Grappling and Grateful

I’m nesting.

No, I’m not pregnant, and I’m not sure when it started exactly, but with the start of residency looming and more free time on my hands right now than I’m used to, l have this strong desire to declutter and reorganize. Thanks in part to a nudge from Mommabee’s recent post on feeling stuck, I dove into Marie Kondo’s Netflix series.

I hoped that I would get some practical tips for decluttering, and I did, but I also found something much more enlightening. It clicked during the 4th episode, when a family of four was working to control the clutter after downsizing from a large house to a 2-bedroom apartment. The crux of the episode was when it became clear that the mother was responsible for essentially all of the “stuff”, both physically, cognitively and emotionally, to the point where her adolescent children and husband would call her throughout the day because they couldn’t find anything. She had taken on the role and implicitly assumed the responsibility while working a full-time job outside the home. I won’t dive into a full analysis of the show (although there’s a good one on the show’s gender dynamics here). The invisible labor of womanhood and motherhood becomes visible.

Suddenly, I saw my impulse to reorganize our home and life in stark clarity. While I’m grateful that my husband is committed to gender equality in our marriage, we’re still fighting generations of inequality and implicit assumptions about men and women’s roles at home and in managing family life. So while some things are straightforward, ie, if I make dinner, he cleans up, and vice versa, other forms of emotional labor are not. Looking back, we can both see the impacts of very unequal emotional labor on each of our mothers. And the “stuff” is just one example. We both moved at least 10 times throughout our childhoods, sometimes internationally, and usually lived in rented housing. While my father was the “packing expert”, my mother managed the bulk of the organizing and cleaning and knowing where everything was, on top of knowing who needed what doctor/dentist/chiropractor appointment or freshly laundered uniform and what we were going to eat for dinner. And I subconsciously still assume that’s my role too. I’ve been able to keep up (mostly) with this invisible work while keeping up in medical school, although it’s gotten a lot harder since my son was born. I’m actually pretty good at managing a lot of this in my head.

But here’s the thing - I know it’s taking energy away from other areas where I want to be excellent, like being really present with my son when I’m with him, and developing into an excellent physician, and building the career that I actually want, rather than just slogging along on a one-size-fits-all career treadmill. I know the other members of my medical-student-mom squad feel it too. We’re constantly exhausted and we’re not even in residency yet. And while decluttering is helpful, it’s not the answer. Delegating is definitely part of the answer, but first I have to list out all of the things that I’m trying to do and then figure out how to delegate them. So keep an eye out for my household organizing/delegating app once I actually figure out how to do all of this. (I'm kidding - this is way beyond the scope of any app.)

No, I put this out there not because I’m expecting someone has a magic answer, but because I’m grappling. And I’m also grateful. I’m grateful for my wonderful mother and mother-in-law, who managed two large, chaotic households with so much love and way more patience than we ever deserved. They fell into bed at the end of every day exhausted for reasons they couldn’t even name. I’m so grateful to them for managing all of our “stuff”, both physical and emotional. And I hope to honor them by finding a way to both love and care for my own little family while letting go of some of those expectations and responsibilities. I hope to honor them by sharing some of the empathy and intuitiveness that I learned from them with my patients and colleagues too. And I’m grateful for the #momsquad that lets me vent without judgement about how hard all of this is, and the husband and toddler who love me just as I am.

A Beloved Mentor Falls

I walk by the closed double doors and frosty windows of the ICU. You’re lying in there, intubated. It feels weird to go to work now. I can’t see you or talk to you, don’t know the drips, don’t know the plan... and it’s killing me. I, along with many others, desperately want to express my love. So many feelings are swirling inside:

Guilt... For having a chill workday that day, leaving early to sneak in a pedicure before the evening’s family duties. All the while, you collapsed in the OR. Our colleagues rushed to your side. Emergent intubation. Hours in surgery... A trivial moment for me that was horror for you. It hurts my head and heart to contemplate that this is the case for any two people on Earth at any given moment.

Bitterness... For the memories that have surfaced of my own health crisis. My own rush to the OR and surgery and stay in the ICU. The immediate change to everything in my life, the upset of all routines. The label of a disability, the worries about the future. A dark time that I try to forget but never can. For having the knowledge that you will experience this same bitterness later on... if you’re “lucky.”

Gratitude... For my health now. For the part you played in it. You were the one I went to when I knew something was wrong with me all those years ago. My tears didn’t phase you for a second, and you helped arrange my much-needed absence from training. Others thought I was just performing poorly; they judged and moved on, but you knew what mattered. When I was finally diagnosed, you facilitated my prompt surgery with our most skilled surgeon. The same one who is now taking care of you.

Admiration... For your completely nonjudgmental approach to everything and everyone. I have experienced it myself but never realized it was your M.O. with all people. We all exchange stories quietly in the lounge, then fall silent with sadness and worry. For your goofy sense of humor. For our days in the OR and call nights together during my training; you were the one I felt most comfortable failing or struggling in front of; only now do I realize why.

Anger... For why this had to happen. What higher being would take down such a beloved leader, such a good doctor? At you for not knowing something was wrong inside sooner, so as to maybe prevent this catastrophe. At your family for keeping us from seeing you now. They don’t understand how much we love you, how much doctors bond together in a practice, working in parallel to preserve life and limb. Damn you for not sitting up in your bed right now, pulling that tube out and cracking a joke with a mischievous smile.

I have to write all this here to get it out of my head. Work is not the same without you there. I miss you.

Letting death in the room.

Taken by the author. Mukwonago, WI. Oct 2016.

One of the most heart-wrenching things I witness at work is people saying goodbye to their loved ones. Today I watched a husband say goodbye to his wife of 31 years, with their son also present at bedside, weeping as his mother died.

I stay in the room for all terminal extubations, along with the ICU nurse and the respiratory therapist. It's always an emotional thing to witness; I think we all find some kind of unspoken moral support in having each other present, besides the obvious practical needs to be there (RN to give meds, I provide orders/ explain things to the family/pronounce/ask for autopsy, RT weans ventilator and removes the endotracheal tube).

I stood in the room and watched the RN bolus morphine and midazolam...I watched the patient's respiratory rate. I watched her face for signs of struggle, her body for signs of stress. There were none, so we were ready to let her go. I gave the final "ok" to the RT to remove the woman's endotracheal tube, as I thought her respiratory rate and sedation level were adequate so that she would not struggle without the ventilator's assistance (pressure and oxygen). Her sats dropped to the 60s immediately once she was on room air, she developed circumoral cyanosis, and her heart rate was dropping. The medical staff all left the room so the family could alone be with her. She lived for about one hour after extubation, deeply sedated, and died without any struggle. I returned later to pronounce her death (1250) and obtain autopsy consent from her husband. He readily consented and said she would've been an organ donor, if her cancer hadn't prevented her from doing so. He asked "What will your team learn from doing an autopsy?" and I explained the top clinical questions that I thought could likely obtained only via autopsy.


In the moments before the medical team goes into a patient's room to do a terminal extubation, there's often a collective "let's do this" sobriety. As in "This is hard. But, we will do it, and we will do it well." And we do, our team always does. Unfortunately in an oncology/BMT ICU, we are all skilled at helping people die well. And at this point in my career, I'm skilled at that part of my job and proud of it. Not proud in a perverse way, but proud to be able to palliate symptoms of pain, anxiety, and breathlessness in one's last moments of life. Proud that I can help guide families through the emotional agony of watching their person die. Proud that the last images they see of their loved one are peaceful, quiet, calm, well-choreographed. Respectful. Clean. I am grateful that we have the ability to allow people to die without suffering, to serve our patients in this way, to calmly let death into the room after beating it back for so long with our various medications, procedures, life support. We spend hours trying to corral irrational forces (life and death) with rational means (science)--it's almost absurd at times.

But as we let the dying person leave the earth, as their suffering ends, the survivors' suffering begins. Their love wasn't free; now they grieve. All of this had me thinking this afternoon--about love. Whenever we love someone we do it knowing (somewhere in ourselves) that someday one of us will say goodbye to the other. It's an overwhelming thought to ponder for too long. You'd think this would hold us back sometimes, but no. We throw ourselves wholeheartedly into love--loving our partners, friends, children, pets...while knowing that it is all temporary and that this will hurt eventually. Talk about optimism! Humans crave love and connection, we cannot resist it (can we live without it?) even though we know that eventually it is 100% guaranteed to come crashing down around us. Every time.

Mother duties = father duties

I recently realized something.  Something I don't like, that I've been doing without even knowing it.  I have been thanking my husband for doing fatherly duties.  Example:  He says he is going to pick up our daughter from daycare, and I say thank you to him.

Does anyone else see something wrong with that picture?  He never thanks me for picking her up the majority of the time.  He doesn't thank me for loading/unloading the dishes, or for doing the laundry.  But I thank him when he does anything more than go to work and come home.  

I have friends who have clear division of labor in different ways, where their husbands are actually expected to do laundry, dishes, wake up with the baby, etc.  Mine has never had such expectations.  The tasks are all mine, with him helping out when he sees fit and convenient.  The dishes will not pile up if he doesn't touch them for days, I will put them away.  The food will not run out, I will make sure we are stocked up.  The kids will not go hungry, I will make sure they're fed.  I don't blame him at all for any of this, because it is the precedent I have set in our marriage and home.  But I wanted to ask fellow MiM's:  What kind of precedent do you have in your homes?

MiM Mail: (Un)happy match day - "It doesn't matter what YOU want"

As match approaches, it is with a heavy heart that I await the results.

This is a story which has been culminating over the years, and in fact, I have many unsent emails addressed to MiM which tell the tale. I am a 4th year medical student with two girls - a preschooler and a toddler. Both of these I gave birth to during medical school (I "took a year off" and did an MPH between 3rd and 4th year). I am married, and it is not a match made in heaven. Few relationships are perfect, but I feel like ours has some really deep underlying issues that perhaps make it stand out. We had a fun relationship in the beginning - but we got married more so because of an unplanned pregnancy. We were legally married in a courthouse. It was important to him to get married prior to the birth because he was already plotting his custody rights. I didn't tell my mother, who would have counselled me against it (and she would have been right), and none of my family or friends were in attendance. I worried about our significant age difference, but he promised me support, and we framed the relationship in that way - he has no competing career, which frees me up to pursue mine while having a secure family life. (Perhaps something like this.)

I wanted to send this story in because the title of the previous mailbag letter, "Whose dreams come first?" struck me. The reason that this resonated with me so much is that my husband told me when I was explaining my rank list, "It doesn't matter what you want."

Having children during medical school has been extremely draining, and now that I am plotting my career path, I wish I had more control over what I wanted to be and where I wanted to go. I am an excellent student and work extremely hard. Despite being a full time student, I have also taken extensive care of my children, especially as babies. I have "studied from home" while taking care of my children as infants for about 3/5 years of medical school/MPH (M1, M2, MPH) so that my husband would continue to have opportunities to work. Opportunities that I don't feel he ever took advantage of.

My husband and I have no family nearby and no family equivalents. As a result, all childcare responsibilities fall completely on us, unless we pay a babysitter. We did have a regular sitter 3 days a week for about one year, which I think was an overall great experience (with the exception that I felt from my perspective that we were hiring her so that my husband could work, with the implicit understanding that as a medical student I needed to work all the time, but from his perspective I was hiring her so that I could go to school while preserving his autonomy), but she went out of town and since the financial equation didn't add up (his overall work income = cost of sitter, and that includes time that I took care of the kids for him to work as well) by mutual agreement we didn't find someone to replace her.

There is not much of a culture of stay at home husbands of doctors. I have seen several blogs out there of the proud and self-sacrificing "doctor's wives" but nothing similar to that for the "doctor's husband." These blogs tell of the hard work of the male doctors, the pride of the doctor's wife in her husband's service to humanity, her story of self-sacrifice for her husbands career, helpful recipes, and parenting tips. My husband doesn't feel this way about my career at all. Perhaps it's because this culture doesn't exist for him. We are essentially at odds about my schedule, my need to study, the housework, the possibility of needing to move.

Because my husband decided on his own volition to be a stay at home dad, he now makes even more minimal income than before. He receives a $1000 annuity monthly from an accident.  I transfer money to him to pay the mortgage on his house/workshop and other bills. Most of it is money from my mother, and she is sending it via me to him with the understanding that he is supporting me in my career and taking care of her grandchildren. He says that he has "sacrificed" his work for my career, but in fact he adamantly did not want to get childcare and work. He has not given up financial security either - when we met, his bank account was completely overdrawn. He has recently characterized himself as been a "servant" of my "wealthy family." However, suggestions I have made that would make him more financially independent: renting his workshop space for income, getting a regular job, etc, have previously been shot down as inconceivable. We paid his leftover defaulted college loans - from almost 30 years ago! - with our tax return credits. I have also enabled him to pay off credit card debt. Meanwhile I feel like I have sacrificed much of the quality of my medical training for him, having lost out on the experience of a normal M1 and M2 year and career development opportunities along the way, but still taking on full expenses for the family either via loans or via my mother's contributions.

Rewind to the end of 3rd year: I am 9 months pregnant and concurrently preparing for the medicine clerkship exam,  starting MPH coursework, and studying for Step 2CK. I destroy the exams because I work hard. I am a machine! Woot! But things really go downhill over the next year. While in labor, I try to write a paper. It exemplifies my experience over the next year: working in pain. The intense emotional pain of trying to do well in school while your infant cries. I had done something similar in M1 year, but the memorization was much more tolerable than the reading and paper writing. And things are much more complicated now with two kids. My husband had encouraged me to do the MPH because of financial reasons - the fact that I will continue to have loans available and that my mom will continue to contribute to us if I am in school. After trying to write my paper between contractions, I give birth the following morning. It is a joyous day. Shortly after, I initiate total 24/7 care of our second child while taking 6 online courses, about 60 hours per week of work. His contribution is taking care of our oldest about 2/3 to 3/4 of the time, and taking her to school every morning. I work from 9pm-3am every night (the hours she most predictably sleeps) plus whatever else I can get my hands on. Even with this, he is pressuring me to do more school pickups for our oldest so that we are being "fair." In all this time, he theoretically could be working at least between 9am and 3pm M-F (and longer when I do pickups) but apparently does not since my mom is still paying the bills. I am feeling like sh*t, alone at home (online courses), taking care of baby, working, doing all laundry, washing diapers, most of the housework, plus the winter is complete hell and I can't even go outside for fresh air or a run because it is too cold for the baby. His first conclusion is that I am cheating on him with a classmate because I am withdrawn from him. !!!!?????! WTF ??????!!! I blow up. I tell him that I don't like him. That I could have done better. Someone younger, better looking, and more financially secure. Yes that is a very hurtful thing of me to say, which is why I guess I didn't say it until it really came to a head. And yes, I knew this about him going in, but I valued the support and partnership he promised more than any of those "shallow" things. I guess, when I felt the support slip away, I wished I had at least some of those shallow things left to hang onto.

He goes and talks to his friend who graduated from law school. Then he tells me that if I leave him, that he will keep the kids in the state. The other stuff he talked about "is between him and his lawyer."

I wish I had initiated something then (legal counsel?) but despite these misgivings, I had no plans to divorce him.  I felt like I had made the commitment, and I was going to do the best I could with it. Perhaps it was me (too picky? don't deserve better?), perhaps I would just never be satisfied with anyone, so I should try and make it work.  Living with him seemed and still seems like the only way I will ever see my children as a medical student or a resident, and they are young. They also love him and I don't want to take them away from him. I value what he provides for them as a father. So I kept it going. M4 starts and he now has finally taken over full childcare responsibilities.

He was not supportive during the application process and was more interested in my lack of sex drive than my career prospects. Then he blames me for not having worked hard enough to find a good program in our area and says I don't deserve "the best" that I should settle for "good enough." I feel like this is a recurring theme in a lot of his beliefs. He has a disdain for wealth. He calls me a "princess" for wanting to live in a nicer house and city. I am not a pro-wealth person and have a fairly nuanced view on the relationship between income and happiness, but he is full out against it, perhaps a defense mechanism for his personal lack of financial success or stability. I don't know if this attitude can be resolved. When I say that my career will bring the family financial stability, he says our kids can go to community college, take out loans, and that they would be happy living out of a van or homeless shelter. Maybe there is some element of truth to this. I think they will be happy anywhere they are with a loving family but I wonder if we can provide that.

I interviewed at 11 programs, 5 within our city and 6 around the country. In this process I have sought out advice from many people, only one of whom said I should make the "self-sacrificing" choice, most who said I should pursue my "dreams." Many have said that my husband can't keep the kids if I move out of state (they are wrong - our state favors keeping kids in the state and I confirmed this independently).

My mother called my husband and asked him if he will support me. He said he was not moving. Why? He was protecting himself from divorce because if he stays put, the state custody laws favor him, but if we move to another state and I divorce him there, then I would be more likely to maintain custody if he then moves out of state. I asked him whether in this scenario (refuse to move, keep the kids) he would continue to ask me to pay his bills? No, apparently he will get it together. Call me doubtful, but he could not pay his bills prior to having children. And wow, if he could actually work to pay the bills, then why wasn't he doing this all along? The wildly emotional thoughts running through my mind include:this man is going to take my kids from me AND live off my future income unless I do what he wants.

Long story short I submitted my rank list while sobbing. My top programs are somewhere in the middle of my list, probably never to be realized. I have given up on the possibility of living near my family - consisting of my mom and sister. In fact, I did not even rank my preferred specialty first given I was so disillusioned, and I really regret this as well. I often wish I had submitted the list I wanted and dealt with the fray rather than be here in this limbo, unable to change or withdraw my rank list. But it was my children that he threatened to keep from me. My children. It made me crazy. (He would say: no, he did not threaten that - all he said was that "I'll keep them in the state" - he is a stickler for legal language.) My mother withdrew her financial support of him and he is now calling her evil and manipulative. She will no longer help us buy a house that he would live in. Nor should she. He now says that since I'm not paying his bills that I need to share half the parenting, including school drop offs at 8:30am (long after I am supposed to have reported to the hospital), BUT that I should NOT quit medical school. I don't know if he actually expects me to do this, or if he is just holding it over my head that I CAN'T do it.

He is looking at my future resident's salary, most likely the local program I ranked first, and salivating with the income "boon" - not concerned about what it means to me. I have watched my fellow "MiM" classmates give up their dream residency for their husband's careers, and I felt bad for them. I feel less bad for those who make the practical decision because of close-by family who are supportive. Now I feel bad for myself. I do not want to pay this man's mortgage with my blood, sweat, and tears. But he has my kids, and I will not have the hours in the day to take care of them for a long, long time.

We are in counselling now and I feel worse and worse about him the more I think and talk about it. I don't think I can forgive him for the position he postured. As far as the possibility of divorce goes, I am sincerely worried that I would lose custody of my children because of my work hours. I could drop out of residency after my contractual period and then divorce him, at possible loss to my career. Then there is always the possibility of a match day miracle, whereby I get the program I actually wanted. I suppose if that happens, I will have to be nice to him if I have any hope of making the move with my family. Or, I will submit a waiver to my dream program. Or I will visit my kids on my day off. Or at this point, do I actually want that program anymore, given that I have already started to plot a career that would be better for a single mother or co-parenting situation?

I know I am not his ideal wife. I don't idolize him and will probably never be in love with him. But I have given him so much of my life. I am willing to work with him in a partnership and possibly even an affectionate relationship for mutual benefit. Perhaps I am willing to settle for "good enough" in this "romantic relationship" part of my life, but not at the expense of settling for "good enough" in the professional part of my life? He probably feels the same way. He is willing to settle for "good enough" in our relationship if we don't move and everything stays status quo, but requires my adoration to move. But I can't fake adoration. I alternate from feeling like maybe I am a "privileged princess" to think that I could actually rank the program I wanted first - big whoop, who cares, you're going to be a doctor no matter which program you go to - to feeling enraged that I worked so hard against so many odds and am placed in this situation where I have to settle.

Maybe the best solution would be to get divorced after Match but prior to graduation, drop out after the contractual 45 day period of residency or apply for a waiver, enjoy a year with my children in the interim while HE works, and apply in a more single-parent friendly specialty with the new understanding that I am restricted locally, and with a feasible plan to co-parent. Compromise like hell, but more on my terms and with more warning.

It took me some time to get oriented on my career path with some bumps along the way as a young adult. Now I feel like I am pining for my own lost potential of self-determination that I was finally on the brink of realizing. My sister recently married a nice young man she has been long distance dating for years, who will follow her unpredictable and highly specialized career anywhere, and is excited to do so, a comparison that is painfully made. I will never get to marry a nice young man who is willing to unconditionally support my career. I will never have the experience of my family celebrating my wedding day. I will never feel deeply head over heels in love with my husband. I will never have autonomy over my career. I have what I have. Such beautiful and wonderful children! So much! Everything!

But so hard.

Well, that is my long story. I don't know what kind of advice I am looking for. Past experiences? Commiseration? Strategy? A reality check?

Vacation sans bebe

I read a few articles recently about Americans and vacationing. Of the only 25% of Americans who have paid vacation days, they have an average of 3.2 days left unused each year (OECD, 2013).

Unused vacation days. Not us!!! We use them all up. Zo travelled with us for the first close to 2 years of his life. However, once he was weaned and could no longer be lulled into a breast milk-induced-coma, we began planning trips without him. Many thanks to my parents and in-laws. And thanks to my cousin for letting us use her timeshare to enjoy fabulous, affordable vacations.

Here is my chronicle of our delectable and delightful second Vacation Sans Bebe, New Orleans style. I will focus on the food because New Orleans has to have some of the most amazing, creamy, luscious, sinful, gluttonous food around and there is just too much to write about (the wonderful people, the outstanding architecture, the cultures, the alcohol).

Best brunch ever - I can’t tell you how much O and I love an excellent brunch. My Sorority Sister B and her husband R who work for a major oil company in Louisiana met us at Slim Goodies. The french toast below was the best I have ever had; crispy French bread crust, fluffy middle, dusted with powdered sugar, and drizzled with syrup! Paired with mimosas that you prepare yourself (orange juice from Slim Goodies and prosecco from a neighboring restaurant they have an arrangement with), it was amazing!

(scrambled eggs, french toast, and large mimosa from Slim Goodies)

Best lunch - oooooh oooooh oooooooh. Gumbo and crawfish at Cafe Reconcile. Amazing nonprofit organization that trains local teenagers and young adults for careers in the restaurant business. Wonderful staff. Delicious food. The crawfish sauce was so complex yet not overwhelming. The grits were soft but had some substance to them and were perfectly seasoned.

(crawfish on grits, from Cafe Reconcile)

And the tie for best dinner - Bacchanal Wines and Houstons.

Bacchanal had to be one of the most fun experiences. We took a taxi into the Ninth Ward past factories and train tracks and end up in a cute neighborhood. You see a line on the corner entering a house with a big fenced in yard. You enter what may have previously been a living room, but has been converted into a wine and cheese shop. You purchase a bottle of wine, get a cheese plate (we unfortunately didn’t order one and the line was too long by the time we wanted some cheese), and go find a table. There are at least 100 people sitting and standing around. There is a live band playing in the courtyard. It is magical.

My husband and I failed on our first attempts to find a table, finally separating while he waited in the 20 person long food line and me making googly-eyes at folks with finished wine glasses taking up space. Finally, a very nice retired couple took pity on my and told me to pull up an empty chair. We sat at a candlelit table talking and drinking until they left.

And then the CHICKEN arrived.

Notice how I put that sentence on its own line. I had confit chicken that literally melted in my mouth with bok choy and a yummy carb I can’t remember. I did a little research on what confit means; it is to cook meat in oil at a low temperature (it’s not fried, it like melts away, oh goodness, soo yummy). That chicken was soo freaking good I am hungry just writing about it; the skin was crispy and perfectly salted and the chicken literally fell off of the bone and just melted in my mouth. O had a grilled tilapia that was equally divine. For dessert we had dark chocolate drizzled with olive oil and sea salt with even more wine.

(courtyard at Bacchanal Wine, image from http://fleurdelicious-nola.com accessed 11/1/2014)

Beignets - and on our last night in NOLA, we toured the city, stopping in shops. Eating. Drinking alcohol-containing beverages in plastic cups while walking (crazy that you can do that legally in NOLA). We ended the night on the banks of the Mississippi eating beignets from Cafe DuMonde with B and R. We heard approaching music as a first-line band leading a wedding party approached. As is the customary, we all stood up and joined in dancing and singing “As the Saints go Marching in” under the twinkling night sky.

Here’s to the best vacation sans bebe, NOLA, we love you bebe!

(Voodoo Tour, St. Louis Cemetery #1)

Our recommendations for excellent food in NOLA:

Slim Goodies, Cafe Reconcile (weekday breakfast and lunch only, nonprofit that does job development and career training for teenagers and young adults in the Garden District), Cafe DuMonde, Houstons, and Bacchanal Wines (get there early and just go ahead and get the darn cheese plate!).

Of note, I have no conflicts or disclosures, we went everywhere based on recommendations from friends and paid for everything ourselves. All pictures were taken by me and O unless otherwise mentioned and cited.

References:

An Assessment of Paid Time Off in the U.S. Implications for employees, companies, and the economy. Accessed Oct 16 2014.

Center for Economic Policy Research. No-vacation nation revisited. 2014. Accessed Oct 16 2014.

Work-life balance. Accessed Oct 16 2014.

MiM Mail: Keeping the relationship strong and resentment to a minimum

I am a third year medical student who recently had a child and am starting back on the wards soon, after a lengthy maternity leave.  I experienced some of third year already (while doing rotations during my pregnancy), and I'm absolutely terrified about going back!  Nope, it's not about the rigors of the wards or balancing school and medicine (we have older kids so I've done some of that already).  I'm terrified of the resentment my husband is likely to feel while taking care of the kids for such long hours on his own while I'm away and also while I'm studying.

He fully admits that he felt some of that in my first and second year and knows he'll feel it again when I go back since the hours will be longer.  To those in med school, residency, and practicing--what did you do to keep your relationship strong when your spouse often feels like a single parent?  I plan to do as much household stuff as possible, find some extra childcare for a few hours on the weekends when I have tougher rotations, try not to complain, and try to book family time for at least a little almost every weekend.  Any other ideas?  What works for you in this regard?  Thanks so much for any advice you have!

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

What It Feels Like for a Guy

*Editor's note: In the spirit of partner guest posts, this post was written by the husband of dr. whoo.

I’m not sure I am worthy of the title of Stay at Home Dad. I don’t have my children all day long every day.

My role to take on more of the domestic responsibilities began in fall of 2008. There was a combination of factors for this decision, but it was largely based on improving the quality of life for our family. Our oldest child had just turned four years old and our youngest, two.

With both of us working beyond full time, we were watching our children grow up in daycare and were limited to an hour or two each evening with them during the weekdays and the weekends were spent catching up on laundry, lawn, grocery shopping and million other items on the must do list. Exhaustion discouraged healthy cooking and exercise, and we ended up eating out or ordering in most of the time. I could continue to list all the reasons, but the truth is we should have done it sooner for fewer reasons. I never thought I would have anything but a long career of continuous development, but my wife had more time and money invested in her career and she was the bread winner. Besides, I have way more patience with children, and all other non-cat related matters.

It has been two and a half years since we made that decision, and it was the best decision for our family. Quality of life for everyone has improved tremendously. Cindy Lou is in first grade now, and we decided that Bean would benefit from the social interaction and academic curriculum at he gets at preschool. I take the kids to school, I pick them up (much earlier than we used to). I cook the meals and clean the house, albeit poorly I am told (seriously, how does dust accumulate so fast?). I pay the bills, clean the pool, and mow the lawn. I also do general repairs, minor plumbing and electrical work and you should taste my stuffed tilapia with white wine lemon butter sauce. During varying times of the day and evening, I work (as needed) to run my unintentionally non-profitable small business with 6 employees. I did get to take a paycheck last January (2010) so that’s good, right?

I now get a lot more quality time….err, snuggling/wrestling/tickling time with the kids which is unbelievably great.

I periodically get a little restless, and send my resume out to test the waters, but every time I get a bite I am forced to reconsider the consequences to my family if I return to the corporate world. Without fail, my decision is swift and clear as to what is best for our family, and that is to stay home. That is to say, stay available. Available for sick children and doctors appointments and field trips and household duties and whatever else needs to be done. My wife’s job as an OB/GYN is stressful and demanding enough, and I cannot help with that or relieve those responsibilities in any way. What I can do is almost everything else, that’s the goal anyway. In reality, she contributes a lot and always has a sense of when I need her help the most.

Anyway, I am unaware of any stigma and indifferent to prejudgments or misconceptions that others may try to attach to me. This works for our family and I am very proud and grateful for this arrangement. I used to think of it as me sacrificing my career for my family, but now I see clearly. We were sacrificing our family for our careers. We’ve both made the necessary changes to end that, and we are a happier family for it.

I am legend.

I am RH+’s husband (Mr. Positive?) and a stay at home father. Recently I’m a hot topic. Yes, I heard tings (said in my best De Niro voice). Here’s a bit more about myself…

• I don’t mind being called “the wife” or “Mr. Mom” or “Daddy Daycare” or when someone says “Oh look, daddy’s day out. Giving mom a break today, eh?”
• I cannot find a stay at home dad’s group in my city with google. Thus, I have no social interactions. And no prospects.
• This life chose me; I didn’t choose it.
• Circumstances left me with no job, so I’m just watching the kids for a while.
• I wear mandals. All the time.

• I can’t make small talk at parties because “I’m a full time dad” is a conversation killer.
• Surfing the internet all day keeps me busy most of the time. The rest of my time goes to Wii.
• I don’t cook well and can't operate the simple machinery stored in the laundry room.
• I’m a failure in the corporate world.
• I can’t look at your MIM website without secretly wishing there was some MIB tie in.

• My right thumb tingles a bit.
• It’s all bon bons and soap operas…and NASCAR.
• Sometimes I feel like I’m shirking my role as financial provider and that my role as homemaker is less significant.
• Grocery shopping is challenging enough, adding small children to the mix makes every outing an adventure.
• I don’t like sports.
• I’m homeschooling my kids, or should be.
• I am the post modern trophy wife.
• I’m an introvert. Or an extrovert.
• My wife wears the pants, but sitting around in my underwear all day isn’t so bad. Someone bring me the remote. Stat!

Hey, stereotypes exist for a reason, but that doesn’t make them right about individuals. Only one of the above statements is true about me and the guys I hang with. (I’ve got a tingly thumb…don’t ask why.) Most of the list are outright lies, some are exaggerations, a few are truly myths, and still others are simply artifacts of times past waiting on society to finally bury them (if the last hundred years have taught us that men and women are equals, then so be it). One thing is certain: a new beast has entered into the public mythology—into our shared societal consciousness—a new superstition entering the unassailable fortress of forever. I am a stay at home dad. I am legend.

So that’s the screw-you-part where I say all your stereotypes are bogus. Oh, and the last line is from the book (which turns, big shock, out to be not much like the Will Smith movie), starting with “a new superstition.” I didn’t make that crap up, just the crap before it. The real-me-part is that although I was raised in daycare and turned out justfinethanks, I always envisioned having my wife raising my kids. Marrying in our early 20’s, we waited 8 years into our marriage before the time felt right to have our first, so we were already on our second house and somewhat financially stable (as opposed to my own parents who were married in their teens and constantly argued about the little money they had). With RH+ in residency making the same salary as me, and with potential to make “doctor money” in a few years, it seemed like staying home fit me best. I tried it and liked it. We had to tighten our belt a bit, with the exception of upgrading to a DVR with the cable company (commercials can bite me). Otherwise, the high cost of daycare and gasoline, plus a favorable mortgage refinance equated to literally ¾ of my salary. RH+ picked up 2 moonlighting shifts per month (affectionately known as “sleeping for dollars” except for the one time she was everyone's hero, but she can tell the rest of that story…). Anyway that stuff plus our conservative lifestyle enabled us to go down to one salary with minimal pain. It was worth it. Totally.

I’m now part of a dad’s group, so I can share some perspectives from other fathers as well. I highly advise prospective full time dads to google yourcity + “at home dad” (use quotes) or check Meetup.com to find a group. It’s cool to talk sports, politics, diapers, and watch the moms groups wince when we arrive at the park only to often complement us as we leave the park. Dads who made a conscious decision to stay home and parent are much happier than those who lost their job and are watching the kids while looking for another job. This is no different than a guy unhappily working at the burger joint while looking for employment in his career of choice. Dads I know who actually took a significant net pay cut to make the deliberate choice they thought was best for their family are happier for it.

I can’t say being an at home dad is for everyone. I do know that everyone should try to have a career that they love. I love being a full time dad and find it to be an easy gig most of the time. This is also no different than a guy thriving in a career that he loves.

As a full time father, I know my son better than anyone. Sending him to kindergarten last year was really tough because his life story now had experiences that I was not a part of, chapters that I did not help write. Now that we have our second son, my decision to stay at home is reaffirmed as the correct one. He’s just started to toddle. Watching him try to mimic big brother at 14 months old is hilarious, its awesome, its frightening, and totally confirms exactly what I’ve always said: better raise your first kid right so he’ll do a good job with the rest. Here’s hoping that I did. And if I did not, well I have only myself to blame.