Mindful Parenting and a Toenail Drama

It started back in May. She dropped her stainless steel sippy, and the bottom rim landed right in the middle of her big toenail. For hours, she was beside herself. All we could do was kiss and hug her and say, “Yep… it sucks to drop something on your toe.”

It was the first, but it won’t be the last. A week or two later, there was a good-sized, eggplant-colored bruise right under the nail. Welcome to the Black Toe Club. She didn’t seem to care too much about the discoloration, and we went on with life as normal.

Fast forward to a week ago, when I noticed that the nail was starting to unroof itself. It became so… flappy... that it started to catch on things, which resulted in fits of pain and crying. Being the Doctor Mom that I am, I devised a treatment plan involving an epsom salt bath followed by lidocaine ointment and a sharp pair of scissors. But after the bath, she had a freakout.

She WOULD NOT let me cut it. Would not let me even touch it. We fell into a cycle of hugging and talking and attempting, followed by pullback and more crying.

Her: “I’M SCAAAAAARRRRED!”

Me: “This is the best way to deal with this. Otherwise it’s just going to keep catching on things and eventually rip off, which will be even more painful. Trust me! I’m a doctor! You just took a bath! It’s soft right now! Let me cut it!”

Her: [uncontrollable sobs]

This went on and on, extending past bedtime. And repeated for 3 days. The toenail would catch on something, even bleed. It separated further from the nail bed until it was sticking straight up in the air. I got so frustrated… if you’re a physician, you’re likely familiar with the experience of family members not taking your medical advice. All those past memories welled up, compounded by a screaming, inconsolable child.

One night I threatened to rip it off after she went to sleep. One morning I told her we weren’t going anywhere until it was dealt with. We devised different plans, all foiled by her going into a crying fit… and when one involved her dad helping to hold her down, he looked at me with his peircing eyes and said straight up, “What are you doing?”

[long pause]

Um…. What WAS I doing?

I was trying to control the situation. I was worried for her, anticipating the great pain she might experience if the toenail ripped completely off on its own. So instead of letting things take their course, I tried to solve the problem for her. Like lots of well-meaning parents these days, I was coddling.

I was acting on my own aversion to the appearance of her toe (as a self-confessed Picker, if it were my toe I would have cut that flapping nail off immediately despite any pain pemature action might have caused). The sight of it bothered me more than it bothered her.

I was using logic to appeal to an illogical, 4 year old little human. Although I want to respect her as her own person, she’s not a little adult. Yet I sometimes talk to her like she is.

I was trying to control someone else’s body. Someone’s body that is not mine to control. And I was using threats (again) to try to get what I want.

These are all Respectful Parenting fails.

Before even having kids, we decided that respectful parenting was the kind of parenting we wanted to do. I read books like The Gift of Failure and The Conscious Parent. I listened to Janet Lansbury‘s podcast. But like so many things having to do with mindfulness, theory is different than practice. It’s easy to have a plan, but what matters is how you act in the moment of need. Sadly, this time it took me approaching the use of force to realize how far I had drifted off the path I meant to be on.

Defeated but brought back to reality, I admitted I was wrong. This was wrong. My emotional bank account depleted but not quite in default, I was able to salvage the day by taking responsibility.

She put on flip flops with her little nail sticking straight up, I tried not to look at it, and we went about our day. I dropped her off at the gym childcare center, assuming I would get a call about another episode when she caught her toe on the playground or something.

But do you know what happened? When I picked her up, the nail was gone! She hadn’t even noticed it fall off; it didn’t hurt a bit. After all that, leaving it be was probably the best thing to do anyways.

I’m so lucky to have her (and him); I’m always learning from them. Being a parent has been the greatest lesson in mindfulness.

(A version of this post first appeared on the blog practicebalance.com)

Learning how to self advocate for wellness and career advancement

I've recently been meditating on personal and professional development and in a lot of ways, maintenance. Part of it aligns with recently discussed concepts of wellness and work-life balance. Part of it also has to do with this intrinsic unsettled feeling I'm experiencing with work. I attended an academic conference recently which I believe was clarifying and is helping me to frame my approach.

Health

This all started with a dive into self care, specifically, trying to make sure that I was taking better care of this 41 year old body of mine. I had not been to a dentist in 15 years. Yes. You read that correctly. I had not seen a dentist since before medical school. Part of it was because I'm irrationally terrified of the dentist... part of this fear probably came from all those times my mother forced me to sit with her and hold her hand through many root canals and extractions while she squirmed, wiggled and held a vice grip on my hand. The other part of it was the silly thought, "If it ain't broke, don't fix it." The final factor was the disease of busy. I flossed. I brushed. I have a nice smile. I'm fine.

It wasn't until my little one bravely sat through the first couple of dental appointments during which we found out he had multiple cavities between all of the molars, necessitating 8 crowns, a failed attempt at in office nitrous and subsequent trip to same day oral surgery center with a pediatric anesthesiologist that I finally made an appointment. So I did it. I had a couple of cavities, needed scaling (which is a special kind or torture) and am now getting teed up for a root canal. I suppose it's not bad for 15 years. At least I'm keeping all of my teeth, for now.

Let's move on to fitness. I'd topped off the scale at 5 pounds over my full term pregnancy weight. I hated what I saw in the mirror. Inside I was happy. My outside didn't match my insides... maybe I wasn't happy. Regardless, I've spent the last year trying to make sure to make time to do tedious things like plan healthy and nutritious meals and get some exercise. I found a colleague and now friend who was an online health coach. I found a supportive environment of other busy, professional women who found time and prioritized this portion of self care and found that they ended up being happier, more patient and feeling more fulfilled all around. I found tools which were easy to implement (albeit requiring some behavior change), accountability partners and fun exercise options. I enjoyed it so much that I myself became a coach.

With everything we give to our patients, our learners and our hospitals, we absolutely must prioritize ourselves in there somewhere. Working out may not be your thing, but you have to identify what it is that recharges you and make time for it. Put it on your schedule or it will not happen. It will ebb and flow, but you've got to take care of you before you can take care of anyone else.

I still need to schedule that Pap and Mammo... I'm a work in progress.

Personal Development

Part of the company's philosophy is ensuring that you spend some time each day on your own personal development. This created an opportunity for me to read some personal development books (the former four letter "self-help" category). Below you will find the books I've gone through over the last 6 months (good grief, whoever created audiobooks is literally the best because I become narcoleptic while reading).

I've read (or listened to in audiobooks) "You are a Badass: How to Stop Doubting your Greatness and Start Living an Awesome Life" by Jen Sincero. She's not a physician, but she's been through some things and many of her struggles and insecurities resonated with me. She is also remarkably sarcastic and funny and I had many a laugh while listening to her book.

I followed that with "The Compound Effect: Jumpstart Your Income, Your Life, Your Success" written by Darren Hardy. This dude for all intents and purposes is a self made gazillionaire and did it all with hard work and discipline, specifically with small changes every day. He had an authoritarian for a father, so we have that in common. It focuses more on the business world, however if I ever consider entrepreneurship, I'll probably revisit it.

I followed that with bits and pieces of several books from Brene Brown... "Rising Strong" and "The Gifts of Imperfection," both of which hit chords with me. Let's figure out how to pick ourselves up after we fail at something because that is what bravery truly is. It takes no energy to stay down after you take a hit. Facing the day, reflecting on how you may have been responsible for whatever you've experienced is an important lesson. Reading her book is like sitting in a therapist's office, without the $200 price tag. She's a shame researcher and she hits the nail on the head when she discusses the mountains of self imposed guilt we shoulder unnecessarily. She's also witty and sarcastic from time to time.

Next was "The Subtle Art of Not Giving a F*ck" by Mark Manson. Now, if you can move past the fact that this guy is a bit like a frat boy in his use of language, there are some important lessons to be learned. Some things just don't deserve our energy. Seriously.

My latest read is "Feminist Fight Club: A Survival Manual for a Sexist Workplace" by Jessica Bennett. I came upon this book on my way to the aforementioned conference. I knew I was specifically attending a workshop designed to appeal to women interested in leadership in academic medicine. I was looking for something which would light my fire and help me think outside the box a bit. Jessica Bennett is a journalist who specifically writes about issues of gender, sexuality and culture. In her book, she highlights the research which discusses not only how institutions may unknowingly or overtly be preventing growth of their female professionals, but also behaviors we may be demonstrating which hinder our own progress.

I take each of these books with a respective grain of salt, but it's really kind of opened my eyes to some self reflection and highlighted some things I may want to work on within myself. When we spend so much of ourselves in tending to other's needs, our own needs and need for growth can get lost in the mix.

Professional development

So, I'm an academic. I teach medical students, PA students, residents, fellows, faculty. I have sought opportunities to develop my educational niche, my ability to provide feedback, teach a skill, develop a curriculum, pitch an idea to my department chair. I teach a lot of things... probably too many things, which is why I find myself feeling stale and unfulfilled here. I feel like I've spread myself so thin that I'm doing an ordinary job at all of the things for which I'd prefer to be doing an extraordinary job. I feel like an octopus juggling knives which are on fire. Is this imposter syndrome creeping in? Perhaps, but I know I could do better with my time and efforts if I peeled away from some things.

I officially mentor some and unofficially mentor others. I've not received any training per se in mentoring, save observation of folks I hope to emulate. I don't know what the steps are. I don't know what skills to hone. It's kind of like teaching, but also very different from teaching. There should be a program for mentoring the junior mentor. There probably is, but I've not yet had the bandwidth to seek out or discover it, but it is something I need. What I found most interesting in the sessions at this conference was the focus on not necessarily seeking out the most sage mentor. Sometimes peer mentors are actually better for you as you navigate different challenges in your career.

I've been at this academic gig for 6 years now. At the conference I attended, many of the female leaders commented on "cycles" and feeling unsettled after a certain amount of time doing each of the jobs they did. That hit home for me. I feel unsettled. I want to do what I'm doing differently and I need to advance my position from my current title to the next. As such, I've been meeting with my closest mentors, having heartfelt talks about what I thought I wanted when I started, what I've done and where I see it going. I see now that I've invested a tremendous amount of time and emotional capital in one path. It was my hope that by working hard and contributing, I'd be rewarded with position. Boom!!! Words from all of the books came to mind and highlighted for me that I in fact cannot do it all and I should be asking for compensation in some way for what I am doing. You will not get 100% of the things you DO NOT ask for. I must focus my efforts on those things which are most meaningful to me in my professional life. I need a new goal. I need a promotion. So, I'm going to spend the next couple of months working on my dossier, writing papers, reviewing and revising the curricula that I am responsible for and pouring the energy freed up by letting go of tasks held by one of my octopus tentacles.

It's exciting and anxiety provoking to have this new approach and challenging in that I've never before created a dossier or gone up for academic promotion. Why didn't someone tell me about all of the stuff that goes into this? Why didn't someone tell me to keep better track of all of the lectures I taught, programs I developed, mentees I invested in, meetings I attended, evaluations I received??? This wasn't part of orientation when I became faculty. It was discussed as an afterthought in my annual meetings "You should be ready for promotion in a couple of years." After reading my most recent book, I wonder if the experience is the same for my XY colleagues. Is the assumption that because I'm a single mother, I must not be interested in promotion or advancement, so I don't really need the guidance or personal investment? To adapt a quote from Jessica's book, "No one gets shit done like a mom."

I'm trying to figure out what my professional and personal mission statement is. What are my values? What do I hold dearest to me? Do my actions align with my values and my mission? How do I parlay these reflections into actions moving forward and be sure I'm looking out for my own professional interests, professional development and advancement?

Mindfulness or multi-tasking as a mother in medicine

And then she said, “Wait what?”   

As a mother in medicine, are you engaging in mindfulness, or are you a multi-tasker?  Perhaps that’s too simplistic of a question, as it’s not necessarily an either/or.  The complexity may rest in which of these two are you striving for? 

My challenge is I find I’m striving for both.  I want to be more mindful and present with the people I’m with, but with things I want to multi-task.  When I’m with my family, I should be with my family.  When I’m with my students I should be with my students.  When I’m with my patients I should be with my patients.  When I'm in a meeting, I should be with the meeting members... that last one is a hard one!  What if you find yourself with people and it’s not worth your while?  When it’s not engaging.  When you have sooooooo many competing priorities and demands.  Do you exit (physically or mentally)?  Do you meditate or do you multitask or do you make your way out the door?

And, what about when the people aren’t fully present with you?  I’ll wait… And I’ll aim to make being there, being here, worthwhile. 

Maybe the key is to be mindful and fully present with people, and to multi-task effectively with things. But that may also mean you have to be around the "right" people and do the "right" things... the people and things that give your life meaning!

I guess it’s kind of a topic or conundrum for us, the busiest people.  And on that, do we agree that the busiest are the mothers in medicine?