Sunday, December 18, 2005

turnover time

Cal learned to flip over from front to back sometime last week. According to reliable sources, he was so freaked out by his accomplishment that he started crying immediately, and took almost 20 minutes to calm down. Of course, I wasn't there to see it. I was on call. Joe told me about it over the phone. After making sure that the baby didn't smother and checking on his psychological well-being, I hung up the OR phone and turned back to my patient, a 91 year-old woman getting a total hip replacement. "My baby just learned how to flip over while I was at work," I told the orthopedics resident.

"Table up, please," he said in response.

There are good days and there are bad days. On the good days, being a working mother is totally doable, no problems, I can take care of my patients and take care of my family too, no sweat, because I AM A GOD. And on the bad days, I'm just very very tired. (As of late, Cal has started switching over to kind of a reverse-cycling schedule, such that he's been feeding a lot more when I'm home from work then when I'm not. Since I spend so much time away during the day, I really don't mind this, so no need to avail me of information on how to break him from this habit. In my rich fantasy life, I tell myself it's because he LOVES ME and MISSES ME and LOVES THE BOOBIES. But the reality of it is probably more that it's awesome to eat in bed.) So on those days I'm a little fuzzy with my patients, and when I get home, the baby is asleep or getting there, and I just sit there trying to cram in as much quality time into those two hours before bedtime as I possibly can, wondering what other wonderous new skills he learned during the day that I missed being there for. Last I heard, he learned to drive.

So yes, sometimes, there is ambivalence. I don't know if I'm going to get busted on this, but I've always been full disclosure about The Real Deal with respect to residency, and I'm conviced that enough other people feel like this that it needs to be said. Some days I feel very lucky. I have a beautiful baby, and I'm in a coveted residency at a great institution, and I'm almost certainly going to have a good job and a flexible lifestyle coming out of it. But then some other days, I wonder whether or not the trade-off is worth it, missing the first three years of my kid's life (the daylight hours, anyway) as well as innumerable other intangibles for the sake of my medical training. I've talked with a lot of my former med school classmates about this issue, and though most of them don't have kids, it's unbelievable how many people feel the same way--torn between feeling lucky and ungrateful for their opportunities, and longing to walk away from it all and just have A Real Life like everyone else our age.

I'm not talking about quitting my job, of course. That would be short-sighted and impractical, and besides, even during my lowest lows, I don't think that staying home with Cal full-time would be the kind of life I would want either. But sometimes I do wonder why I switched residencies at all, adding another two years of training to my life. Why, if I'd stayed in Peds, I could be done in six months, and work part-time moonlighting in the ER or the PICU starting around Cal's first birthday. I could have made my own hours, made a decent living (certainly not much less than I'm making now) and just generally be there the next time he learns to sit up or talk or operate heavy machinery. I would be there.

But you don't make a career out of moonlighting, and at some point Cal's going to be going to school, and I'm going to need--to want--a "real job," something that will pay the bills, or the college tuition in the long run. And the fact of the matter is, I've gone to school for a long, long time, and there is a sense of obligation to want to make something of that. These are the rational arguments that I have with myself. But then, as one of my co-residents once said, "Sometimes I have to tell myself, 'Well, I should be grateful, it's not the worst job in the world.' But then agin, I didn't go through all this training just to have the second-worst job in the world."

Does saying all this make me feel like an ungrateful wimpy whiner? Yes, of course. Does saying that I want to spend less time being a doctor and more time being a mother make me feel somehow anti-feminist and regressive? Sure, sometimes. Do I remember that residency is, above all, temporary, and while I may spend five years as a resident, I then get to be an attending for the rest of my life? Yes. Do I realize that I have a pretty good life, and that I should see the glass as half-full? Hell, beyond half-full, three quarters-full. Yes, yes, a thousand times yes. But are there still days that I feel ambivalent or conflicted about the choices that I've made?

I think I've answered that one already.

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