What makes you a #bettermother?

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Nope, not a better mother than your neighbor, than your friend, or than the president of your local PTA…but what makes you the best mother you can be?  Going even further than that… What makes you successful as a person?  As a human being?

 

John C. Maxwell defines “success” as:

“knowing your purpose in life,

growing to reach your maximum potential, and

sowing seeds that benefit others”.

 

Very recently I was approached by www.inspiringwomeninsurgery.com to provide some words of advice or encouragement, and while my 4 year old was brushing his teeth at night I thought about work/life “balance”, envisioned a set of scales, and came up with this.

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Why am I a #bettermother because I am a surgeon?  Because I know my purpose in life, I am growing and I am sowing seeds.  I know that this mother may be sad that I miss my son’s soccer practices, but I also know there are lots of other mothers out there that are glad I did… because I was able to help their children in their time of need.  And although my children may miss me at times, I know they also gain valuable lessons from my career – independence and selflessness chief among them.  My children always know that I love them, and they are important to me… whether I am sitting at their bedside, or at the bedside of one of my patients.

And no, you don’t have to be a trauma surgeon or work outside the home to be successful, or a #bettermother.  Again, look at the definition.  Nowhere in that definition does it mention spending every moment of every waking day with your child(ren).  It doesn’t mention making your child’s first birthday cake by hand, or becoming Vice President of a company.  Nor does it mention “leaning in” to the point that you are about to fall over.

YOU are at the center of your success, and you have to give back to yourself in order to be in a position to give to others – whether that is your spouse or your children or your community.

An example for you.  The wife of one of my partners volunteers with her daughters’ Girl Scout troop.  This makes her a #bettermother – not because she spends time in an activity that involves her own children, but because she gives of her time to an activity that gives many children joy when other mothers can’t.  Another friend is a #bettermother because she is a Crossfit addict… She is teaching her daughter that strong is beautiful, and physical health helps build emotional health.

Taking time in activities, away from your family, work related or not, that develop your sense of self, fulfill your purpose in life, and replenish your soul is not selfish.  In fact, it is essential to being a #bettermother and a successful human being.

So what makes you a #bettermother?  Is it the 30 minutes you spent exercising this morning?  Or is it the 2 hours over the weekend you took to train for a marathon?  Is it the overnight business trip in another city that allowed you to present a project that will better your company?  Is it the hours you spend volunteering at your child’s school because other mothers can’t?  Is it that extra time you took at the hospital treating a patient who needed you?  Is it the time you spend organizing a book club giving women the opportunity to fellowship with other women, building their support system?

Success doesn’t require a title, or a degree, or a paycheck.  It requires YOU being the best YOU possible.

So take that time to develop yourself, replenish yourself, fulfill your purpose.

Enjoy it.  Own it.  And snap a photo of yourself doing it.  To keep as a reminder – when you are coming home late, or have 18 loads of laundry piled up, or serve Cheerios for dinner for the umpteenth time that week, or in any way feeling like you are “failing”…that you are, indeed, not.

I am a #bettermother, and so are you.

 

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Here’s to all the Lead Parents, the co-Parents, and the Village it takes to Raise a Child.

I get the working mom dilemma. I am a mother and I work the hourly equivalent of 3 full time jobs. I get it. It’s hard to do it all. And sometimes the tasks involved in either or both are just not that much fun. Though I have never been a stay at home mom I suppose this is why many call this the hardest “job” of them all.  It’s not all coos and snuggles. Parenting can be onerous.

But every time I hear a working mom athem or a stay-at-home mom  anthem I feel sad for everyone who is left out, or worse, by implication, accused of not being able to or interested in parenting. As far as I can tell, other than gestating and breastfeeding, men can do every bit of parenting – the good and the bad, the fun and the tasking, the easy and the hard – that women can. And, just ask any adoptive mom or mom through surrogacy or step-mom and she’ll  probably tell you that those to bio/physiological processes aren’t requisite either. 

To be sure,  I too am guilty of getting caught up in the mob mentality of the “moms have the hardest job in world” even though my husband does the vast majority of parenting in our household.

But, it’s 2016.

We do nothing but reinforce old stereotypes about gender roles with tales of the plights of moms. These are plights shared by all parents. Single parents. Gay parents. Heterosexual parents. Widowed parents. Each person’s role in the day to day tasks of parenting will vary. Sure there are deadbeat dads (and moms!) out there and, without congratulating them on their parenting failures, let’s just agree that the definition of an involved parent will vary based on a number of complex, overlapping factors ranging from natural affinity for children to income potential.

I understand that statistically the bulk of childrearing in our society is provided by women. Social norms, cultural discourse, and possibly some biology are at play in determining this statistic. But, as a woman whose children have been well-reared by a devoted lead parent (who happens to be my male heterosexual partner), four healthy-able bodied grandparents, and a neighborhood of friends who I trust to nurture and admonish my children, it just makes me cringe when a mixed audience of dedicated parents is subjected to a “The Hardest Job is Being a Mom” mantra.

Parenting is hard no matter who does the parenting. It’s also filled with incomparable joys. So hats of to to all the lead parents, to the co-parents, to the moms and the dads, and to the various villages who are doing their best amidst the ups and downs to raise a child in our modern world.

Here is my village. 

  

What Brock Turner, his asshole dad, and a biased judge make me want to scream at my daughter (and my son)!

The internet has been consumed this week with outrage regarding the trial of Brock Turner a varsity swimmer at Stanford University who was convicted of 3 counts felony sexual assault and only sentenced to 6 months in the county jail for a crime punishable by upwards of a decade in the state penitentiary.

Evidently the trial was a classic blame the victim set up by the well compensated attorney hired by Turner’s family who was painted to be an all-American good guy. The jury didn’t fall for it and he was convicted. The judge, however, himself a former Stanford varsity athlete with seemingly similar racial and socioeconomic background, worried about the impact of a longer sentence on the convicted rapist. And so, the extraordinarily light sentence followed was in sharp contrast to what a young man of a different racial and socioeconomic background might expect from our judicial system.

Now twice victimized, first when she was raped and second when her behavior on the night she was raped and her character were drawn into question in a court, the young woman who was assaulted by Turner wrote a powerful letter that galvanized social media followers who were soon calling for the judge’s recall. The convicted rapist’s father countered the letter noting how just ‘20 minutes‘ of his son’s life had resulted in such a detriment to his well-being. He went on to suggest that his upstanding progeny take up motivational speaking on the the topic of alcohol and promiscuity on college campuses rather than taking up space in a jail cell. Not surprisingly, this sent the twitterati into an uproar.

‘Rape Culture’ and ‘White Privilege’ have been hashtagged repeatedly these last few days and I too am enraged. But, I am not here to talk to you about my rage. There are plenty of others who have expressed my thoughts on this brave victim, the entitled brat who victimized her, his piece of shit father, and a judge (no matter how neutral his prior rulings might be) who clearly was woefully imperceptive of his own unconscious bias in favor of affluent white males in rendering a sentence in this case.

I am here to express my grave concern about what to say to my children in response to this.

I don’t want my daughter to have to go through what this young woman went through. I don’t ever want to see her spirit wiped away by the most gruesome of personal violations and to have her reputation destroyed in the process of seeking justice. I want to provide her with wise counsel to protect herself from ever being raped. And by this I don’t mean the scary bogeyman rapist who lurks in the bushes preying on unknown victims; for that she will have a black belt in Krav Maga.  Since the vast majority of rapes are perpetrated by known assailants upon known victims, be they long-term intimate partners or recent encounters on a dance floor, my daughter needs solid advice on how to avoid the Brock Turner types now and in the future.

Wharton Professor and author Adam Grant’s post on Facebook (pictured below) sums up the causes of rape exceptionally well.

 And if these are it, then what can I say to my daughter to not play into the blame the victim stance that is so common in our society? I want to scream at her:

“Don’t ever, not ever, drink a single drop of alcohol, ever no matter what! I don’t care how safe the social scene appears to you. I don’t care how solid a crew your girlfriends promise to be. I don’t care if you are the legal age. You have no idea if and when you judgment will be compromised; and, since the Brock Turners of this world can’t be relied upon to exercise any judgment even when you are sloppy drunk to the point of unconsciousness just don’t let yourself to be vulnerable to the likes of him due to intoxication so JUST. DON’T. DRINK!”

“Ditto for drugs. Don’t expect anyone around you to exercise good judgment on your behalf. They won’t, especially if they are Brock Turner. Got it? NO DRUGS!”

“Don’t dress provocatively. No cleavage. No short skirts. Nothing that accentuates your femininity, NOT EVER! You can read about how rape is about violence, aggression and power rather than about sexual arousal, pleasure, and sex in the text books but in real life I beg you not to do anything that could possibly make you more attractive to the Brock Turners of this world. They are incapable of exercising control over their sexual urges and they will lash out violently and aggressively to satisfy these urges with bodies that are simply more powerful than yours so NOTHING SEXY on that body!”

“Ditto for flirty behavior. I wish a coy remark here or a sideways glance there could be just a fun, arm’s length interaction but to someone like Brock Turner it is like an invitation for sex even if it takes violent aggression to get it. So please DO NOT ACT LIKE YOU ARE ASKING FOR IT!”

“Don’t walk alone. You never know when a stranger is going to assault you. Wait you have Krav Maga for that. What I really mean to scream is DON’T GO ANYWHERE ALONE WITH SOMEONE LIKE BROCK TURNER! Especially if you have not obeyed my prior four rants about drinking, drugs, dressing, and flirting. If you do, you better hope that the non-Brock Turners are randomly riding by on their bikes or their skate boards to save you.”

And here I am seriously teetering on the edge of an unprovoked screaming fit at my daughter because my first reaction is not to scream at my son:

“DON’T BE LIKE FUCKING BROCK TURNER!!!!!!!!!!!”

“Nope. Not ever. I don’t care how she dressed or behaved, or how compromised her judgment may have been for whatever reason, or whatever fantasies have been imprinted in your brain from the media, or how our society tends to treat men and women differently when it comes to matters of power and sex and everything in between. You are better than that. You treat women-all humans for that matter-with respect. You protect those who might be vulnerable, be they male or female, young or old, drunk or sober, black or white, whatever their potential vulnerability may be. You stand up for what’s right and you squash all that is morally reprehensible. You be the guys on the bikes or the boards. You help. And unlike Brock Turner, his asshole dad, and this biased Judge you be the one who sets a good example for all the little boys that follow.”

An Open Letter to Young Women Considering a Career in Surgery

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Dear Young Woman Considering a Career in Surgery,

It was lovely to meet you the other day. Many times a month, a young woman just like you comes to me with similar interests and concerns. “I really love surgery,” she says, ” But I am afraid of the lifestyle and I really want to have a family.”

Oh, and thank you for also inviting me to speak at your seminar the other day on Women in Traditionally Male Dominated Fields. I have been speaking at similar panel sessions since 2005 when I was a bit of a novelty at my training program as a clinical PGY-4 with an infant daughter. Your collective curiosity on what my life must be like is of great interest to me because to me it’s just my life. It’s the only reality that I know because, like you, I was young (just a few days into my 25th year, just 5 days into my first ever surgical rotation) when it occurred to me that I really loved surgery. It was unexpected; but every day since then (from the remainder of that MS3 rotation, to my sub-internships, to my years in residency, to research and clinical fellowships, and to these past 6 years on staff) I have crafted a reality, as tenuous as it is, that works for me and my family in any given moment in time.

And I am here to tell you that you can do the same too if you, in your heart of hearts, can think of nothing more exciting than surgery as your professional passion.

People outside of surgery will tell you that it’s a career that is too hard to integrate with family life. They are correct that it is generally harder than other fields in medicine; but, ask yourself if you truly want a career in general pediatrics, or dermatology, or invasive cardiology or anything in between. If the answer for whatever alternate field(s) you are considering is no, then no matter how many fewer hours your profession requires, no matter how much more flexible those hours may be, your family will be left with a present, well-rested, yet bitter wife and mother.

[NB: I use the word integrate very purposefully here. Anyone from a demanding profession, surgery or otherwise, who tells you that work-life balance is possible is conning you. Your life will never be in balance. Something will always have to give: your work, your family, or yourself. It’s in how you integrate these things in a shifting, fluid professional and personal lifetime that you will craft your own reality.]

 

The same can be said of those who encourage you to enter surgery training but then offer that you may consider a career in breast surgery or start an exclusive vein clinic or choose some other presumably less time sensitive and/or less time consuming surgical practice to balance your professional work with your desire to have a family. Again, ask yourself  if you can truly be happy in such a practice. (I personally would be bored with only a few kinds of procedures in my armamentarium and the absence of physiologic chaos; but everyone is different.) You may not know the answer until you are well into your training; but, choosing a medical specialty in the first place, or a surgical subspecialty in the second, simply because you presume it will be easier for family life is fraught with potential for professional dissatisfaction. I promise you that professional dissatisfaction will always stand in the way of overall family life satisfaction. Always. Forever.

Finally, as hard as it might be to envision yourself as a surgeon who wants hobbies, and a spouse, and a smoking hot body, and children of your own someday,  remind yourself that divorced parents, widowed parents, disabled parents, parents with deployed military spouses, and parents with far fewer socio-economic resources than practicing surgeons, and trainees for that matter, somehow get it done. Every life has it’s particular challenges when it comes to parenting but surely being a surgeon is not the most insurmountable of them all.

So think long and hard about alternatives to surgery; but choose one only if it speaks to your professional soul. No matter what career you choose, you will likely spend more time at work than on any other aspect of your life be it parenting, self-care, love-making, you name it. Therefore, it is critically important that your choice of career light the fire in your belly to show up every day leaving behind, at least temporarily, everything else including your children. Because one thing is for sure: when you are practicing surgery, your head needs to be in the game. You cannot be distracted by guilt about not being with  your family or about delegating some of the more mundane aspects of childrearing or homemaking to others. You must love the work enough to drop the guilt and create practical solutions to raise your children and provide them with a safe and loving space in which to grow while reimagining whatever stereotypes you hold about being the perfect parent.

Because you know what: There is no such thing as a perfect parent, surgeon or otherwise. So there will never be any point in beating yourself up about it. Know that you will love your children more than you could have ever imagined loving anything, including surgery, but that you will still be a great surgeon. The two are not incompatible, but it takes some effort and creativity.

So, now that I have convinced you to choose the career of your dreams here are some thoughts on the effort and creativity it will require.

Do not underestimate the importance of choosing a life partner who gets the soul inspiring nature of your career choice. He/She may be another surgeon, or physician in another specialty, or a non-medical professional, or a skilled laborer; it doesn’t matter as long as your life partner understands that, when you are tired from the long days and nights, or sorrowful for the lost lives, or otherwise distracted, it is not because you love work more than you love them. Bottom line: as awesome as any career may be there is something messed up about your priorities if you really would choose work over loved ones. So your life partner needs to get that you aren’t messed up; you just have a demanding career.

With the demands of that career comes the need for a real partnership in planning life. That doesn’t mean a 50:50 split or a 80:20 split or anything conscribed; it means a constant openness to splitting however it needs to be split or not splitting at all to ensure that life outside of work happens. It means making the most of precious few waking moments together through physical contact and communication. It means having a very user friendly calendar/shared to-do system. It means providing feedback without judgment for the practical things in life and making space for shared emotional and spiritual needs. If you find yourself paired up with someone who can’t work with you on life this way, then consider dumping him/her. Seriously, it’s not worth trying to make them happy if they just don’t get this hugely important part of what makes you whole.

[NB: If a life partner is not your thing or things just don’t work out, that’s okay. The same principles of reimagining, outsourcing, and dropping the guilt apply. It’s just that your village, or metropolis as may be the case for some surgeons, has a different population structure.]

 

Choose your job based on both professional and personal needs. Training is finite and there is always an end from which to take on a new direction. However, even though many surgeons change jobs, think of your job as your forever job so you don’t accept a situation which will turn out to be toxic for you. Choose partners who will have your back, and you, in turn need to be willing to have theirs. Choose geography that at least satisfies some of your desires for commute time, distance from extended family, lifestyle, weather, etc. and makes life easier. You can’t blame surgery if your long commute destroys your soul, or if having your parents thousands of miles away makes you sad, or if humidity, piles of snow, or whatever your most dreaded weather phenomenon is drives you crazy, or if it takes a flight to get to your favorite past time of hiking, biking, skiing, etc. That’s on you and the choices you have made as a surgeon and not on the profession itself. Finally, choose a practice type and setting that will make you excited to show up every day (for me it was research, teaching, and a level 1 trauma center in a university based system).

If you do have a life partner and working is important to him/her, don’t pick a location that will railroad his/her career. As much as being a surgeon defines you, your soul mate is similarly defined. Please don’t create a situation where he/she will be susceptible to resentment about having his/her professional goals squashed. (I’ve been there. It puts a real strain on a marriage. It sucks.) It’s already hard enough to be paired up with you, a surgeon. Both your jobs may be equally demanding, or one may be more demanding; it doesn’t matter as long as together you negotiate a mutually satisfying life-long give and take about who prioritizes what and when depending on the stages of your respective careers and the ever evolving needs of your family.

When is comes to family, do not waste too much mental effort over-thinking when you should start it. Fertility, along with finding the right person with whom to test your fertility, is a complex and unpredictable thing. No pregnancy is guaranteed to proceed smoothly. Given these inherent limitations and unknowns, along with the demands of a surgical career, there is no perfect time to start a family. This is about as certain as death and taxes. I will spare you the perceived pros and cons to having children during training compared to while in practice. Just know that every time period poses challenges and every passing year makes infertility more likely; so if you are ready in your personal life to try to get pregnant go for it; because, if you choose to wait for a perfect time, you will be waiting for a very, very long time.

And, if having children in a traditional sense is not possible for whatever reason, there is also no perfect time for assisted reproduction, adoption, or surrogacy either even though the salary increase a staff surgeon or faculty job may be necessary for these options. In the end, whatever approach to becoming a parent will be required,  you will figure out a way to get through the challenges because you will have mentally and emotionally committed yourself to the idea of being a mother who also happens to be a surgeon.

[NB: If you choose to not have children-by this I really mean choose as there are myriad other mishaps of life and physiology that prevent women who want to be mothers from becoming mothers-, please do not make that choice simply because you want to succeed as a surgeon. You will never forgive yourself. Not ever.]

 

When it comes to family there are various options to manage childrearing and homemaking. A nanny, two nannies, an au pair, daycare, a nearby grandparent, a neighbor who is a stay-at-home parent, or various combinations of these may be required to keep your children loved and safe. It’s different for every family and I promise you that you will find what works for  you. It will be a source of stress but it is doable. And, no matter how much time others spend rearing your children on your behalf, those kids somehow know that your are their mother, that you love them in a way beyond any other love, that you would give your own life if it would save them, and that you also happen to be a busy surgeon. Trust me. They will. And, they will be really proud of the uniqueness of their surgeon mom. They really will.

When it comes to your home, be it your 600 sqft rental in residency or your 2500 sqft grown up home in a cul de sac, outsource any jobs you and/or your partner simply do not enjoy. I cannot emphasize this enough. You will, in fact, have precious little time with your family. Ask yourself how you want to spend that time. Do you want to being cleaning and doing laundry? Or do you want to plan a family outing? If hopping on your John Deere and showing your lawn whose boss on your Saturday off is a fun activity for you, then by all means go for it, otherwise someone else will be happy to mow your lawn for a fee. If you love cooking, knock yourself out planning, shopping for, and preparing gourmet meals along with the associated clean up, but if you don’t then find a meal service. You get the point. If you don’t love it and it can be done by someone else outsource it. Even on a trainee’s budget you should strive to rid yourself of any household obligations you abhor. (For me the $55 spent every other week during residency for cleaning was well worth never having to spend a day off cleaning a toilet and now the extra hours we pay our nanny to do all of our laundry has spared me a monthly power weekend of washing and folding 10 loads of laundry because we just could not get to it all with the many kids’ activities, call nights, etc. that prevent daily washing.)

Remember: as little time as you will have at home to spend with family, you must also prioritize time for yourself. Don’t expect it to just happen. Just as you schedule elective OR cases, you must schedule elective you time. It may not happen very often but if you don’t take the time for self care in the midst of the stresses of the job and the stresses of parenting you will be cranky and miserable to be around. How you spend time away from family when you have so little time with them will change over time and you may even develop hobbies incorporating your family (we have taken to family bike rides and kayaking trips as the kids have gotten older to combine wellness with family time) but remember to schedule things that feel completely selfish to you. A girls’ night, date night, a pedicure, reading a trashy novel, going to a Zumba class during bath/bedtime, or whatever you enjoy is totally not selfish but you will feel that way; so a good barometer for whether or not you are making time for self care is how selfish it feels. My advice is feel selfish at least once a month.

[NB: If your selfish thing is not a fitness thing then you have to also figure out how to fit that in because your patients and your family need you to be healthy.]

 

Being a surgeon is not incompatible with being a good wife, mother, athlete, whatever else; it’s just trickier. But, if young women keep being scared away from surgical careers then these same fears will linger generation after generation; we will never achieve a critical mass of women surgeons in the profession who can set good examples for one another and for future surgeons. With the same focus we apply in the OR and the same organization we bring to rounds and the same compassion we bring to patient encounters, we can create a life strategy that overcomes these perceived barriers for both a happy family life and a successful surgical career. The barriers will change depending on the stage of the career you love so much and the needs, wants, and development of what and who you love outside of work; but, take it from this surgeon mom: they are barriers to be overcome, not shied away from.

I am pretty sure that’s why you showed up at my door and asked me to that seminar, to make what seems impossible to you at the moment seem possible. Let me tell you: if I can do it, you can too. Go forth, be a surgeon, be a wife, be a mom, be good to yourself and craft a reality that works for you. Then, pay it forward so that someday these meetings and seminars might be rendered obsolete.

Sincerely,

@surgeoninheels

Not just a token surgeon-mom-wife-runner

PS. Here is some inspiration. Your potential in surgery is limitless. https://www.womensurgeons.org/in-practice/leaders-in-surgery/

PPS. The Association of Women Surgeons is an invaluable professional organization whose goal is to: ENGAGE current and future women surgeons to realize their professional and personal goals. EMPOWER women to succeed. EXCEL in those aspirations through mentorship, education and a networking community that promotes their contributions and achievements as students, surgeons and leaders. https://www.womensurgeons.org/

PPPS. I have been fortunate for the last 10+ years to be a part of the American College of Surgeons Women in Surgery Committee working towards improved gender parity, opportunities for professional development, and better work life integration in our careers. https://www.facs.org/about-acs/governance/acs-committees/women-in-surgery-committee

An Ode to the Minivan – “Gin and Juice” Version

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I blame my husband.

We had a lovely still “cool” looking Yukon Denali to which I just had to say “goodbye”.  Why is it my husband’s fault you ask?  He’s 6’6″.  And, well, because we found out last week that a car seat will not absolutely, positively, in any way, shape, or form, fit in a seat behind my husband while he is driving.  This would then relegate my three year old to the third row meaning someone (me) would be required to gracefully (insert eye rolling emoticon here) climb back to the third row every. single. time. to buckle him in and out of said car seat.  Oh and yeah, say goodbye to any cargo space for anything other than an umbrella stroller.

Fast forward to two days ago, when my husband walks into the minivan dealership and loudly proclaims,”This must be what a dog feels like on his way in to get fixed.  You guys got accessories?  I mean, if we are going down, we are going to go down fighting!  Chrome wheels?  No?  How about 22’s?”.

For real, peeps.  This happened.  So, we are now the semi-proud owners of a new Honda minivan.  But in keeping with the chrome 22’s theme, I have set the Ode to my Odyssey to the tune of that ever classic, ever catchy tune, Snoop Dog’s “Gin and Juice”.

Enjoy.

 

Rolling down the street hauling 6 kids sipping on their boxed juice

Laid back

With my mind on my ‘mini and my ‘mini on my mind

 

With so much drama in the S-U-V

It’s kinda hard being a mom to at least 3

But I somehow, some way

Keep climbing into the 3rd row like every single day

May I, find a better something for the kids

And, make it easier for me to breeze through

Grocery shopping and car seat swapping cause my hubby ain’t home

I got too many kids just piling junk on

And they just keep bringing more of it home

So, what you wanna do, sheeit

I got a car full of strollers and my homegirls do too

So get me a van with sliding doors

But (but what) they don’t look cool and so?

So we gonna trade my Yukon for this

Mommy up, get excited, let’s all bounce to this

 

Rolling down the street hauling 6 kids sipping on their boxed juice

Laid back

With my mind on my ‘mini and my ‘mini on my mind

Allowing myself to just be deserves accolades, not guilt

I am always telling myself to not be one of those bloggers who gives a play by play of his or her day. I prefer to blog about fun things or things from which I derive meaning and I hardly think that anyone gives a rat’s ass about what I did and when so fair warning:

THIS IS A POST ABOUT WHAT I DID YESTERDAY.

I woke up even earlier that I do when I feigning to be morning exercise person to get my daughter to a 6:30am arrival for a field hockey tournament 70 miles away. 4am is brutal for mom, for the tween player who now routinely sleeps until 10 or 11am on weekends, and for the sad sap of an 8 year old brother who needs to tag along since dad is away on a much needed and well deserved guys’ weekend. Of course I am chronically fatigued and it’s nice now that the kids are older that I can use the weekends to catch up on sleep. So to have this privilege stolen from me for a sporting event deeply hurt me but parenting wins so there I was driving 1 hour and 20 minutes each way. The kids both slept in the car both ways. I jacked myself up with caffeine hoping not to become a statistic we trauma surgeons like to study on driving and fatigue.

When we got finally got home at midday I was exhausted. Despite the caffeine coursing through my veins I could not keep my eyes open so I stumbled into a sleep on our ever so cozy sectional. But it was a broken sleep. I refused to simply go up to the bedroom and just give in completely to the tiredness. Nope, I kept hoping that I would soon rise and have a productive day. You see, after several years of working on work-life integration, I am still having a hard time with simply relaxing. I am so trained to think of it as lazy and unproductive that when I do nothing in particular (or choose to sleep rather than doing) I feel an enormous sense of guilt and failure.

In between my fits and spurts of sleep I was thinking:

The house is a mess. (I should be tidying up!)

There are multiple loads of laundry to be done. (I should be washing and folding!)

The kids are somewhere in this house fighting boredom. (I should be playing with them!)

The work to-do list is out of control. (I should be tackling whatever I can remotely!)

There are thank you cards to write. (I should be putting pen to Crane’s paper!)

The Kindle is filled with newly downloaded e-books. (I should be reading!)

My ass is getting fatter as I lay here and the sun is shining. (I should go out for a run!)

I woke up at dusk. I felt like kicking myself for these myriad failed opportunities to get stuff done, to be a better wife (who helps around the house every so often), to be a more engaged mother, to utilize any one of the 7 habits of highly effective people, to take care of myself.

Argh! The self-loathing was quick and sharp.

Later on, once the kids had made sure I ate and stayed hydrated (their dad has trained them well) and had headed to bed (after showering and reading to themselves)* I took the dog for a nice long walk feeling the need to pad the mere 1k steps I had accumulated up to that point since my daily target is 10k. It was a serene and beautiful night. There were no cars zipping by. No sound of Lifeflight that is frequently overhead. No other dog walkers even. Most lights in the neighborhood were off on the eve of returning to school after winter break.

As I was retelling myself all the failures of my day and tryinng to forgive myself, the peace and calm of the night got to me. It occurred to me that I surely deserved some peace and calm with all that I do day in and day out, at home and at work (okay, fine mostly at work!). It turns out that a perfectly calm and peaceful night was a fitting ending to a day of rest that I unintentionally engineered for myself despite all of my intentions (including with this blog) to take better care of myself. I deserved accolades and not self-flagellation. And so I tacked on 4k steps dropping a little more guilt with each stride, congratulating myself on a job well done, not for being lazy but for successfully allowing myself to just be. 

Today, I can see that it helped recharge me for the household chores, unending work obligations, needy family, and self-care that are still there today waiting for type A, get-the-job-done, me.

[*NB: It gets better as they age, I promise. I miss the cooing and burps and smiles of my babies but I sure do appreciate their self-sufficiency on these lazy, ummmmm restful, days.]

 

Can this child learn emotional awareness?

When I talk to surgeons and other trauma care providers about burnout, I tell them that the first step avoiding the emotional exhaustion, depersonalization, and a low sense of personal accomplishment characteristic of burnout is to be emotionally aware. I make my audience stare at an empty black slide and ponder their emotions to explore how those emotions are impacting their impression of their day, their reaction to my talk, their distractions.

By the end of the talk, most in the audience know that the surgeon who flips out and throws things in the OR is not emotionally aware. The surgeon who goes home and gets into a fight with his/her spouse over some totally minor household to-do item because he/she had a long day and someone died and the work to-do list is getting out of hand is not emotionally aware. The surgeon who turns to alcohol or drugs to get through his/her days/nights is not emotionally aware.

And it occurred to me, as I was still reeling from and strategizing about what to do about our son’s recent behavioral issues, that my 8 year old has no emotional awareness. Whether it’s about brushing his teeth before going to bed, or wearing long pants when the temperature is below freezing, or losing a board game to his sister, anger and frustration drive his immediate response. Though the response is the opposite when he is excited about something, the effect is the same. His boisterous enthusiasm about getting picked to use the iPad in class, or lining up to see the neighborhood haunted house, or getting the gift on the top of his wish list under the tree on Christmas morning results in disrespectful acting out.

Whether he behaves like an angry petulant child or a boisterous obstreperous child, his emotions, in the absence of any emotional awareness, are driving him. I say “he behaves” rather than “he is” because I am convinced that he’s a balanced kid on the inside. He just needs to become emotionally aware and behave in a way that is safer and more socially acceptable. So here is what we have done as parents to move toward a more emotionally aware child.

We don’t ignore the minor transgressions. It’s easy as parents to zone out on the cacophony of kids. But now, when we hear a cupboard slam (because his favorite cereal is out) or perceive a wrecking ball to a lego structure (because it just wasn’t coming together the way he wants), we remind him that this is the kind of behavior we are now discouraging. If he learns to manage his emotions with the little things, he will be more like to do it with the big things.

We are talking a lot more about feelings. When he acts out or appears as if he is about the act out, we bring him to a full stop and have him verbalize what he is feeling, what is driving him. Often he does not know, but having him pause is helpful. And if he can put his finger on it, giving him the chance to bounce his feelings off of us validates his emotions while reigning in his destructive responses.

Now that he is aware that he has a physical response when he is frustrated or disappointed or angry he can work on ways to contain he outward behaviors. We have taught him how to slow down and take deep cleansing breaths when he feels his emotions getting the best of him. If we are near, his slow deep breathes are enveloped by a giant loving bear hug. If we are far, he squeezes a stress ball which he can find in his back back, or desk at school, or in various places in our home.

While these reactions in the moment are important, our son needs to learn a more constant sense of emotional awareness. Therefore, we are finding calming activities which had been increasingly absent as he grew into boyhood. My son now spends much more time coloring “adult” coloring books, working through origami, sewing, crocheting, balloon sculptures, and gimping. He was forced into these activities nearly full time during a 34 day period of “house arrest” following his misbehavior on the eve of Halloween. Putting his hands to work in a quiet, non-competitive way has been incredibly effective in allowing him to remain calmer, more centered, more contemplative when his is back to playing with his buddies.

Meanwhile, our newest adjust is practicing mindfulness and meditation via several apps we are currently sampling. It’s been 3 months since the epic transgression leading to our son’s loss of Trick or Treating. We are proud of his progress so far. We are proud of our progress as parents of a child who can, in fact, learn emotional awareness.

We are simultaneously monitoring our own emotional awareness with higher acuity. Whether the stressors are at work, or from a spousal disagreement, or related to raising an 8 year old, we are hyperaware that how we manifest our anger or frustrations influences what our child feels is acceptable. Therefore, we are challenging ourselves more than ever before not to fly off the handle but rather to be the kind of emotionally aware, present parents our rambunctious young man deserves.

 

 

Sometimes being a parent is hard (aka we took away trick or treating)

I am sitting here on a plane crying. I just don’t feel like leaving my son today. 

He is 8 years old. He is generally a good child. He does well in school. He devours books. He enjoys math. He is just as likely to break into dance as he is to play.  He is obsessed with all sports and loves memorizing stats and reading biographies of famous athletes past and present. 

He studied every detail of Roberto Clemente’s life story and picked this as his Halloween costume. He was so excited for weeks as each piece of the costume arrived. 

My son is outgoing  and has always been the boisterous one in the crowd. He has lots of friends. So of course he was over the moon excited to go out with them in his costume last night. 

Whatever our criticisms of Halloween may be (it’s a made up holiday, it encourages unhealthy eating, it exemplifies our society’s socioeconomic divides, getting dressed up in costume is just stupid…) the thrill of kids on this day (before they hit the sugar feuled meltdown anyway) is a joy for parents to witness. 

And last night my husband and I had to deny my son that experience. He will grow up some day and may read this and so I will be purposely vague on details here. And I know he already feels so bad.  But, suffice it to say that his behavior the last few weeks in terms of respecting others has been deficient. The poor boy feels terrible afterward each incident buy can’t seem stop it from happening in the first place. We have had three episodes of disrespectful behavior in as many weeks. 

Despite his obvious remorse for his most recent transgression, we couldn’t just let life go on as usual. He needed to be sternly punished. So we took away trick or treating. He sobbed in his room for hours leading up to the evening. He paced the yard while all the other kids came to trick or treat at our door. It was a tough night for him though he finally did settle down to enjoy a neighborhood party we hosted afterwards. Still the heartbreak in his eyes when the other kids were trading their candy was hard to witness. 

It was so hard to stick to our guns yesterday.  And today, when I walked by his open door and saw his uncovered pillow since he had taken off the pillow case first thing yesterday morning for his candy bag, I just lost it. Now I was the one sobbing while he was calm and introspective this morning. 

Today, he did not seem mad at us anymore. He expressed understanding of why we did what we did and what he needs to work on in the coming days, weeks, and months to regain our trust. But my heart was still breaking for having robbed him of that stupid made up experience that would have made him fat and rotted his teeth. 

It was an appropriate punishment but I still feel awful. As I fly away with the poor guy in seat 21B wondering why I am sobbing, I feel awful that my typically rambunctious yet sweet boy is acting out. I feel worse that I won’t be spending the next few days with him to help him sort through his feelings and strategize about how to behave better from now on.   

Whatever parenting pride I had yesterday that we stuck to our guns and rendered a swift and appropriate punishment is gone now, replaced by the emotional pain of a really hard moment in tough love parenting. Hoping this feeling and my son’s misbehavior will be a thing of the past soon.  

  

Musings of a Surgeon Mom with a Febrile Child

Oh poor thing. She has a fever. Look at her. Wet rag curled up on the couch already because she was too congested to sleep while supine. 

Yikes. I contemplate regular life in medical terms. Did that happen?!

Crap! It’s 6:30AM. I am already late for work. Ugh. Why did a choose a career that will forever me no sleeping in?!

But I should probably acknowledge my poor sweet sick baby before a run out.

Huh? Interesting the fever has knocked the tween angst right out of her. No attitude whatsoever. Just a sweet but needy girl.

{feeling her forehead}

Oh no. She’s on fire. Brain is probably too hot to mount an attitude. Now I feel bad for liking her lack of attitude for that moment.

I should probably take her temp. Wow this infrared thing is so cool! I wish they had this when I was a kid. I hated keeping quiet with a thermometer under my tongue.

Keeping quiet is not one of my strengths which paradoxically might have ended up being a strength in my career.

Eek. Her temp is 103.7. What’s that in Celsius again? I can’t actually process information in Farenheit anymore. It must be close to 39. 

Anyway, I should engage with my sick child before I tend to that career. Maybe she needs some anti-pyretics. Thank god we know about Reye’s Syndrome now. I am sure I took aspirin as a kid.

Whatever. I am an adult surgeon. Why am I thinking of Reye’s Syndrome right now? We don’t even have any ASA in the house. Thankfully no one is old enough and our arteries are presumably clean enough to hold off on cardio protection for the moment. 

“Hey. How are you feeling?”

“Awful.”

“Where does it hurt?”

“Everywhere.”

Crap. I hate viral fevers. Right lower quadrant pain and I could help my baby. There would be a clear solution and in a day or two she would be as good as new. 

I was about the same age when my appy came out. I have a gigantic scar now what with the hypertrophic scar tissue and the pregnancies stretching my skill. Damn babies. She has lighter skin than I do so maybe it won’t happen to her. And she’d have a much smaller scar now since there is laparoscopy. 

But it doesn’t matter since clearly she does not have an appy. I do love doing appys. Such fun little cases for the most. People typically feel better after surgery than worse. Definitely feel good surgery. 

But no my kid can’t be fixed with surgery today. Instead she has that full body malaise that comes with viral fevers. That I have been hit by a truck feeling. 

Well, actually come to think of it, I fix people who have been hit by trucks too. No help here too. 

So bummed. Cannot fix my sad, to sick to mount an attitude kid today. 

And, I can’t even stay with her today.  Nope instead I need to run out that door to tend to other humans instead of tending the one I gestated for well over 9 months. Yeah. She was giving me tween push back from the womb in retrospect. 

It’s a good thing I have a dedicated lead parent to snuggle her today. To call the school today. To tell his boss he can’t make it in because his child is ill. 

Not something I can do today. Or tomorrow.  Or any day this week. 

Crap I better not get sick now that I touched her. I cannot get sick. Not this week. Too much to do. I am on call. It will be a disaster if I have to work in viral turmoil. Sure I have rounded and operated with IVs in and snuggled with biohazard bags and emesis basins in between trauma activations. But really this week I need not acquire this viral illness. I. Just. Can. Not. 

Crap I am late. 

“Bye. I love you. I’ll see you in a couple of days.”

{A tear runs down my right cheek.}

Lead parent sent me this photo of her later in the day. Still on the couch. Finally able to snooze. My poor sick baby who I didn’t help today. 

 

1 (usually growing) reason why every single man in America should care about maternity leave

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You all have prostates.

Seriously.  But let me explain further to those people who simply can not fathom as to how a woman could dare ask for maternity leave and expect her other team members to “pick up her slack, because she chose to get pregnant”.  (yep, check the comments section on my last post here, pretty entertaining, in fact!)

Life happens to everyone.

If my profession as a trauma surgeon has taught me nothing else, it has taught me this.

“Life happens to everyone,” and unfortunately, a lot of “life” isn’t pleasant.  Car accidents, strokes, heart attacks, broken legs, and ill family members are just a few examples of life situations that happen to everyone, whether or not you have a uterus.  And guess what they all have in common?  A need for time off of work.

Now, the distinct disadvantage here is that women usually need a set block of time off for maternity leave that seems relatively long (to some, at least) and at an age where they are usually young and healthy, but let me tell you gentlemen, people are going to be covering for YOU when your prostates need to come out and your coronary artery needs a stent.  No, you may not need 12 weeks all at once, but, between doctor’s appointments, procedures, recovery, and complications, or at some other point in time in your life, you are going to need significant time off of work, with your partners/coworkers/etc. chipping in and helping out.  And, oftentimes without the 6 month’s notice that your pregnant colleague is able to give.  And guess what else?  That is OKAY.  That is what life is about – building relationships and working in teams to get the job done, even if someone is having a bad day, a stroke, or a baby.

Oh, and just as an FYI, let’s just say you break your leg while skiing and you need at least 6 weeks off of work… I don’t think people will judge you and say that went skiing and break your leg – accidents happen.  So being judgmental and saying that every woman chooses to get pregnant is pretty inane.  You chose to go skiing, she chose to have sex. Get over it.

Maternity leave = family leave. (Or, hopefully will equal family leave at some point soon in the future.)

I have to admit, I was blown away by the responses I received on our blog, through FaceBook, Twitter, and even my own personal email from my last post.  Women from all walks of life shared their stories, and overall, as Americans, and as humans, we should both be encouraged and appalled.  Some female physicians wrote how supportive their partners were, but as a group, would have to sneak around HR to get her time off.  Some women went back to work in less than one week to preserve their family’s income and sometimes their job.  Office administrators refusing to allow 15 minutes breaks for new moms to pump breastmilk.  A new mom, forced to use a surrogate, being allowed zero time off because she wasn’t actually birthing the baby herself.  The stories unfortunately go on and on.

Yet, the stories of finding support from male coworkers was encouraging.  And, I do think most men and women without children also, absolutely see the value in family leave – whether it is paternity, maternity, sick leave for themselves or to care for an ailing family member.  Bottom line, every single one of us is going to need time off of work, expected or unexpected, and we are all are going to have to rely on each other, and a system to help us out.  Unfortunately, for most of us, that system does not yet exist… and at the end of the day, we can do this better – for ourselves, and each other.