Good Doctor and Good Mom

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What do you sacrifice in pursuit of your dreams?

What does your calling cost you?

What are the returns on your investments?

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Last week I mentioned Dierks Bentley’s, “Woman, Amen”, a song I love.  After listening to it for many days on repeat this past week, I decided to tour his nine albums this weekend.  His songs vary in topic and form, and at the same time he has a consistent style and vibe.  I like it.  Yesterday I heard his song, “Damn These Dreams”:

Now honey I know you miss me, I feel it when you kiss me

Trust me when I say every goodbye hurts

Well damn these dreams

Playin’ my heart just like a guitar string

Pullin’ me away from you and everything I really need

Well damn these dreams

Chasing that same old whiskey melody

All up and down these Nashville streets

It’s hard to look true love in the eye and leave

Damn these dreams

 

Instantly I remembered two other songs with similar themes:

 

Goodbye Again”, by John Denver:

Other voices beckon me, and for a little while

It’s goodbye again, I’m sorry to be leaving you

Goodbye again, as if you didn’t know

It’s goodbye again

Have to go and see some friends of mine

Some that I don’t know

Some who aren’t familiar with my name

It’s something that’s inside of me

Not hard to understand

It’s anyone who’ll listen to me sing

…Lying by your side’s the greatest peace I’ve ever known

But it’s goodbye again…

 

And “I Play the Road”, by Zach Brown Band:

…She says daddy where to you go

When you leave me all these nights

With a suitcase and guitar in your hand

Kissing me and mom goodbye with a tear and a smile

Where do you go? 

Daddy where do you go?

I play the road

And the highway is our song

And every city’s like the same three chords

Been helping us along when the story’s told

And the crowd is done and gone

Shaking off the miles and trying to make it home

…Mile after mile… 

Baby, I’m comin’ home

Years ago, I think it was either Dana Carvey or Martin Short who said something like one can only tolerate the life of a comedian because s/he simply cannot do anything else—they must do comedy.  If anyone can find the reference, please share!

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As it is in music and comedy, so it is in medicine.  For many of us, we simply must do it; we have no existential choice.  These songs describe well our pain and conflict when we take call or have to work on weekends, or miss the kids’ school and sports events, and spend hours at home on the medical record or answering pages.

I recently read an article, “A Good Doctor or a Good Mom, Never Both”.  Early in this physician mom writer’s career, an elder colleague told her, “’You can be a good doctor, and you can be a good mother, but you can never be both at the same time.’”  The author disagrees, saying it’s either/or, never both, ever.  At once hearing Bentley’s song, I felt a moment of panic, mortified that I’m destroying my family for my job.  Am I totally selfish for choosing this career, and are my priorities so distorted that I so often put work before my family?  Have I chosen to be a good doctor and a horrible mom?

Thank goodness for Simon Sinek who, in his 2014 book, Leaders Eat Last, referenced a 2011 study that showed “a child’s sense of well-being is affected less by the long hours their parents put in at work and more by the mood their parents are in when they come home.  Children are better off having a parent who works into the night in a job they love than a parent who works shorter hours but comes home unhappy.”  This idea has saved me from countless episodes of self-flagellation and guilt.  It was so instantly redeeming that I recall the exact moment I heard it—I was at the airport, traveling solo, likely for a work related conference.  I can’t say I’m ecstatic every evening coming home, but I generally feel satisfied by a fulfilling day doing something I love.  I can confidently report that my husband feels the same.

I’ve attended one swim meet in two years.  I miss any school event that occurs during the workday.  I still get lost walking the maze that is the kids’ school, though we (they) have been there over a decade.  But I get to choir and orchestra concerts, and dinner potlucks.  I know my kids’ friends and am friends with their parents.  The kids’ teachers think they feel loved by us.  I think I do okay.

My kids hear me on the phone with patients and colleagues.  They know it takes time and understanding to take good care of people.  I’m confident they see and feel how meaningful this work and these relationships are to me.  And the science is pretty cool, too.  I would never pressure my kids to go into medicine, but I would not be surprised if they did.  I would absolutely encourage it, if it gives them the joy it gives me.

“You can be a good doctor, and you can be a good mother, but you can never be both at the same time.”  I respectfully agree and disagree.  You can absolutely be both, often at the same time.

 

The Status of Women, 1999-2019

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What happens for men when women speak Feminism?

I intend to ask this question to more men in my life from now on.  What do you hear as Feminism?  Where do you think it comes from?  What do you think women are trying to accomplish by talking about equity and representation?  What moves a man to ally with women in this movement?  What keeps him from doing so?  What are the risks, costs, and benefits for us all when he does and does not?

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Women in Sports

The US Women have just won their fourth World Cup Soccer title, kicking balls and ass, I like to say.  What an accomplishment, and how far they’ve come since winning the first ever Women’s World Cup in 1991, the year I graduated high school.  I don’t follow soccer, but as an American woman, this victory carries meaning for me.  At halftime this morning I read about Brandi Chastain, the 1999 US World Cup champion midfielder who famously, spontaneously, took off her jersey in unadulterated celebration after firing the winning penalty kick in double overtime against China to win it all.  The New York Times featured her story yesterday, commenting on the evolution of our perceptions and treatment of female athletes over these 20 years:

In that pivotal moment of arrival for women’s team sports in the United States and around the world, viewers saw Chastain removing her jersey and twirling it like a lariat, spinning around and falling to her knees, pumping her arms in exultant triumph. What resulted was perhaps the most iconic photograph ever taken of a female athlete, a depiction of pure spontaneous joy.

It was a moment of freedom and liberation, Marlene Bjornsrud, a longtime women’s coach and an influential sports executive, once told me. She called it a “casting off the burden of everything that kept us down and said, ‘You can’t do that because you are a woman.’ It was a moment that screamed, ‘Yes, I can.’”

Title IX was signed into law by President Nixon in 1972, one year before I was born.  So I took it for granted that girls could play sports just like boys in school—not every sport, but most.  I also took for granted the inherent assumptions about women in athletics—that we cannot be as fast, as strong, or as competitive as men.  I have so much more appreciation now for icons like Billy Jean King, Martina Navratilova, and Pat Summitt. I think about the WNBA, and women coaching in the NBA, NHL, and NFL, and I marvel at how far we have come.  Take a look at this timeline of women’s sports in the US to get a fuller perspective.  I know many will say we have a long way yet to go.  But today, let us joyfully celebrate all that we have accomplished already.  Wahoo!! [fist bump and dancing woman emojis]

 

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Journal of Bone and Joint Surgery, January 2012

Women at Work

I’m thinking about the culture of orthopaedic surgery.  In the twenty years since I graduated from medical school, I see more and more women in this field (as well as other surgical specialties), which makes me proud.  While women comprise only 5% of practicing orthopaedic surgeons, 15% of American orthopaedic residents are now women, which is roughly double the percentage in 1999.  But what’s it like to be a woman in orthopaedics?  How do these women present, perhaps differently, at work compared to in their personal lives?  Is it truly safe for them to be themselves as surgeons?  The American Orthopaedic Association held their annual meeting recently.  My orthopod friend returned from the conference and commented that the rare women leaders in his field seem ‘fierce’ and ‘tough’—but in a good way?  It struck him to wonder if they are just like that in general, or do they have to be that way to navigate their male-dominated specialty.  He wondered how they would be seen if they displayed sensitivity and emotion, “because a man can be seen as sensitive and kind” and not only does it cost him nothing, his social status is likely to be elevated because of it.  My friend was not sure this is the case for his female colleagues, and he seemed both empathetic and powerless at the idea.  Looks like gender parity may take a bit longer in medicine than in sports.

At work in general, women’s status varies considerably.  But research points to common issues such a 22% pay gap and too few women in leadership (5% of US corporate CEOs), though these are improving.  One need not look far for abundant evidence that having more women on the corporate team improves earnings and morale.  Much is also written on strategies for improving gender equity at work.  Two of my favorites are exit interviews and work-life balance initiatives for all employees, not just women.  But as I wrote last week, it’s not just about including women as participants in the workforce.  It’s about truly appreciating the diversity of experience, biology, and contribution that women bring to any group they serve.

 

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Women and Men

There is no way I can do justice to this topic in the remainder of this post.  So let me just share some ideas and resources I will continue to explore in the months and years to come.

I asked at the beginning what happens for men when women speak Feminism.  A corollary question is what happens for all of us when we hear the words ‘toxic masculinity’?  My guess is men get defensive and women get aggressive.  Personally I love the phrase because it’s so incisively descriptive.  But it can also be a flashpoint phrase, one that immediately incites conflict and emotional hijack.  Let me be clear: toxic masculinity does not imply that men and manhood are toxic by nature.  Quite the contrary, the phrase refers to a culture of expectations of men that is just as toxic for men as it is for women.  Male surgeons may well benefit from being sensitive and kind, but not too much so, lest they be seen as weak.  This is a vast oversimplification, by the way; the history and complexity of toxic masculinity are explored articulately here.

Readers of this blog know how much I love Brené Brown.  Her explanations of how shame (where toxic masculinity is born) manifests and organizes around gender—and why it is toxic for both men and women–are the most poignant and real.  Read her first hand comments to Ms. magazine here, and a stay-at-home dad writer’s interpretation of them here.  If you seek a nonjudgmental, objective, and real-life exploration of the complex dynamics between men and women, read The Gifts of Imperfection and Daring Greatly.  Sister (she’s not old enough to be Aunt) Brené’s books are the most accessible form of evidence-based, all-around relationship advice I have ever read, and I’m so grateful for her.  From the Ms. Interview:

What role do you think vulnerability played in the #MeToo movement?

Know what I love about the #MeToo movement?—and, me too—I thought until I was 25 or 30, that sexual harassment was just the price of entry.  The greatest casualty of trauma is the ability to be vulnerable. So this #MeToo movement is re-defining and re-claiming vulnerability, and putting vulnerability in the context it belongs in, which is power and courage. 

 What gives you hope?

The thing that scares me about the world today is the same thing that gives me hope. I believe we’re witnessing white male power over. It’s making its last stand right now. And it’s scary because last stands are dangerous, and people get very backed into a corner. I think this is the last stand, and that we’re going to see a shift, mercifully, from white male power to inclusive power with it too. And I think from that paradigm, we can do anything, change anything, and be anything. 

And it’s not just women who can claim agency against misogyny and sexism.  Men who identify as feminists serve as allies for gender equity and respect.  But men can also help themselves and each other break free from the restraints of machismo and chauvinism.  Movements like The Good Men Project and Evryman give men a forum for honest, vulnerable emotional expression and connection.  Just like women surgeons and corporate executives, all men need inclusive spaces where they can feel true belonging, where they are free to be all of themselves—hard emotions and all—for all our sakes.

Men I admire in this space include Nate Green, Ozan Varol, and David Brooks.

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To lift my spirits here at the end of this long post, I’m listening to a song on repeat: Woman, Amen by Dierks Bentley.  It’s such a shining anthem of a man’s unabashed love and appreciation for his partner.  I can also imagine modifying the lyrics and hearing Faith Hill singing about her man Tim McGraw.

Thanks for reading to the end, friends.

Our relationships kill us or save us, and we really need to be better at taking care of each other, locally and globally.  We, men and women alike, are all in this together, inextricably, in sickness and in health, forever.

Only Love can save us.  Let’s get on it.