Mummy days: balancing doctoring and mothering

Humanity

CJEM 2005;7(6):427-428

It's early in the morning. I wake up to the sound of footsteps and open my eyes to see the tousled hair and sleepy face of my 4-year-old son climbing into bed with my husband and me. As he snuggles his face into my neck he asks plaintively (or so I imagine) "Is it a Mummy day?"

My children live in a world partially defined by my changing schedule as an emergency physician and shift worker. "Mummy days" are magical days where I don't go in to work a shift, have no scheduled meetings, teaching sessions or seriously pressing research issues. On Mummy days we hang around the house doing nothing in particular except reinforcing my hope that I can parent my children effectively while working in a demanding and often stressful job. And I never feel like I have enough Mummy days.

Since the birth of my daughter 7 years ago I have struggled to find a balance between my working life and my mothering life. My female physician friends and I endlessly discuss the issues that arise when you juggle the twin demands of a medical career and parenting. It is ironic to me that the attributes that make us good physicians are the same ones that cause us to consider abandoning our careers in order to be proper mothers. All our lives we have been disciplined and focused in our quest for excellence. Now we want to be excellent mothers, and the definition of an excellent mother is still, for many people, a mother who stays at home. We cannot be both excellent doctors and excellent mothers; there are not enough hours in the week. So we get by, rushing in and out of our homes and workplaces, cutting corners where we can, and generally feeling like we are falling short in both arenas. And you can be sure that we are neglecting ourselves far more than we neglect our children and our careers.

I know countless female doctors (myself included) who have reduced their hours, taken leaves of absence, or quit practising medicine altogether in order to feel that they are adequately meeting the needs of their children. Cynical male colleagues comment that the simple solution is to limit the enrolment of women in medical school — fewer women means fewer mothers which means more "committed full-timers." But my female colleagues have a different perspective and practice style than my male colleagues; not better, but different. And when we pull back from our chosen profession to help us with our biologic one, the patients ultimately are the losers. Just ask all those patients who are looking for a female doctor.

Newspapers are full of published opinions bemoaning the lack of women in high-level business positions. There is a similar lack in the medical field: women deans, full professors and medical leaders. Glossy photos of gatherings with mainly male doctors in suits (and the occasional woman) celebrating some important initiative or medical achievement frequently appear in my mailbox — this is the face of our profession. Where are the women? I suspect, though I can't be sure, that they already have too many competing responsibilities to put in the kind of time and energy required to ascend to these professional heights.

It's not the fault of our partners either. Most of us have supportive husbands or partners, and they are trying hard to be excellent fathers. But they are struggling with their careers, and there is very limited acceptance of reduced hours and responsibility for fathers. Many studies have shown that while the academic productivity of women drops substantially when they decide to have children, the reverse is true for men. The combination of a young family and a young career is overwhelming for many people, but the men seem to fare better in the career areas. And I do not see or hear about the same level of guilt and grief from my male doctor friends over the separation from their children. Men are meant to work in order to excel at their career. This is an uncontested fact, even in the new millennium.

I don't know what the solutions are. I remember the gut-wrenching feeling of leaving my precious infant with a caregiver (however loving and trustworthy) while I went off to work. Trying to pump breast milk behind a locked door while praying that no disasters arrive at the ED during my 20 minutes of "self-expression." Running to the daycare after a busy shift and seeing my daughter's face framed in the window searching for my face (how long has she been at the window?). Prying a crying child off my leg as I rush to my day shift 10 minutes late. Are these the memories of a "good mother"?

I think of the feeling of satisfaction and pride that I get from my work. My job allows me the privilege of providing care to patients, care that is rooted both in my medical skills and my own female perspective. I was a doctor long before I was a mother, and it is a huge part of how I define myself. I hope (oh, how I hope!) that I am providing a positive role model for my children and their friends. And while I rejoice with my brilliant female colleagues as they celebrate their pregnancies and their babies, I also feel sad as I watch them return to work and begin to struggle.