A straggling piece of advice

I was held up yesterday so my post is late. Straggling, as it were.

People in my medical school did not talk much about life, the universe, and everything. We were concentrating on the cerebral aspects of medicine, not necessarily the humanitarian elements, and not the life outside med school.

So if I did medical school again (and, yes, I absolutely would), I would take this advice back with me: have a human perspective on all things. During my training, we all tried so hard to be professional, but I think that, in the process, we started to ignore or even invalidate our own feelings. Our emotions and reactions may not always need to be open and visible, but it's okay to feel the burden of your patients' experience and not be closed off to it. I think too many people have the fear that allowing themselves to feel too much will cripple their medical ability. I don't think so.

In my years since medical school, I have seen many of the best and brightest doctors from various disciplines getting their hands and their hearts dirty (so to speak). They have an intimate knowledge of their patients, and I see how they are invested in their patient's care. These professionals have taken down the wall that is supposed to exist between the medical brain and the feeling person underneath. I have immense respect for them and the care that they provide. They manage to be involved, yet they don't make inappropriate recommendations or have nervous breakdowns. They just see the patients (and themselves) as the human beings that they are.

These are my role models, from my unique spot from behind the microscope. But if I were a medical student again, I think I would allow myself to feel a little more sadness, frustration, helplessness, and love.

My kids hate me (and I'm sure it's because I work)

pI'm convinced that there are parents out there whose kids do not talk to them the way my kids talk to me. My son has, of late, been lashing out (usually when he gets in trouble for something), and he will tell me that I am "mean" and he "hates me." It does wear you down after you hear that too much.

Last week was bad. My head was spinning after trying to compensate for short staffing at work. Then not only my son, but my 3-year-old daughter starts in on me. She throws a fit, gets in trouble, and has to go to her room without stories that night. I go in to talk to her. Through her tears, she tells me point blank that she 1) doesn't love me and 2) wishes I would die (!). I told her "you don't mean that." Of course, she says "yes I do!!"

I told her I wasn't going to let her be mean to me, and I retired to my bedroom, where I promptly burst into tears. I told my husband "ss-ss-ssophie s-s-said she...she wanted me to DIE..." Friday night is not a good night for anything emotionally taxing to happen to me.

As I said, I know there must be kids who don't say these kind of things to their parents. Which makes me think, "what am I doing wrong?" Bingo-I am a full-time career woman! Of course my kids hate me, how could they not? Maybe I shouldn't work, then my kids would be awesome to me and really appreciate me all the time.

As soon as that thought crossed my mind, I realized how ludicrous it sounded. My kids will hate me (at times) no matter what. I'm not naive enough to think that spending more time with them will make them hate me any less; I may just be around for them to express that to me more often! Pathology may be a thankless job at times, but being a mom is in a thankless league of its own!!

I told a friend Saturday that what surprised me most about being a mom was not the work involved, but how ugly the ugly times could get. And I had to screw up my courage to write this post, because it is really hard to admit how awful your own kids can be sometimes. Those of you who read this will belong to one of two camps: those who have, either by virtue of their much younger or infinitely better behaved children, are aghast at the events above; or those who read this, laugh, and say "oh yeah, sister, been there! In fact, that's the tip of the darn iceberg!!"

time management 101 (minus 98)

There are only 3 things I do for my time management:




I make sure I keep track all the things I HAVE to accomplish that day.





I come in early the next day if I have left anything behind.





I take lunch behind my desk.





That's my imperfect scheme, but those three things get me home in time to have dinner with my kids, and that's what I think is important!

The high price of motherhood

My little daughter takes violin lessons, typically on Saturdays. This Saturday, we had a conflict, so I took the only other spot available, a 3:00 pm Wednesday lesson. I don't get off work that early, of course, so I figure I will quickly take her and then bring her back to work with me.

The workday was packed. I wanted to back out of this cockamamie scheme that I had somehow let myself into. But I just went ahead and did it. I had heartburn and a mild headache by the time I got back. Having my daughter at work with me proved very inefficient, but by 6:00, we were set to go home, with a little residual work left for the following morning (I came in at 6 am this morning to catch up).

I don't think I have any wisdom to share. If there was a simple answer on how to have a medical career and be a mother, we wouldn't have stress or angst. I think that I have two of the most wonderful kids in the whole world, and I absolutely cherish them and thank God for them. I also have a fantastic career that I love. My payment is stress, both physical and mental. It's also the guilt I feel when I can't devote the time to my career that I would otherwise before I had kids. It's the grating knowledge that others may either resent me and/or think less of me when I have to put my kids first. But these are all payments I am willing to make, because my life is full and beautiful. Nothing truly great comes without sacrifice.

Anyway, nothing this week will top my experience yesterday at work when, during an intense conversation with one of the general surgeons about his patient's biopsy results, Sophie gets right in my face and says "MOMMY, I have to POOP! I have to poop REALLY BAD! (I was trying my best to shush her) Really, I'm NOT trickin' ya! I have to POOP REALLY BAD! MOM-MY! I have to POOOOOP!!!"

Don't worry, we made it.

Mothering a med student

Pathmom has been off the air for many weeks, primarily due to the addition of a full time med student last month. I have a healthy amount of respect for med students (we were all students once), and this one was particularly bright and appeared to have the requisite "good eye" that any successful pathologist must have. So in the title of this blog, I don't want to sound pandering or condescending in any way, but there was an incident that I found particularly memorable, and worthy of sharing.

This young woman had a 4 month old baby girl at home. She came back from maternity leave and went straight into her general surgery rotations. Her medical school was in the habit of "farming out" students to community groups across the metro area (and even the country) for their clinical rotations. The two surgeons she rotated with were geographically close, but had a reputation for inappropriate behavior.

"K", as I will refer to her, had an initial interest in surgery, but she was fully cured of that in the process of her rotation. Apart from being bad-tempered and complaining vocally about having to have med students at all, these surgeons were apparently openly misogynistic. They reduced one female med student to tears by verbal abuse, got cited for making "inappropriate remarks" to another, and told "K" directly that the only way they would ever hire a woman was if she had a hysterectomy.

The last incident really burned me, but I was more appalled by the way "K" told me about it, almost like she was waiting for me to chuckle or at least smile.

"Are you serious? They said that to you?"

"Well, these guys are pretty old school."

"Old school, nothing! That's an extremely offensive remark!"

I had that bewildered sense of reacting very strongly to something that appeared to have no effect on someone that I would consider more or less a peer, based on age and being the mother of a small child. I explained that you can't change individuals, but that she should not take that comment as something either acceptable or amusing. I also thoroughly derided her medical school for allowing students to be with these physicians (apparently, options are rather on the slim side). Despite having quite strong opinions about many and varied things, I actually do not "soap box" very often. This, however, did ignite a spark. The term "flipped out" sums it up nicely.

I couldn't help but wonder if it was her upbringing or just a lack of social aptitude that made her fail to realize the abhorrent nature of that comment (and, yes, I am intentionally leaving out the option that I was just plain over-reacting).

I also couldn't help waxing philosophical about the whole incident. Obviously, this blog is built around the notion that mothers in medicine are worthy and capable members of the medical field. We are also, frankly, necessary to the system. If every "mother in medicine" were to disappear from the profession, and if only those women who were indeed sans uterus were allowed to practice, what then? Not so great for aging baby boomers, that's for darn sure.

This student was convinced that surgery was not an option for her - and maybe it wasn't her path for other reasons - but these horrid surgeons certainly made it clear that she wasn't a candidate based on who she was. "Of course you can be a surgeon!" I explained to her that my sister-in-law is a practicing general surgeon, and has had two girls and plans to have more. I also pointed out that 3 of the 6 general surgeons at my hospital were women, all of whom had small kids. That being the case, I had already melded her mind towards the utterly cool and completely irresistible field of pathology, so I believe it's unlikely she will do anything else (path props).

Frankly, mothers in medicine typifies a scenario that all professional women of this era face: creating the reality of how working moms fit into the American workforce in the 21st century. We're living at a time when there is no "norm" for working mothers, and the expectations and experiences are supremely varied. Some moms get months of maternity leave with full pay; others get paltry weeks (or even days) and pro-rated salaries. Some moms have to take leaves of absence; others invoke FMLA. But we are an increasingly powerful and valuable voice in the professional community, and I believe the situation for working moms reflects that more with every passing year (a generation ago, my mother in law and her female residency colleagues had to sign contracts with their programs explicitly stating they would not get pregnant - they did anyway). We are more involved in making our own reality today than ever before, and I believe that what we want to be and how we want to practice are out there waiting for us, be we single, married, pregnant, or toting around that mysterious black bag with the plastic suction devices on it. And if there are still the remnant neanderthals who feel that the possession of fully function female parts excludes someone from consideration, they are, of course, free to limit themselves thusly while the rest of the world spins ahead with diverse, talented, and dedicated mothers in tow.

Contributions to my career

As working mothers, we often focus on how we can manage to not allow our "with-kid(s)" status to affect our work. We overcompensate to prove we do as much work as the next *man* and we play ourselves into guilt cycles if we are either away from work or away from our kids (which is the case almost constantly).

I say, baloney. Being in medical school and residency has taught me much about medicine; however, being a mother has taught me a lot about myself. And that has furthered my ability as a physician far more than I ever expected. I have, therefore, decided to make a list of all the things I have learned by being a mother, which have made me a better doctor:

1) I recognize a temper tantrum for what it is, whether it comes from a child or an adult.

2) I realize that I may make good decisions that are not popular. I don't need to apologize for them.

3) If I subscribe to the "if you want something done right, do it yourself" adage, I will be doing everything for everyone all of the time. Then by definition, no one else will never learn to do it right because they will have no experience.

4) My daughter is being raised to be unapologetically bright without the influence of gender stereotypes. I should be no different.

5) Consistency is a vital skill.

6) Hand-washing must be frequent and thorough. This may seem obvious to anyone in medicine, but 2 kids with gastroenteritis brings this issue home with a vengeance.

7) I leave work at the end of the day only to begin the even more difficult job of managing kids and a household. So does my husband. We are partners after all, and our relative value units have to be equal (we have a joint checking account). If I expect him to pull down his share at home, I have to pull down my share at work.

8) My life is crazy enough right now, I can't imagine how empty I'll feel once my beautiful kids go off to college. I appreciate that I have this great career of mine.

Following in my footsteps....

...by compulsion. For the record, the pictured garb were provided by my father. He is a doctor himself, and had to have the grandkids participate in his medical clinic-sponsored float during our home town's fall festival parade.

So literally, I was parading my kids around in these.

Although I don't have expectations that my kids will become doctors, it would be nice to think that, should they opt to go that direction, I inspired them that way. Of course, my husband is a physician too, so it would technically be difficult to tell who was the primary influence.

Okay, I'll admit something. I not only kept my last name upon marriage, but tried to persuade my husband to adopt mine. This was not a battle that I won, nor did I really expect to. I just thought it was worth the argument.

Sometimes, though, I think about what the difference would have been if things had gone that way (indulge me for a minute in some unladylike egotism). My kids would bear my name, and if they became doctors, they would be the next (third) generation of doctors in my immediate family with my surname. If people called me and asked for Dr. ______, I might have to ask clarification for which Dr. ____ (and yes, I realize this would also have been the case had I taken my husband's last name, so don't bother pointing that out, that is not the point).

Mothers are not so different than fathers, after all. Sometimes we just kind of want our kids to follow in our footsteps.

It's a shame though. I guess the world will have to do without two more "Dr. Singh"s.

Taking my kids to work

Ok, obviously with a 3 year old girl and 4 year old boy, I do not take my kids to work for the entire day. However, when granted the opportunity for a brief run-in, I will snatch it up, whether it means 30 minutes in the morning for breakfast in the cafeteria or an hour over lunch. I can't help it--I love having my kids in my hospital workplace!

Truthfully, things never go as I anticipate. I always have this vision of my daughter showcasing her adorable made-up songs and my son making hilarious (though appropriate) jokes, thus bringing all my anecdotes and imitations into a stark and incontrovertible reality for my co-workers. In actuality, my kids have, over the course of several visits, managed to: 1) sit in a corner and pout, 2) scream at each other about who gets to push the wagon, 3) scream at me for not letting them eat a donut they dropped on the MRSA-ridden hospital floor, 4) pull my shirt down so that my bra is fully visible to a half-dozen people, and 5) inform my boss that he (my son) didn't want to be at this "stupid (retirement) party" (okay, maybe that last one was an avoidable error on my part, but they had food there).

Am I crazy? Why do I let myself in for this recurrent exercise in mortification? One thing I underestimated was the fun of seeing the hospital through my kids' eyes. My son's "favorite place" is the...cafeteria. Think about it - donuts, soft serve ice cream, juice, cookies, french fries. How cool is that to a 4 year old?! It's like working at a Luby's. They also think my microscope is one of the neatest things on this earth, and I have essentially no one else in my life who agrees with me on that.

Also, I have this irrepressible desire to merge my work life and family life. I want the people I work with to know my kids, and my kids to know them. I guess the folks at work are getting to know them in a certain way, which at the very least, should garner me sympathy for going home to a veritable nuthouse (or on the flipside, garner criticism for being a mom of two out-of-control hellions). But I don't care. Sooner or later they'll see the whole package, and until they do, they will just have to settle for my imitation of my daughter singing Rihanna:
My umbwelluh - elluh - elluh - eh - eh - eenee my umbwelluh!!