Women in Medicine… hunting nesters or nesting hunters

This is Women in Medicine month. We’ve come far. Really far. We have a chance at leadership, recognition and even job satisfaction. From mothers we’ve gone to become working physician mothers. Most of us have gone from working physician moms to working physician leaders who are also moms. We are doing it all. Most of us are responsible for it all. We wipe tears and deliver bad news. We pick them up from school and help with homework. We finish charting at six in the evening and then look for the nearest mall that would be open because tomorrow is the tenth anniversary of being together. We put in a central line and then check the phone to find out that mom needs her medicines picked up from the pharmacy. We are responsible for our marriages and our divorces. We are responsible for our kids and their birthdays. We are responsible for dinner and laundry.

What happens if a woman is sick for one day? Have you ever thought of that? What happens when a woman times out for one day? When she’s in the hospital birthing another one and takes at least two days to come back home?

I know you’re laughing. You’re laughing because you know women don’t get sick. They don’t time out. They don’t just up and leave for their hospital when their contractions kick in. This whole picture is ludicrous.

When women are sick, they still work. They still make it work. They continue to work through a pregnancy and the peripartum period. They have meals in the fridge for when they’ll be in the hospital giving birth. Nothing, absolutely nothing, will be standing up if a woman didn’t spend her entire life preparing for tomorrow. Every second of every minute of a woman’s life is spent making sure her people are okay when she’s not there.

Now let’s see who a physician mom’s people are. She has her regular people. Her husband, parents, siblings and kids. And then she has her very important people. Yes, her patients!

The life of a physician mom is punctuated with medical decisions, procedures, counseling, watching out for her patients and delivering bad news.

The life of a physician mom is riddled with the same dilemma that a physician dad’s is. THERE IS NO OFF SWITCH. There is no way to forget that she just told her 31 year old patient about her metastatic cancer. There is no way to forget that her 91 year old patient, who had been living a healthy life until now, is being defeated by the flu. There is no way to forget that a healthy man in his forties who has just returned from his honeymoon from the French Riviera is now in the intensive care unit with a massive blood clot in his lungs and fighting for his life.

How much can any human being compartmentalize? How can I dissociate myself from my patient who is internally bleeding and there is nothing that anyone can do except wait for the bleeding to stop? How can I not think about my kid who is going to have a lonely lunch on her tenth birthday while I’m seeing patients at the hospital?

Some people have recommended to me to not think about my patients when I’m home. But the same people have never advised that I don’t think about my kids when I’m at work. Why? Because kids are important. The most important thing to a woman. Can I share a secret with you that many of you will find shocking? My patients are JUST AS IMPORTANT. But people have recommended that I stop thinking about them when I’m home. Think about this again. How can a physician do that? For some patients who are recovering wonderfully I can do this very well. But for some really sick and sad cases, I can’t.

Society has failed physician moms. Society hasn’t seen our real calling and so has skirted its responsibility to let us hold our job as important as our families. Society has given us medicine with a benevolent air and then left it to us to figure it all out. Society didn’t build a system to prevent burn out. Society didn’t make sure that our kids and our patients get our best. Society hasn’t thought of us as sexual beings, women who’d like to date, women who’d like to travel, have kids, may be have a hobby. Society really wants us to live in absolutes. Society wanted to box us as nesters or hunters but when we refused to be boxed…….. society created a situation which has led to a lot of burnout and dissatisfaction. It has led to a lot of emotional exhaustion.

Burn out in women physicians isn’t a phenomenon that just their significant others or their employers can address successfully. It’s a societal phenomenon therefore society will have to work to prevent our burnout.

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