailbag: 7 on and 7 off

Hello MIM! I love this blog and have been reading it for a couple of years now.  I think its wonderful that a group of female physicians are able to talk at liberty about their personal lives and struggles with motherhood. 

 

I am currently a hospitalist who has been in practice for a few years.  I love hospital medicine and I really enjoy my job but after I had a child,  everything has changed.  Although I never particularly cared for my 7 on/7 off, I have begun to resent it.  I this roller coaster of a life where I either am with my child 24/7 or only see her for an hour or two a day and its not working.  I've spoken with other mothers in the same situation and I have heard it.  "7 on/7 off is great!  You can be a part time SAHM!"  "7 on/7 off is awful!  How do you ever see your kid??"  People also bring up the point that at least with shift work, you don't feel the pressure of trying to get out early each day and that your time at home is protected.   I'm truly unable to make my own assessment because I have not had the benefit of working another schedule for comparison.   Now I am at a crossroads because I have the opportunity to leave this group and go to a more conventional schedule:  Monday through Friday where you rotate morning and afternoon ER admits and can leave when you're finished.  I'm worried that the naysayers will be right and that my life will be more stressful if I have the opportunity to leave early because I will be rushing through my work.  On the other hand, there are days here when there really is no need for me to be at work for a 12 hour shift and I feel frustrated that I can't leave when I'm finished.  I also feel that my life needs more stability on a regular basis.  Its difficult to keep up with friends, exercise routines, house work when I'm working 12 hour shifts 50% of the month.  Everything tends to go into disarray when I start my work week and I'm hopeful that can change if I am able to have more time in the evening. 

 

Has anyone had experience with this dilemma?  Any insight into either schedule?

 

Thank you. 

MiM Mailbag: When to disclose your pregnancy at work?

Two MiM Mailbags with a similar theme...


Hi,

I am about to start Internal Medicine internship at a medium-sized county program.  I have a 2 year old son.  I had originally applied to residency when I was pregnant with him, but withdrew my application.  The Program Director of the program I matched in told me at that time "We wondered what you were going to do when you had the baby.  Glad you made the choice to take time off before starting."  Well, now I find myself pregnant again.  I am due Dec 20.  My current schedule has me scheduled for Medicine wards from Dec 13-Feb 6.  I know that I will definitely need to make a schedule change.  I am nervous to tell my Program Director.   Luckily, I am not showing yet at all (so my family and friends tell me).

Regarding childcare, my husband is taking a leave of absence from his career to care for our son and for our future child. So, While I do not really "want" a short maternity leave, I am prepared to only take off the minimum I will need.

Any thoughts or advice on how to navigate these waters?

Thanks,
S

***

Hi,

I am pregnant with twins and going to start my new job in the fall, and I am trying to decide whether to tell the hospital/group I am working with before I start which is right at the beginning of the second trimester.  Or should I tell them before they pay for my move in case they don't want me?  I think they will as it took them a long time to recruit me and recruiting has been an issue since it is somewhat rural.  And they knew I was planning on becoming pregnant at some point and were fine with that.

What would you do?

Thanks,
A

Water water everywhere...

If you haven't heard this news, Mayor Bloomberg has proposed a ban on sodas larger than 16 ounces in NYC, as a response to the obesity epidemic.

I'm not a big fan of laws designed to save us from ourselves. I appreciate the smoking bans, because I've been in restaurants where I couldn't enjoy my meal because there was smoke being blown on my face, but it doesn't keep me from enjoying a movie if the guy next to me is drinking a 20 ounce soda.

I know I've written a few posts here that make me seem like I'm some kind of champion of bad health, so I'd like to do the opposite today. I'd like to ask that instead of making laws to save us from ourselves, like no large sodas, they should make laws to help us be healthy.

For example:

A few years ago, I gave up soda. I used to drink one can of Coke every evening with dinner, and I decided I wasn't going to do that anymore. Now I mostly only drink water (or Gatorade when I get very dehydrated). I do think soft drinks are pretty unhealthy, although I mainly stopped doing it because I wanted to eliminate caffeine. Thanks to my example, my husband stopped drinking soda at home too. And my daughter drinks mostly water or milk.

On a recent road trip, we stopped at a McDonald's off the highway. I got a chicken sandwich and I wanted a water to drink. Was it actually possible to get tap water to drink in a cup? No. I had to purchase a bottle of water.

Then when I went to fill the bottle up with more water later, there was no "water" option at the soda station. I could have gotten any sugary beverage I wanted, but not water. So I went to the counter, hoping they could help me:

Me: "Can you fill this bottle up with tap water for me?"

Cashier: "No."

Me: "Really? You mean there's no way I can just get plain water?"

Cashier: "Nope, sorry."

I finally filled it up in the bathroom. Still, it's an outrage that in mall food courts and many chain restaurants (ranging from McDonald's to Chipotles), you can't just get plain water to drink. This happens to me all the time. I'm at the mall food court and I ask for a cup of water with my food, and they look at me like I'm crazy. I've been refused or I've been given a tiny cup that contained three swallows of water. Even if I offer to pay for price of the cup, sometimes they won't give it to me.

Instead of trying to save us from ourselves and banning 20 ounce drinks, I think Mayor Bloomberg et al. should make it easier for those of us who want to avoid sugary drinks to do so! Whatever else you can say about the health value of these foods, soda is certainly tons of empty calories. If you agree, urge local vendors to make water more readily available!

Guest post: Heavy heart

It's been a long day on ICU, and I'm patiently waiting for the night float resident to relieve me of my duties so I can go home, sneak into my kids bedrooms and kiss them goodnight.  Although they won't see me with their smiling faces for another 2 days.  I am a second-year family medicine resident in the southwest, and am at this point officially burned out and miss my kids terribly.  I had my second child (a girl) 8 months ago.  My son is 2 1/2.  Dad works full-time as well, but carries the brunt of the duties when I'm on challenging inpatient rotations.  "Guilty" does not go far enough in describing the perpetual feelings I harbor about leaving home every day to take care of others, when all I really want is to be taking care of my family.  Don't get me wrong, I love being a doc, and have worked years and years to achieve this goal.  But I can't help but wonder whether I will regret this all when my kids ask "Mom, did you stay at home with us?" or "Mom, who did you leave us with when you were at work?"  They are cared for by a very good friend of mine who cares for a few other kids together in her home.  She is the mother we all want and want to be for our children.  And they LOVE her.  But I can't get past the fear that they will somehow resent me being gone when they are older, and realize just how much I have been absentee.  Thus, I carry a heavy heart, nearly every day that I am away.  I've never felt like this about anything.  It's always been about me, about my goals, about my plans.  Now it's about them, and I want to give them the best of everything.  Can I still do that even when I'm away?

-Gem