My career choice twenty years ago…..

I know The NY Times article stirred some controversy and some emotions. The article reminded us of how far we’ve come and how much work still needs to be done. I can’t say the article rings true with most women but do I have a general agreement with the article about how medicine has proved to be a family-friendly profession for many of us? Yes.

When I was a third year internal medicine resident I found out that my daughter has autism. Devastating? Yes. Resources that I knew of? No. Much help around? Hardly.

I really needed some time off of work to get myself sorted out and get her plugged into therapies. Turned out that wasn’t so easy. Not only my citizenship process for the USA would’ve been delayed, I also noticed myself thinking more about autism in my free time. Every second of it. I found respite in work. I signed up to be a chief resident after completing my three year internal medicine training. Reasons for taking up a chief resident position? A few!

1. I knew I wouldn’t be able to go into fellowship training again. When your child is diagnosed with a life-altering diagnosis, your immediate plan is to make their future financially secure. Your immediate plan isn’t the fulfillment of your career aspirations. As much as I had hoped to be in fellowship one day, I knew that dream was over. I knew I needed a plan that could help my child first.

2. I expected my chief year to help me learn a little about hospitalist medicine and its nuances and whether it was even something that I wanted to do.

3. I really needed to clear my head about my child’s diagnosis and learn more about autism. I also needed to collect information about therapies for autism. I didn’t think I could make a good choice about which state to pick based on what they offer in terms of special needs services, which job to choose and be sure of their flexibility to work with me. My kid had all her therapies well in place and was making slow and steady progress and I didn’t want to uproot her just then. I was passively trying to keep my marriage afloat. It was a lot to switch healthcare systems and land in a new job. I needed that one year to be with myself and my child and in a familiar, comfortable environment with my attendings and junior residents who were like family at that point. That support was priceless.

But a year later I was back to thinking about what to do. As my chief year came to an end I started looking for a job. I had no idea what hospitalist positions entailed, how many hours I’d roughly have to work or if I’d ever get enough time to have another child if I opted to be a hospitalist.

I chose a state that had a reasonably well-documented history of robust special needs services. I found a job in a huge healthcare system . But more than that, I found work in an environment where my needs were met with compassion, empathy and immense consideration.

I have worked many different schedules to meet my daughter’s therapy needs and my penchant for traveling. I have worked an all-weekend schedule briefly so I could be with her during the week. My work allowed me that. I have worked all nights since the birth of my son two years ago and have had nothing but cooperation from work. I have also been able to have a pretty customized schedule and am truly very grateful for that.

Has my choice of institution impacted my favorable opinion of my choice of career for myself twenty years ago when I set foot in a medical school? Absolutely. I know not all women work with the type of team I work with and that can absolutely color our opinion.

Is my work environment and the people I work for perfect? Not by any means. But that’s the whole point. Our work environment and our employers don’t have to be perfect. Just like nothing else in our life is perfect. What matters to me is that my employer and my direct supervisor are compassionate people who know enough about my life that I never have to go into major details when asking for an accommodation. That alone reduces my risk for burnout and loneliness.

Women don’t find medicine family-friendly generally and I can relate to it on some level. There have been days and nights when I’ve promised my family I’d be there and have missed being there. Patients get sick unexpectedly and they always come first for a physician. But that was part of my promise to myself when I became a physician that I’d be there for them. And slowly my family has come to terms with my commitment to my patients also. They don’t see my absence from major events because of patient care as “another work thing”. They see it as my biggest promise to myself and my profession.

I run another ship when I’m back home and that’s where the balance isn’t fair exactly for most women. Women aren’t nesters anymore but are expected to function like one at all times. We have play dates to make, birthdays to plan, vacations to book and family to attend to. We can’t come back home and tune out automatically. I’m sure many men can’t either but I’m not entirely sure if most working men live the life of most working women.

The system that’s letting women down everyday isn’t the system at work alone. It’s the system that our society has come up with. It’s the system of a woman being the first one to get the call from school, the woman asking for days off in her schedule so she can be at a game or a recital, a woman rushing to pick up the kid from school if they get sick, a woman looking for a nanny and making sure the nanny doesn’t leave. That’s the system that needs changing. Work environment changes will follow.

I’m blessed with a spouse who gets it but imagine the burnout that spousal nonsupport can bring. It can be huge and undocumented. It can also go unnoticed and unaddressed. Our spouses and significant others have to be our first support system. It really starts from there.

I’ve never been paid less than my male counterparts but my friends tell me that they have been and it makes me sad. It makes the relevance of feminism even stronger. Feminism isn’t about getting more . It’s about getting fair and having an environment that focuses on equality and equity.

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