July 23, 2019

Balance is a Myth: Integrating life as a mother, wife and physician

By Hilary E. Fairbrother, MD

This article was originally published in the Spring 2019 issue of Physician Family Magazine.

Balance. The very idea I could “balance” my roles as a full-time emergency medicine physician, wife to another full-time professional and mother of a 16-month-old is somewhat insane. Rather than the word balance, I use the word “integration.” It is a more meaningful concept for me. I am always a wife, a mother and a physician; I have just integrated these very important roles so that, hopefully, I am doing a good job at all three.

My current integration of career and life looks a lot like this: Wake up, feed and snuggle the baby while my husband takes out the dogs and feeds the cats. By the time the nanny arrives, I am getting ready for work. At work, it just depends whether I have a shift seeing patients or if I am doing non-clinical work. I essentially work until late afternoon, and then I head home to relieve the nanny. At home I take advantage of the afternoon hours to play with and spend time with my son. Before I know it, it’s time for his bath and then bedtime by 7:30 p.m. While I take care of the little man, my husband usually makes dinner. We eat and spend some time together from 8-9 p.m. At least 3-4 nights a week, I work a few more hours before bed. Then I wake up six hours later and do it again.

Because I am an EM physician, I also have days when I work late into the evening or the dreaded overnight shift while my husband, nanny or in-laws take care of my son. When we got pregnant, we decided to move closer to family, which made everything easier. The biggest change for me when relocating to Texas was moving to a new department. I came to Texas six months pregnant, worked for four months and then took three months off for maternity leave – definitely not the ideal start to a new job in a new state. Fortunately, my new department profoundly supported me as a mother of a young child.

Everyone worries about taking maternity leave (paid, unpaid, etc.). I am a huge believer in paid maternity leave, but I actually believe that what comes AFTER the leave (i.e., the return to work) is much more important. I have now been back for a year. One of the first things I was told when I arrived at my new job was “women in their third trimester don’t work night shifts,” and I wasn’t doomed to “owe” this decrease in night shifts back as soon as I came back from leave. This really set a precedent that women are supported in a concrete way. In my group, everyone (from the Chair on down) works the same percentage of nights, evenings and weekends. This kind of fairness and democracy was very important to my continued success as a new mother when I came back after leave. My group is well-organized and well-staffed, so I could work fewer shifts during my first few months back and then make up those shifts later in our fiscal year. Department level measures that allow for such progressive policies allow women to be successful both at work and at home, and I am thankful to work with such a wonderful group of colleagues.

I think policies that minimize late afternoon or evening shifts, which interfere with the time parents would normally spend with their children, can be helpful. Weekend time is also precious, so work events on weekends should be kept to a minimum. Finally, when departments are looking at investing in benefits and incentives, parents often use things like free grocery delivery more than gym memberships. Although I wish I still went to the gym with the same frequency, now I am more likely to take my child with me on a run.

To the medical student, resident or attending physician who is considering starting a family, I would say: “Do it!” And do it now. Don’t wait. It is tough to have a child and start your family during school or residency, but it is also very tough to start your family while you are a brand-new attending in your first job. The finances might get easier, but life doesn’t. The stressors don’t disappear, they just change. I think that the best advice I got when starting a family was to pick a really good partner, and this has certainly made my parenting journey. The rest of parenting and having kids will come to you; it’s different for every couple and family.

Try to support and love each other, and remember you still have to spend real time with your partner, even after starting your family. Your relationship with your partner can be the part of your life that makes everything else work, but without attention, it can also easily fall apart. Love each other and realize that every so often you need to spend time together without your children (easier said than done).

I love being a mother, wife and emergency medicine physician... and not necessarily in that order. Depending on the day, whether I am at work, seeing patients, spending the afternoon with my son or enjoying a quiet dinner with my husband, my situation dictates which of my different roles takes precedence over the others. I encourage you not to try to “balance” the various roles you play in your family and professionally, but rather to integrate these different facets of who you are into one beautiful, whole person. I would not be as good a mother if I weren’t also a full-time, academic EM physician. I would not be as good a wife if I weren’t a mother. I would not be as good a physician if I weren’t a mother and wife. You get the picture. I am many things, and it is actually the integration and intersection of these roles where I find the most fulfillment and happiness.

Hilary Fairbrother, MD, MPH, FACEP, is an Associate Professor at McGovern Medical School, UTHealth at the University of Texas Health Science Center at Houston. She has a joint appointment to the Department of Emergency Medicine where she is the Director of Undergraduate Medical Education and at the medical school where she is the Assistant Director of the Doctoring Course. Hilary has a Masters of Public Health in Comparative Health Care Policy, and also is currently the Chair-Elect of the Young Physicians Section of the American Medical Association. She lives in Houston with her husband, 16-month-old son, two Italian Greyhounds, and three post-Hurricane Harvey cats.

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