Tag: working mom

COVID, finally

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Well, after 2+ years of avoiding COVID-19, we finally all got it.

It started innocently enough. My husband had an intense work week pulling all-nighters. That Friday evening, he started to cough. I reflexively antigen tested him and it was negative. “Must be sleep deprivation,” he concluded. Pro tip #1: antigen tests are crap.

The next day, he began to have symptoms of a gout flare. One of his feet swelled up and he was fairly immobile. Still had a bit of cough and was more tired than usual, but a repeat antigen test was negative so we chalked it all up to gout. Gout and sleep deprivation.

Sunday night he experienced chills and I began to have a slight cough. I was still coughing the next day but otherwise felt totally fine and I myself was now antigen negative (and he was STILL negative as well). However, by the end of my morning clinic, I began to feel worse. Muscle achy, runny nose – just generally unwell. So I drove myself to occupational health for a PCR. I needed to know for sure before going back in the next day for a full day of clinic. (Of note, I still wear an N95 mask + surgical mask + eye protection in clinic and was wearing all of the above when I saw the few patients I did that morning.) I decided to pick the boys up from camp early just in case. But, it turns out that I left my lights on when I parked the car, so when I came back to it after my test I couldn’t turn it on!

I had to call my husband to pick me up and deal w/ the dead battery while I went to pick up the boys and relieve or nanny. Truthfully, I was most worried about our nanny. She is vaccinated and boosted but also pregnant, and I was most concerned about her and her baby. More on that later.

When I finally got everyone home, I felt terrible. I took ibuprofen right away and lay on the couch. My husband made me soup. We somehow made it to bedtime and that’s when I got the result: positive PCR. Crap. I contacted our clinic manager to cancel all of my clinics for the week. I told our nanny to stay home and monitor for symptoms. I reached out to the kids’ camps and told them they would be staying home due to COVID in the family. Interestingly, the policy is that kids with a home exposure can still go to camp (and I definitely knew of two moms who had COVID who were still sending their kids to one of the camps), but with two positive parents, I knew we wouldn’t be able to isolate. I had also decided that we weren’t even going to try. This was probably a gamble on my part, and maybe a risky one since we did have two unvaccinated kids at the time (under 5), but I didn’t want to start a game of domino COVID, whereby we’d have one kid at home at any given time, with no childcare since we wanted to protect our nanny, meaning an even longer work disruption than just two weeks.

The next 2 days were rough. My husband started feeling like crap. Not only did he definitely have COVID (he kept testing antigen negative until I finally had him confirm on PCR and that was positive), but he had a gout flare that was so bad (TWO feet affected) that he couldn’t even walk. I can laugh about it now, but it was a rough few days. Four kids 7 and under at home with only one parent who could physically participate in caring for them, and that parent (me) had fairly symptomatic COVID. My symptoms were fever (to 102.8), sore throat, runny nose, muscle aches/pains, fatigue. But, we somehow made it through those 2 harrowing days. The kids started to develop symptoms and/or become antigen positive in close succession. Everyone was positive by the end of the week. Our unvaccinated kids had the most symptoms: 2 days of fever. One of our vaccinated kids had a sore throat and one night of fever. One of them coughed twice and a had a slight sniffle, but since we were waiting for it, we tested him and it was positive.

The days were a bit of a slog. My husband took off most of the first week and even during the days when I felt like crap, I tried to get the kids outside for a bit. We could only frequent places that were outdoors, where we were guaranteed to not be close to other people. I’m sure for the kids it was quite the adventure – both parents at home, unstructured time, a loosening of rules, exploring new outdoor spaces. I’m sure one day I’ll look back at the time with rose-colored glasses. But right now I’m finding myself under a mound of work – actual job and life – with little time to catch up since I had to add so many clinics back to make up for 2 weeks of lost time.

Pro tip #2: once positive, the antigen tests take forever to become negative. I wish someone had told me this. The rules for work and camp are 5 days of isolation and you can test out after 5 days if your antigen test is negative. So like a crazy optimist, I antigen tested everyone after day 5. Well, no one was negative even close to day 5. Myself and at least one of the kids were still positive by our respective day 10s. I finally went back to work on day 11 (no further restrictions and I was obviously masked and finally positive). The kids returned to life the following week. But, wow, that was a crazy long time of disruption in our family.

And here’s the thing: the reason COVID is going around life wildfire is that no one is keeping themselves and their kids home for 2+ weeks. It was honestly really hard, and we are fortunate to have flexible jobs that allowed us the time off. But we also lost out on thousands of dollars of childcare those 2 weeks between kid camps and in-home care. That’s a lot of money. And if your employer isn’t going to give you paid time off, what option do you have? And remember, the kids were only symptomatic for 1-2 days. 2 weeks is a lot of lost time for 1-2 days of symptoms. So I imagine there will be some changes to the rules down the line – maybe now that the under 5 vaccines are approved?

Pro tip #3: if someone in your life gets COVID, don’t ask them what they need – just send them something you think they might need or want. Prior to us having COVID, I would ask my friends who were diagnosed with COVID what I could send – a meal? toys for their kids? other? Without fail, everyone said thanks and nothing. I did the same thing when we all got sick. But the sweetest surprises were from people who didn’t take no for an answer and just sent something – a lunch delivery, a homemade dinner, a sweet treat, toys/activities for the kids. The novelty of these thoughtful tokens was enough to turn an otherwise ordinary day into something special. And the feeling of being loved was overwhelming.

So now, I’m happy to be on the other side. I spent so long being so afraid of COVID, and now that’s it gone through our family I feel a sense of freedom/peace. Although I also recognize that this is fleeting because immunity post-infection does not last forever. I also feel incredibly grateful that our children were minimally symptomatic and have no long-term symptoms. Despite the adults having a bit more symptoms, we also fully recovered. And I will be forever grateful that our pregnant nanny did not get sick.

End of an era

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I feel a huge sense of relief and a ton of positivity this week. Where do I even start?

Obviously there was the inauguration. I have never been a political junkie. My parents came from a country where there was a military coup during their lifetime, all books with dissenting political ideas were burned at their universities, and friends and acquaintances were taken from their homes in the middle of the night and murdered for having dissenting political opinions. Because of these reasons, my parents were always largely apolitical. We never put out yard signs, protested as a family, or watched States of the Union, inaugurations, etc. I myself have adopted some of this trepidation around openly expressing political opinions – especially in my role as doctor. We are so divided as a country that it seems so loaded to me to bring up politics or, more commonly, to respond to a patient’s comment on politics. But lately, due largely to the impact of social media, I have begun to wonder how much of my reticence to discuss politics comes from a place of privilege. I’m an immigrant who has been a citizen of this country for decades longer than I’ve lived outside of the country. I’m White passing, gender normative, heterosexual, educated, financially comfortable. So I have been trying to step outside of my comfort zone to be more vocal in order to advocate for others. And also, to be honest, because the events of the past four years have been disturbing beyond words – so, so, so much worse than anything I could have ever envisioned in November of 2016.

But now, there is hope. And yesterday, I sat with my two older kids and replayed some of the performances and speeches from the inauguration. The kids celebrated it at school. And I breathed a sigh of relief that my older children, now 4 and 6, would have memories of a President who is decent, humble, honorable and a good human being.

Second: this is my last week before heading back to work. I have a lot of mixed emotions regarding this. I think: this is the last time I will ever have an infant. The last time I will ever hold someone for every nap during the day. The last time I will ever spend so many hours per day, every day, every week, with one of my children. I feel a sense of nostalgia about this moment, but not necessarily sadness. As my husband likes to joke, we have done this four times – and that’s plenty! I am also looking forward to this next phase of my children growing into adults. I already see changes in my 6 year old – bigger worries, harder questions, the ability to read and digest actual novels (he is currently reading the second Harry Potter book). He is losing some of his child-like innocence.

To be honest, being home with four children 6 and under is a lot. As I always say: being a stay-at-home parent is MUCH harder than being a working parent. Yes, work is demanding. Yes, it adds a full-time job on top of full-time responsibility. But work allows you to tap into the essence of who you are. A lot is lost in motherhood – hobbies, memories of who we were pre-children, meaning outside of these small humans. For me, working is a way to hold onto a crucial component of who I am. I’m able to have adult conversations, use my analytical mind, help others in ways that are tangible, eat lunch, go to the bathroom alone, have uninterrupted thoughts, etc. I’m very much looking forward to that. But, in addition to missing the baby snuggles and extra quality time with my kids, there are two things I will miss dearly: (1) flexibility – the ability to make every last-minute school engagement without thinking about it, the ability to attend to a child’s needs 24/7 with no other obligations, the ability to run an errand for the home every day of the week, the ability to pick the kids up when they are not feeling well without having to cancel clinic, the ability to quarantine for 2 weeks without being disruptive and (2) mental space. I have been thinking about this one a lot. For a variety of reasons, I was feeling pretty burnt out before going on maternity leave. Not working has off-loaded work stress from my life (that sounds pretty obvious but it’s true!). I don’t have to worry about having a difficult conversation with a colleague, feeling disrespected by administrators, challenging patient cases. It’s hard for me to leave work at work – to compartmentalize it – especially when I have the ability to be connected 24/7 and also when I do split my workday to make time for pick-up, kids’ activities, etc. I see sick patients and I worry about how they do, and it is impossible for me to turn that off at 5pm. So I am going to see how to compartmentalize the things that I can – non-clinical work – while also feeling relieved that I have dissociated from the more toxic work environment I was previously in.

Third: I received the second COVID vaccine. I am so so relieved by this. I will, of course, continue to use PPE at work and masks when out in public, but I feel so much better knowing that I will be somewhat protected against COVID, especially when seeing positive patients or those who are being evaluated for active disease. My parents have both received one dose of their respective vaccines (they work in healthcare) and my brother and parents-in-law recently recovered from COVID, so I am hoping this all means that we can have some sort of reunion later this year.

Finally, I have restarted on of my favorite past times: reading. I am on my fifth novel this month and have been working to actively carve out time to read each day. Of course, this will be somewhat compromised when I start working, but I am hoping to keep at least 50% of this reading productivity. Reading brings back such great memories for me of reading during childhood and I think it’s so important for the kids to see me reading as well. It has also provided some much needed escapism during a year that has afforded such few opportunities for activities that remind us of normalcy.

Here’s to the end of one era and the beginning of an even better one.

Maternity leave in review

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In two days I’ll return to work after my third maternity leave. That’s one job, three pregnancies, three maternity leaves and three “first days back at work”. My first post on this blog was about returning to work after my second was born (see October 2016 archives) and now here we are again! In honor of this occasion, I wanted to spend some time (kid naps allowing) to reflect on the past few weeks.

This maternity leave started earlier than planned when my contractions started the morning after my last day of work. I had been expecting at least a few days (if not weeks!) of extra time to wrap things up, but baby had other plans. I subsequently spent the first 3-4 weeks wrapping up work. I know that sounds really terrible, but it was actually okay. Everyone knows that newborns don’t sleep, so it gave me something to do in the wee hours of the night, and it was something that would definitely prevent me from dozing off with the baby. I am also fortunate to have a lot of support staff and they helped me make phone calls to patients (since that’s not something that can be done in the middle of the night!).

My husband didn’t take his paternity leave right away, so it was a bit of a whirlwind. Even though we had family helping out, if I had to do it again I would ask him to take a few weeks off in the very beginning. It would have been immensely helpful to have a bit more overnight help those first few weeks and I would have probably been able to take some daytime naps without the baby! It seemed pretty stressful for him to work while so sleep-deprived and this definitely led to more bickering than usual. Fortunately, things improved with time (and sleep!).

We briefly had a night nurse helping us out…until she fell asleep holding the baby. I couldn’t believe it. As my husband always says “why are people so bad at their jobs? You have one job – learn how to do it right!” So I guess another thing I would do differently is not hire a night nanny. Yes, it was helpful to have someone hold the baby for a few hours overnight, but I did enjoy doing the bulk of evenings since so much baby bonding happens during that time. I also found that I didn’t rest easy when she was over, perhaps because I was worried about the above. Fortunately, our little guy persevered and now his sleep isn’t as atrocious (although it is definitely nowhere near ideal for having to go back to work!).

My older kiddos have done really well with their new little brother. Toddler Y (our middle child) had a tough time those first few days, but now he is sweet as pie. One of our major challenges when I return to work will be carving out individual time for all three kids. Right now, the older kiddos have independent activities on Saturday mornings, and I plan to build onto that time.

One of the highlights of maternity leave was seeing a lot of family. My mom spent a few weeks with us right before and after Baby Z was born – not quite as long as the last time, but just the right amount of time during the hardest days. We also had both of our families visit on separate occasions and I was able to visit home twice (the last time for 3 weeks!) during maternity leave. The kids have a blast around family, so it was so nice to see everyone on multiple occasions.

Another highlight was meeting an awesome group of moms with kiddos around Baby Z’s age. I have excellent mom friends whom I met shortly after my first was born. Some had second babies so I didn’t feel the need to branch out much with Toddler Y. But this time around I knew that Baby Z would need some baby buddies and went out of my way to meet people. Well, this group of moms is just awesome, and it’s been great getting to know them.

On an organizational front, I did a TON around the house. I cleaned out the whole attic, donated and threw out a bunch of items from all throughout our home (trying to get a head start on minimalism for 2019!), made headway on two home improvement projects we have been working on, had the guest room painted, reorganized the guest room/soon-to-be Baby Z nursery, cleaned out the entire shed and organized all of the kitchen drawers. I gave away a ton of baby things we no longer needed, worked on Baby Z’s scrapbook and first-year album and also researched and toured a slew of private schools in the area. I did much of this with the baby strapped to my chest, but needed a bit of assistance for the manual labor.

Of course, the highlight of maternity leave was the hours upon hours I got to spend with Baby Z. I wore him almost constantly in a sling (now carrier) during the daytime hours. He often slept in bed with me overnight (not necessarily by choice, but we made sure the bed was as safe as possible for infant sleep) and he accompanied me to appointments, a handful of work meetings and a slew of errands. He’s an excellent eater, and I will forever be grateful to my employer for allowing me to have all of this time with him.

When I return to work, he will be about 4.5 months old. I know international readers will balk at how little that is. However, having had all of my children in the US, I feel so incredibly fortunately to have had 4.5 months of paid maternity leave, as well as the assurance that my position is stable. When I return, I’ll be able to set time aside as I wish to pump and to adjust my schedule as needed to make this year as manageable as can be. In fact, I’m returning part-time this month, and I am so very grateful to be able to rev up gradually.

I will always be sad about leaving my baby. What will it be like for him to not be strapped to my chest all day? (Honestly, probably not as bad as it will be for me!) I will worry incessantly about something going wrong while he is out of my care and I will miss his little noises and tiny fingers and sweet smile. I will stress out trying to give everyone attention in the few hours we have before work and after work/before bed. But I have faith that it will all be okay. Not easy, but okay.

Many moons ago, when I was obsessing about going back to work vs not going back to work (not really an option for me at the time but an interesting hypothetical argument) and then obsessing about daycare vs nanny, the one thing that stuck with me was reading that kids will thrive with a decision as long as the parents are happy with that decision. So I always focus on the positive aspects of my job and the positive aspects of their relationships with other caregivers.

I also have this to get me through: my older kids are alright. They’re happy little clams, in preschool now. My oldest is four. If we repeat his life cycle 4 more times, he’ll be twenty – an adult! In other words: time flies. As my children have grown, I’ve had (some) opportunity to think about who I am independent on them, how my husband and I interact independent of them, what I will do once they leave. Yes, I am not very far in and they are still very, very small and very, very dependent, but there are snippets of time when these opportunities for thought arise. When they have arisen, I have always been very happy to be working. This is what has worked and been okay for me, but it may not be the best case scenario for anyone else, and that’s okay too.

So in less than 48 hours, I’ll be waking up and changing out of my pajamas first thing. I’ll put on make-up, grown-up clothes, triple check my bags to make sure I have my work things plus my pump things, and then I’ll leave my sweet little baby behind. First I’ll have to convince my older kids (who have been out of school for three weeks!) that getting dressed and leaving the house early is also a good idea. I am not sure which of those feats will be harder! And in a few weeks time, doing this will be the new normal, and these lovely (and hard) maternity leave days will be a distant memory!

How I do it

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I can’t get into Instagram. Like other social media platforms, I follow a handful of friends, family, and acquaintances and post very sparingly. I don’t post a lot because I’m fairly paranoid about privacy (all I can say is: thank goodness it did not exist when I was in high school – I would be mortified to have those memories immortalized) and I honestly just don’t have time for it. I’m constantly in awe of people who capture and share so much of their lives. How do they manage to do it? I have no idea.

I worry about young women following certain “influencers” (what does that even MEAN!?) who post regularly on working motherhood, work-life balance, etc.  These influencers leave out so many important details of their lives when they post. They talk about being imperfect but then always post “perfect” photos. I couldn’t believe it when I learned that some people hire photographers to take their pictures! What happened to authenticity!? How can these people write about “keeping it real” when someone’s following them around with a camera? I’d love to see more influencers post while wearing yoga pants (not actually used for exercise, mind you) with their unwashed hair pulled up into a tight bun because they haven’t been able to escape for 15 minutes to take a shower in 3 days.

These influencers also rarely address the role of privilege in their lives. Did they come from money? What role do their husbands play in their financial success? Have they faced any hardships? What does “hustling” mean in the context of not really having to work?

I would be a terrible Instagram influencer because I don’t sugarcoat things. I am very upfront when I give advice to young women who ask me about work-life balance. So I’m writing this post today to share the authentic side of working motherhood, how I’ve been able to balance both aspects of my life, and how I’ve learned to be at peace with my decision.

1. How I decided to keep working full-time after my first child was born: I actually didn’t have a choice.* This is not a glamorous answer, but it’s the truth. My husband supported us through medical school (full disclosure: my parents also supported me quite a bit through medical school, before my husband and I were married) and residency. Once I graduated and had a real job that brought in actual income (sorry residents!), it was my turn to support our family while my husband started his own company. I came home from the hospital after my son was born and announced that I never wanted to go back to work (I loved my job and still love my job, but those postpartum hormones and attachment to your newborn are strong forces!). My husband, who is very loving and supportive, looked at me and said that wasn’t an option. Ultimately, he was right. We had a mortgage, lived in a high-cost of living area, and both had to hustle to set our family up for success, because we were not about to inherit millions of dollars any time soon (or ever, having both come from humble backgrounds). So 4 months later, I went back to work.

I vividly remember new moms I met during maternity leave saying things like: “I can’t imagine going back to work and leaving my baby with a stranger”, “babies need their mothers”, etc. and feeling so incredibly hurt. I never once congratulated myself in front of them for going back to work, or made any arguments as to why working motherhood was “better” (is there a better? I don’t think so – I truly believe every parent tries to do their best within their means). Although I was hurt at the time, I think they were trying to rationalize their own choices, and I don’t fault them for it. I now have almost 4 years of perspective to see how that decision has impacted their relationships and careers, and I also see that our kids don’t differ in any appreciable ways, despite mine having had >1 caregiver. So the first thing I tell young women is this: you have to do what’s best for you and your family. How much choice you have in the matter will depend on many personal circumstances, but you can never go wrong if you love your child and try your best. And don’t listen to anyone who tries to tell you there’s only one right way to do things – they are trying to convince themselves, not help you. 

2. How I “do it all”: Today, a weekday, I organized a play date with a close friend and her kids. I ran errands, prepared dinner for everyone, read a story to my son’s preschool class, and spent some time calling patients with results, speaking with other doctors about complex cases, and working on administrative projects. My friend sent me a text saying “Wow – super mom! You crushed it today!”. Yes, I was pretty productive, but I also have a lot of privilege and extra help, so it’s really not that impressive.

First of all, I have a very rewarding and flexible job. I love what I do and who I work with, I have great benefits, I have a lot of autonomy, and I have the opportunity to do some work from home. I’m not in the hospital taking 24 hour call and I’m not working a dull, minimum-wage job. So how did I get here? Well, I have always been driven, but I also had parents whose main goal was to set me up for success. They were present, supportive, loving, and sacrificed their own livelihood to put me first. This allowed me to focus on my education, to attend an Ivy League college, and to ultimately graduate from medical school and enter into a competitive specialty. I worked hard, but I also won the lottery by being born into an amazing family, and also encountered a lot of luck along the way. There are many bright and promising people who are not so lucky, or whose lives are transformed by tragedy. Second of all, I have an amazing husband. He is very affectionate, closely involved with the kids, does groceries 90% of the time, and cooks pretty much every night (my cooking tonight was indeed an anomaly). He has also been very successful in his career, and this has set a solid financial foundation for our family. I truly won the husband jackpot. Finally, we can afford to hire help. We have our oldest in a nurturing, full-time preschool (and his brother will join him in a few weeks) and we also have a full-time nanny. Without family in the area, I can’t imagine doing this without our nanny. She has been a true lifesaver, taking great care of our kids, tidying up our home, doing our laundry – I could go on and on. And because our jobs are flexible, we don’t utilize our childcare resources to the max, so we are still able to be their primary caregivers.

Now, there are certainly many people who are much better off than we are, and our arrangement may also not work for everyone. But the advice I usually give is this: split the household responsibilities with your spouse. If you can afford it, outsource household work you don’t enjoy or find fulfilling (e.g. washing dishes, cooking, etc.). If you can’t afford it or can but wish to reach financial independence more quickly, figure out what you can do without. Can you ignore the laundry piling up for a few days? Can you leave dishes in your sink? In sum: try not to sweat the small stuff so that you can focus on what you truly love, which for most people is spending quality time with their kids. Doing it all is really just a matter of how much you put on your list. Put less on your list and you’ll automatically do much more!

In sum: I don’t think my situation is all that impressive. I continued working because I had to (but 4 years later am so incredibly happy that I did, because I truly do believe I have the best of both worlds now) and I “do it all” because I was privileged enough to have been set up for success and I can outsource some household tasks and afford quality childcare. And this is precisely why I would have a terrible public Instagram account – the truth is not very awe-inspiring, but I do think it’s important for young women to hear it so they are not discouraged by “perfect” lives on social media.

*In truth, there were things we could have done to make my staying at home feasible. My husband could have stayed at his well-compensated job, we could have moved to a lower cost-of-living area, we could have relocated closer to family. Ultimately, however, we chose to remain on this trajectory because we liked where we lived, I had a great job, and my husband had a lot of opportunity with his new endeavor. It was not an easy decision, and I shed a lot of tears, but I don’t regret making this decision.

 

What people are saying

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I am finding that the reaction you receive when you tell someone you are expecting your third baby is quite different than the reaction you receive when you tell someone you are expecting your first baby.

When people found out I was pregnant with baby #1, they were ecstatic. There were congratulations all around, experienced moms waxing nostalgic about those early days, huge baby showers to be had, and overall excitement. Everyone was thrilled.

When we were pregnant with #2, people were also excited, but perhaps a bit worried. They seemed pleased that our son would have a brother, but did sometimes comment that the less than two year difference in age was a bit aggressive. Overall, however, there was excitement.

With this baby, baby #3, we have definitely received a number of congratulatory comments. But we have also heard quite a bit of:

  • “Was it an accident?
  • “Was it planned?”
  • “What?”
  • “OMG, why!?”
  • “Let me guess – you’re pregnant” (in response to: “I have something to tell you”)

So, it’s been a bit different. But we ourselves are very excited for this third baby, for whom we did plan!

 

 

 

Vulnerability

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I don’t write much about being a doctor because I do it every day and I prefer to write about non-medical topics, but my absolute favorite part of doctoring is meeting different people and hearing their life stories. I’m admittedly slower than I should be because I love hearing about people’s families, childhood, histories, etc. With my return patients, I always ask for updates and love to learn about what’s new.

Doctoring is a lot like waitressing – another job I really enjoyed. It can be tough on an introvert and draining after a long day of multiple patient visits. It can be taxing not only because of volume and patient turnover, but also because of the heaviness of the stories I hear. I am so honored that my patients share with me the things that they do. I keep these stories with me and often recall snippets years down the line.

Many years ago, one of my patients gave me a shark-tooth necklace. He was dying and making necklaces during his time in the hospital. I still keep this tucked away in my jewelry box, almost a decade later. It was my first gift from a patient, and he was one of the first patients I encountered during medical school.

Similarly, snippets of conversations weigh heavily on my mind. I think about my treatment plans – was everything correct? What will that one outstanding test say – will it change my management? How is my patient who just left the hospital – has she improved? Being a doctor is a tough job to leave at work. I can rarely escape it.

When I was growing up, my father would say: “Don’t become a doctor to make money.”

When I was in medical school, people would say: “Medicine isn’t what it used to be.”

I have known people who have dropped out before medical school, during medical school, after medical school, during or after residency. It’s not for everyone. You don’t clock in at 9:00am and clock out at 5:00pm. My husband will ask “How come if your last patient was at 4:00pm you didn’t come home until 6:00pm?” and it’s because medicine is messy and patients can’t be tucked neatly into 15 minute appointment slots. Also because there’s a load of electronic documentation that has to be done – but that’s a story for another day.

It’s rarely easy but I love what I do. The hours fly by in a blur. The patient encounters invigorate me. I learn something new every day and I come home with the knowledge that I have had a positive impact on someone’s life as well as their health.

What I would say to someone choosing a career in medicine: it’s so hard to know whether you will love it. And it’s true that so much has and will continue to change within medicine. But if you love science, interacting with people, and healing, it’s a great career choice, so don’t focus too much on the naysayers.

 

The Morning Hustle

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Google “working mom” and this is the first image that pops up:

Screen Shot 2017-10-25 at 8.59.58 PM Newsflash: this is not reality. I have 0% of the time ever sipped leisurely on a cup of coffee while wearing a clean suit and holding a quiet cherub in my arms.

Let me use this morning as an example. I wake up at 7:15am to the sound of my oldest (X, almost 3) screaming “Mommy, I’m awake! Mommy, come get me! Mommy, I’m awake! Mommy, come get me!” Pro: it is 7:15am. This is definitely sleeping in for my children. Con: he is not going to stop until I get out of my warm, cozy bed and head to his room. I check the Nest cam and see that my youngest (Y, 15 months) is also up. Time to start the day!

I make a pit-stop at Y’s room and take him into his brother’s room. They play while I get their milks and then we read a few books. Wednesday is one of my nanny’s earlier days, and she arrives at 7:35am. Neither kid wants to go to her (I should add: our nanny is awesome, we have known her for 3 years, and she is wonderful with the kids. However, they are both going through super clingy phases at the moment-even when their dad tries to take over-and this makes it difficult for everyone, but mostly for me). Noticing that it is now 7:45am and I have to be out the door at 8:15am to drop X off to school and then head to work, I start trying to motivate the little ones. I am able to hand Y over, but not before he sheds a few tears. X is another story. He can’t be persuaded this morning (although I am certain I will have to drag him out the door when he finally decides he’d like to play with her) and ends up hanging out in my room while I shower and get ready. This translates into water dripping all over the bathroom floor as he repeatedly pulls back the shower curtain, every item on our counter being perturbed by tiny toddler hands, and general inefficiency. Once I am showered and half-dressed, he decides that he does want to play with our nanny after all. I drop him off in the playroom, at which point Y jumps into my arms and refuses to be put down. So now I have another child in my room while I attempt to finish getting dressed, apply make-up, and style my hair (“style” is an overstatement: I have curly hair and 100% of the time wash it, apply product, and scrunch it). Y entertains me by attempting to throw everything down the toilet (succeeding only once), teetering on top of a step stool (clearly not a great idea) and repeatedly slamming the cabinet doors (only miraculously keeping all fingers).

I then head into the kitchen. My husband has already prepared X’s lunch, so I only need to pack it into his lunchbox with an ice pack, water bottle, and utensils. Meanwhile, Y (still in my arms), starts looking around the kitchen and pointing at everything he sees. I place a few Cheerios in a bowl for him to nosh on, and although he initially protests to being set down to eat (in this awesome kitchen helper), he is eventually quiet. I then try to pack some semblance of a lunch for myself, which ultimately ends up being yogurt, an apple, Goldfish, a Clif bar, a fig bar, and cashews. Nutritional fail but it’s 8:25am and I am definitely running late! But I do find time to fill up a water bottle and take coffee (+soy milk and sugar) to go.

My wonderful nanny has already dressed X (thank goodness) but he is NOT ready to go because he wants to play longer – of course! So I drop Y off to play and give X 5 more minutes as I pack everything into the car: X’s backpack and lunchbox, my work bag, my lunch bag, my water, coffee, and white coat (thank goodness I’m no longer lugging along pumping supplies!). Time check: 8:30am. Crap.

I hustle back in and X is now ready to go. Y senses that I am leaving and begins to cry again – so tough to hear this! I have to take a deep breath and remind myself of how happy he is when I come home and how well-cared for he is during the day. We step outside but X insists on lining up his pumpkins in a row, so we are 5 more minutes behind. He finally gets in the car and we’re off to school – 8:39am and 21 minutes to drop X off and drive to work before my first patient arrives at 9:00am.

We get to X’s school and he doesn’t want to go in. He says he wants to rest on the porch. Seriously kid!? He finally agrees to go in but then doesn’t want to sit with his friends during circle time (side note: X has been at this school for almost a year. He was initially in the 2’s class and now graduated to the 3’s class. He delays leaving in the afternoon to the point where we have waited 30-45 minutes while he plays! But he recently has started to try to delay in the morning.) Finally, he decides to sit with his friends. Phew!

Back to the car. Time check: 8:55am. Crap. Fortunately, my entire life is within a 2-5 mile radius, so it is a 15 minute drive to work during rush hour (clearly, this is the only way I can function given the above). Don’t worry – my first patient will be in good hands because my resident will be seeing her and will be ready to present her by the time I arrive (although yes, I do prefer to arrive a few minutes before clinic, hence the 8:15am goal estimated time of departure). I park in the garage and am upstairs by 9:10am. I find out that my first patient is late (maybe her morning schedule looked like mine!) and settle into the crazy rush of morning clinic.

If I had to add 3 things to my morning, they would be:

  1. Meditation/relaxation/thinking
  2. Working out
  3. Taking a look at work and preparing for the day

 

I am just not sure where to fit this. I don’t want to take time away from the kids, and I also can’t imagine waking up before 7:15am (I usually go to bed between 11:00p-12:30a. Maybe one day I’ll write a post about evenings!).

But I love many things about my mornings. Although this and 1-2 other mornings per week are my earlier ones (leaving between 7:45am-8:30am), I leave later 1-2 mornings per week (depending on the week) and generally have no clinic one day per week. I usually ask our nanny to come later on those mornings so that I can spend more time solo – reading, playing, eating breakfast together, etc. Whenever I have a later day, I always think: I should go to the gym, I should head to the office earlier, but then I remember that soon enough the kids will be in real school and they’ll have to go in early, and we won’t have time to spend leisurely mornings together. So I don’t work out, and I don’t meditate, and I don’t think about the day until I’m in it. And I definitely don’t sip leisurely on a cup of coffee with a peaceful babe in my arms. In sum: being a working mom is messy, so don’t believe those stock images!

What my nanny knows

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For the past few weeks, whenever my husband and I would try to put our littlest pea down for a nap, he would point to his forearms. At first, we thought he was pointing at a mole, but this didn’t entirely make sense because he only has a mole on one arm.

After a few weeks, I pieced together that my nanny must be doing something to his forearms when she puts him to sleep. When I asked her, she told me that she uses her index and middle fingers to “walk” up his arms while singing a song. No wonder! He was probably like “What’s wrong with these people? Don’t they know my routine!?”

When I was a first-time mom returning to work after maternity leave, not knowing these details pained me to the core. I would agonize over what was going on: how is our nanny/my mother/my mother-in-law putting him to sleep? Were they feeding him too little/too much milk?  Did they dress him in the correct pajamas? Were they sticking to the nap schedule? Were they careful while taking him on walks? And on and on and on. The mental load was exhausting!

But there were a bunch of little things too: what songs was he learning, what books was he reading, what words was he hearing over and over again? Our first nanny taught my son to refer to his bottle as “teta”. Now “teta” translates into “boob”. Although I speak Spanish, this term is culture-specific and not something we say. So for months we dealt with our son essentially screaming “BOOB!!!” every time he wanted a bottle. Fortunately, most people in the U.S. don’t speak Spanish, so it could have been worse. The point is: when you’re not with your child all day, you give up a certain degree of authority over what happens. This can be challenging for control freaks.

2.5 years in to having other people (family, nannies, “school”) care for our kids during work day hours, here’s with I’ve learned:

  1. Most of the details don’t matter. As long as your caregivers are adhering to the “big picture” rules, you can let the small things slide. In our case, we want our caregivers to be fully engaged with our kids – loving, patient, and kind. But we don’t need to micro-manage what happens during the day.
  2. Other people often do things better than you do – be open to suggestions! Having a variety of caregivers in our kids’ lives allows us to learn from people who have more experience than we do. Our kids benefit from different types of learning, play, and knowledge. In my opinion, this adds to their lives (and ours!).
  3. Having others care for your kids earlier in life may make later transitions easier. I have friends who are heartbroken because their children are starting kindergarten (which I imagine is so tough after 5 years of being their primary caregiver!). This transition may be less stressful for parents who had had their kids in day care, preschool, etc. on a full-time basis because the schedule doesn’t drastically change. Don’t get me wrong – it’s always hard to give up this autonomy, but if you had to do it once when you went back to work, you don’t have to worry as much about doing it later on.

Back to work

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In three weeks, I will return to work after maternity leave.

Before my first was born (he is almost 2), I didn’t understand what was so difficult about returning to work after maternity leave. I was no naive! I watched as colleagues of mine, physicians who had spent years in training and who had accrued sizable debt, decreased their hours to part-time or dropped out of the workforce completely. I vividly remember discussing this with my husband in utter disbelief: “How can they do that? What a waste of all those years!”

Fast forward to 2014: the second we brought my son X home from the hospital, I remember thinking “I can never go back to work again.” My baby boy, my heart, had finally arrived. Despite our struggle with infertility, despite a minor scare at the hospital after his birth – here he was. How could I leave him!? It didn’t help that X refused to sleep longer than 30-60 minutes at a time day OR night unless someone held him. I was exhausted – a zombie subsisting on coffee and snuggles from this warm little being. I’m sure that all of the postpartum emotions did nothing to help my vocational morale. There were days when I couldn’t even get it together to leave the house ONCE. How was I going to wake up early, shower, get dressed in something other than nursing tanks and sweat pants (or maternity pants for that matter – why aren’t huge elastic waistbands trending? It’s a genius design!), and then interact with patients, diagnose their conditions, and actually treat them? All while pumping 3 times during the day? It seemed impossible.

I was fortunate to have a generous maternity leave. 18 weeks of paid leave may not seem generous if you live outside of the US or work at Netflix, but I felt so lucky to have it, especially considering that I had only worked 3 months prior to going out on leave. I count my blessings every day that my employer and colleagues are family-friendly and supportive. It makes working mamahood a lot less stressful. And to any employers reading this: longer maternity leaves will help your company. Moms will return to work MUCH better prepared for peak performance. They will be less sleep-deprived, less upset at having to leave their newborn in someone else’s care, and they will be so grateful for your generosity that they will work their butts off.

So how did I go back to work, and how has that experience prepared me this time around? I wish I could say something like “I wanted to set a good example for my children” or “I couldn’t imagine my life without adult interaction and the ability to use my brain”, but it would not be true and it would also be inaccurate, as I truly believe that you can set a good example, have adult interaction and use your brain as a stay-at-home mom. At the end of the day, it boiled down to necessity and fear of regret:

  1. I had to go back to work. We live in an expensive region and we needed my salary to continue living there comfortably and to accomplish our long-term financial goals. We had just settled in the area and it seemed premature to flee so quickly.
  2. Teenagers can be terrible people. Having been a terrible teenager myself (I used to tell my own mother to go back to work full-time so that she would stay out of my hair – terrible, right?), I envisioned myself frantically second-guessing my life decision when this adorable infant turned into an unbearable adolescent. How marketable would I be in a competitive practice environment after taking so much time off?

And so I counted down the days with dread and cried at the drop of a hat until the actual day came. When it did, I learned that there was much to enjoy about work. Some were hugely gratifying – interacting with my patients again, truly helping people, feeling challenged, learning and being inspired by my amazing colleagues – while others were small but also enjoyable – eating with both hands, using the restroom without an infant, speaking to human beings who could respond with words.

Of course, everything is rosier now. At the time, it was incredibly difficult. Leaving our baby with someone who was, at the time, a stranger, was HARD. Tearing myself away from him in order to arrive at clinic on time was often painful as it meant rushing, pumping instead of nursing, or not reading our usual books. Some mornings I would leave before he woke up, which broke my heart. I was also upset when I could not be there all day when he was sick, or when I learned that he had learned something new in my absence, or when our caregiver did not adhere to the routine I so carefully laid out. Lack of control is terrible when you are a control freak! Eventually, these things stung less. I saw that he was well-cared for and that he was thriving. He knew who his mama was and loved her. I cherished our time together and spent every moment at home trying to be as present as possible.

This time around, I am better prepared to deal with these emotions because I know that it all works out. X has so benefited from spending time with caregivers other than myself. Each has taught him something unique and special, and I feel fortunate that my baby, Y, will have the same opportunity.

At the end of the day, we all do what is best for our sanity. There is no “right” decision and I am so embarrassed to have ever judged mothers in the past for doing what they felt was best. Motherhood has certainly been a humbling experience. For mamas out there who are returning to work or deciding whether to return to work, I’ll share the two bits of advice I found most helpful:

  1. Find great childcare. You will never be able to focus on work 100% if you do not believe that your child is being well cared for. Trust your instincts, don’t settle, and change arrangements as soon as possible if something feels “off”.
  2. Do not make any drastic career decisions during your baby’s first year of life. Sleep deprivation, raging hormones, the postpartum state – these variables do not encourage a clear mind. It is so important to take a step back and look at the big picture and this can be very difficult to do when your time is consumed by an infant’s needs (which is 24/7).

Good luck to any moms returning to work and any moms who have decided to work at home. Mamahood is not for the faint of heart!