Mom Love

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Somehow tonight I got to thinking about all my patients who are moms.  I am filled with love and admiration, and compassion for all of them.  Maybe it was because today that is what I did most—momming.  Chauffer, meal planner, shopper, meal preparer, science project thingy seeker, organizer of the week to come (meal planner, babysitter/transport arranger, meal planner, shopping planner, piano lesson re-scheduler)…

I feel so grateful that I can work part-time.  I accomplish most of these life tasks on days when I’m ‘not working,’ as I used to say.  Now I call them days on which I ‘don’t see patients.’  All moms work; it’s a full time job with intangible and transcendent benefits, as well as hellish hours, often disproportionately low appreciation, and obviously no financial compensation.  Some of you may have seen a popular article this year on the mental workload of moms.  I highly recommend the short read.  Here’s a slightly older article that also includes references to research on the ‘work-home gender gap.’  And I absolutely love this eloquent, hilarious, and heartfelt to tribute to moms from last year, which is basically encapsulated in the first sentence: “I am the person who notices we are running out of toilet paper, and I rock…”

What tugs at my heart the most sometimes are the moms who have chosen to stay at home, giving up, at least temporarily, a fulfilling and meaningful professional career.  So many of them feel conflicted over making this choice, and then shame over feeling conflicted.  Countless times I have heard some version of, “Please don’t think I don’t love my kids, because I LOVE my kids!  …But (sheepishly) being with them 24/7 is so tiring, and I really miss using those other parts of my brain, having conversations with adults, and solving problems that employ my education and training.  But I love my kids, really I do, and I love being with them and I chose this and I know I should feel so grateful that we can afford for me to stay home, I just feel so guilty for ever wanting to be away from them, what good mom wants that??  But I’m so tired, and sometimes (pause) I wonder if I should have kept my job, worked it out somehow?  I never thought I would feel so torn.”  In these encounters I do my best to validate my patients’ choices, to reassure them that in no way do I question their love for their children just because they long for the company of peers and colleagues, and to address the consequences of their inner conflicts on their health and relationships—with self and with others.  I feel sad and angry that anyone would shame a mom for wanting to have a meaningful life outside of momming.

There’s the guilt of the working mom, also—which springs from the same pathological thinking that no good mom would want to be away from her kids.  But somehow these women seem easier to console, in my experience.  They often derive significant meaning from their work, and even if that is not the case, they take pride in providing for their families.  They also often report seeing themselves as role models for their daughters.  Regardless, I hate that these women have to deal with the same social gremlins as their stay-at-home counterparts—that somehow being a mom and having a career are necessarily divergent ideals.  This is an example of a false dichotomy that serves no useful purpose, and causes many of us to suffer unnecessarily.  Thankfully, others have written extensively on solutions; I really like this article on 8 ways to overcome mom guilt, regardless of your W2 status.

In looking up the articles for this post, I also came across this one, addressing the invisible mental workload of men.  I’m so glad I read it, because it reminds me of another fallaciously dichotomous rabbit hole: when we start exploring and addressing women’s challenges, the discussion too easily devolves into man-hating.  I claim my own susceptibility to this mindset, and thankfully this article helps me rein it in.  The same antiquated social pressures that tell women they ‘should’ always want to stay at home also tell men that they ‘should’ always want to be at work, and GAAAGH, it just kills all of our souls, a little at a time.  The author, Josh Levs, writes:

“All women who notice and keep track of their families’ many needs deserve big props and respect for it. So do the men who do this work. It’s crucial, detail-oriented, and never-ending. It makes a home a home.

“For 2017, let’s resolve to put aside misguided gender assumptions and work together to achieve a better balance and healthy work-life integration—for the sake of women and men.”

I wholeheartedly agree.  Let us stop with the guilt trips and shaming, and give all moms, and dads too, all our love for the ‘momming’ we all do!

 

The Movies That Move Us

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NaBloPoMo 2017: Field Notes from a Life in Medicine

The weekend has gone by too fast, and I have done none of the tasks on The List.  Oh well, it’s all good.  I got up this morning and made the green onion pancakes that my daughter loves so much.  We had a very successful shopping binge at Trader Joe’s and Target, woo hooooo!  And in between, we had something of a Christmas movie marathon:

“Love, Actually” (2003)

“The Holiday” (2006)

“While You Were Sleeping” (1995)

I’ve seen each of these movies so many times that I anticipate my favorite lines with giddiness and delight.  But they often end up serving as background on theTV as I accomplish other things.  Today, though, I was able to relax, sit, and watch.  It was touching and emotional, something of a re-centering.

What I love about each movie is how human all the characters are—there is something to relate to for every aspect of humanity in these films.  No one is perfect but all are lovable, all are flawed.  The relationships between characters—siblings, spouses, neighbors, friends, coworkers, parents, children, boy/girlfriends, and ex-es—are all interconnected, interdependent.  Somehow, watching these three movies in a row today, I’m struck by the portrayals of vulnerability, honesty, humility, judgment, love, and commitment, as well as lapses thereof.  It’s all so real, so human.

The hero’s journey is real.  We are all called to our own adventure, inevitably facing challenges and conflicts against our will.  We search for the easy ways out, alternative paths around our problems.  We avoid the hard feelings, the discomfort, the morass.  And then, somehow, we find a way—we meet someone who can help, we marshal our resources, we find the inner strength to do what’s needed, to carry on.  It’s messy and awkward, meandering and stumbling, often also hilarious and worthy of eye rolls and head shakes.  Looking back we find ourselves thinking, “Well why didn’t I just do that in the first place?”  And we can also appreciate the inevitable, valuable learning from the missteps and wrong turns.

Movies are movies, of course, not real life.  They are an escape.  They are also a mirror, as most art is.  They tell our shared stories, remind us of our relationships and connections through time, across nations, between genders and generations.  They’re called “movies” because they are still pictures shown in series to give the illusion of movement.  But perhaps we can think of them as moving us at our core, drawing us nearer to one another through shared experience and imagination.  The best movie experiences leave us a little cracked, a little exposed, a little sensitive—or a lot.  They remind us of our core humanity, inviting us to bring it forth and live it in authenticity.

Many thanks to all those who create and contribute to this art form.  You make us better.

Dr. Jerkface In Context—Healing the Patient-Physician Relationship

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Excuse me, I took an unintended break for Thanksgiving!  Hope you all had a wonderful holiday!

NaBloPoMo 2017: Field Notes from a Life in Medicine

For the past year or so, maybe more, I have increasingly tried to engage my friends in discussion around allied advocacy for physician health and well-being.  Inevitably, however, I’m met with anecdotes from my friends about asshole doctors.  It is a strikingly common experience, I’m sad to report.  And it makes sense:  If a patient has a bad experience with a doctor, ie the doctor behaves badly or the patient feels dismissed, ignored, disrespected, or mistreated, the normal response is to blame the doctor and assume that s/he is an asshole.  In each of these interviews with friends, it took a while for them to come around to the idea that the doctor him/herself may be suffering and therefore not behaving/performing their best.

But the next question is this: Do patients care about doctors’ suffering?  If they knew how the system harms physicians, would they have compassion for us?  What about if they knew how physician burnout and dissatisfaction directly affects their quality of care, all of it negatively?  What would move patients to stand up with and for doctors?  This is my goal for the indefinite future: to help us, patients and physicians, the end users of our medical system, stand up with and for one another, for positive systems change.

Right now I see it as a very personal, grassroots endeavor.  Outside of a one-on-one patient-physician relationship, ‘patients’ and ‘physicians’ in general are abstract groups to us all, and it’s hard to feel compassion for and connection with an abstraction.  “Patients are too demanding, entitled, and ignorant.”  “Doctors are arrogant, dismissive, and profit-driven.”  We carry these overgeneralized internal narratives and others into our encounters, often unknowingly and unintentionally.  Even when we think we see and know the person right in front of us, these underlying assumptions still color our experiences with them.  So whatever conversations we may undertake will take many repetitions to finally reach true mutual understanding.

I have been a member of my church since 1991.  Many others in the community have been there much longer than that.  There are other physicians, and we are all patients, ranging in age from infants to octogenarians.  I have proposed to host a focus group to discuss patient-physician relationship, especially as it relates to the effects of physician burnout on patient care.  The plan is to do it once, with whomever is interested, and see what happens after that.  I picture 10-20 people, patients and physicians alike, seated in a circle.

The objectives will be stated:

  1. Hold an open discussion about people’s experiences in the patient-physician encounter, and explore the context of forces that influence those experiences. Such forces include visit duration, documentation requirements, workflow inefficiencies, patient expectations, insurance status, and clinical setting (hospital, outpatient clinic, etc.).
  2. Participants leave with improved mutual understanding of one another’s experiences in the medical system and more likely to feel empathy and compassion toward their counterparts in the next encounter.

In the long term, I wish for patients and physicians to form a unified platform from which to advocate for policy change.  We, patients and physicians, are the end-users of the healthcare system, the largest combined demographic in the system, and I believe we are the ones who benefit the least from the system.  Health outcomes for American patients are dismal compared other developed countries, despite our exorbitant expernditures.  Physicians kill ourselves at more than twice the rate of the general population.

It’s not enough for medical professional societies to write co-authored, open letters to Congress.  It’s not enough for individual patient constituents to stand up at town halls and berate their representatives.  We must orient ourselves as resistors in series, rather than in parallel.  I think the movement will grow most effectively out of existing connections and relationships, through which we can find shared interests, common goals, and a strong, unified voice for change.

I seek your feedback:

  1. How do you picture this meeting going?
  2. How interested are you in learning about physician burnout and how it affects patients?
  3. If you were invited to such a meeting, what would you think and feel about it?
  4. What would make you more likely to participate?
  5. Would you want to host such a meeting in your community? How would you do it?

Thank you for considering, and see you tomorrow!