Residency Mama-Hood and It's Career Effect

Whenever I get into the discussion with fellow physicians or medical professionals and the topic of children is brought up - there is inevitably one question that gets asked every.... single... time.....

Why on EARTH did you decide to have a kid when you did?

Micah came into the world during my 3rd (and final) year of pediatric residency and John's 3rd year of plastic surgery residency (in arguably one of the hardest rotations of his entire residency.... the burn unit). Oh and we just happened to live in one of the most expensive areas in the country on a dual resident salary with no family surrounding us.....

In hindsight, it was quite a bold move. But at the time - John and I just knew that we were ready, we were going to do it and somehow it would all work out. As you've likely been able to piece together, it has worked out, but not without lessons along the way. The number of lessons were many but one of the most significant, for me, was how that little human forever changed the direction of a career I'd been working toward my entire life. As much as anyone tries to prepare, there is simply no way that a mother can know what motherhood will do until it happens. The things I told myself I would be totally OK with pre-kid are laughable to my post-kid self.

While in pediatric residency I had always known that I'd likely sub specialize. When I did my pediatric cardiology rotation as a resident - I knew it was my field. How did I know that? It was the same gut instinct that I had when I decided I was going to be a doctor, when I decided to go to U of C for med school, when I realized I would match in pediatrics. The gut instinct that led me to recheck labs or go to the bedside of a sick patient on call nights in the ICU that would go on to thwart badness. My gut instinct/intuition/inner sense has been something I've learned to carefully listen to over the years. It NEVER leads me astray.

Navigating through the next step once I started fellowship was not as straight forward. I'd found a field I loved, but I didn't quite know where my place within it lied. Most people would assume that being a pediatric cardiologist is pretty specialized - but turns out there are even more subspecialties in the field. I flirted with the idea of being an interventionalist, an intensivist, further training in echocardiography..... this time my gut was not quite as loudly opinionated. Finding the right job was a little more complicated as it was more than just about me - John and I were a dual sub-specialized couple and finding two subspecialty jobs in the same area was not going to be a cake walk.

Do I train more? Do I want to work part time or full time? Do I want to be in academic medicine or private practice? One question would inevitably lead to another and another.... until I ended up more confused than when I started. This time my intuition wasn't giving me a clear answer - it was instead leaving me small breadcrumbs leading me along a path.

I went back to basics and decided to change my initial question. Instead of starting with "What should my career look like?" I changed the narrative to "What do I want my LIFE to look like?".  

When I looked deep down inside and asked myself the tough questions, I realized....I didn't want to spend nights sleeping in the hospital. I didn't want to be called in for emergent interventional cases. I loved the physiology, the medicine, the teamwork surrounding the care of critically ill patients - but knew that my longevity in those kind of professions would be extraordinarily limited. Put quite simply, I knew I'd burn out. I want to practice for the long haul. I want my grandkids to nag me about "finally retiring". Ok maybe not that long...... but you catch my drift ;)

Having a baby in training gave me a clear understanding that I wanted (needed) time with my kids. Not just time on the weekends, for a few hours at night or on a random day off here and there.... real regular consistent time. I wanted to be available for an 11am Wednesday toddler swim class, a 330pm Monday preschooler gymnastics class, a 1030am random school performance. But years training to be a doctor gave me a clear understanding that I wanted (needed) my career. It is as much a part of me as being a mom. The personal fulfillment that occurs during those sacred moments with patients is a constant reminder that doctoring is my calling.

I also recognized that at this stage of life - with young children in tow - the balance needed to be tipped more in the direction of less work. Also recognizing that as life progressed and the stage of young children passed, the option to work more would be ideal. 

When all of those pieces were finally put together - it was easy to see the best choice for me. Each day since has only reaffirmed what my gut instinct already knew. I am an outpatient pediatric cardiologist working two days a week practicing medicine I love, in an area that I love, in an organization that I love. It is honestly a life that I don't think I could have crafted better if I tried. 

Having a child in the middle of training was hard. It was extraordinarily difficult to be away from him during moments and milestones every mom longs to see. But, I am so incredibly grateful I did it. At the end of the day, there is no way I could have known what career would give me what I want (need) to live my LIFE in the best way possible. 

So often we don't listen to our intuitions. Whether it's because

- it's telling us things we aren't ready to hear

- it’s saying something different than others (who we greatly respect) tell us we "should" do

- it’s going against things we've always "believed"

or any number of reasons. I share my experience with you not to say that my choices are some magical recipe for happiness. This post is not meant to be a step by step guide. You are not me. I cannot begin to understand what brings you joy in your day to day. 

What I do know is -  if you aren't truly listening to the voice that is leaving breadcrumbs or shouting at you - you are going to end up on a path that is going to leave you unfulfilled. Eventually, it will add up to regret. You should be investing time really listening to your gut. It is just as important as the time you spend honing your professional skill and pouring love into your family. If you aren't good inside, the rest of the areas will suffer; it's only a matter of time. The intuitive path may not always be easy but it will be 100% worth it.

(PS. To all my fellow female physicians and physicians-to-be... if it isn't crystal clear by now.... when is the right time to have a kid? When YOU decide it is. Love love love to you.)

My Unpolished Path to MD

Deciding to write this post about my early days has spawned from interactions I've had with kids in my clinical practice who live and attend school in pressure filled high stress areas. The Bay Area is a place I absolutely love, but it's also a place where kids feel so much pressure. In my humble opinion..... too much pressure.

I was pretty young, an 8 year old to be exact, when I made the proclamation that I wanted to be a doctor. Obviously it took many more encounters and exposures to solidify that decision. But they did just that and I found myself committed to the long arduous path of physician hood.

Going in, I had a vague sense of how long this path would be. I didn't have anyone close in my life who was a physician, so I was kind of winging it. I understood I would be sacrificing time and money, again in a vague way. There was just something deep down inside of me that always knew this was my calling. I'd learned from an early age (from my hardworking parents) that nothing in life that is worth it comes easy - and I knew this path wouldn't be easy.

I'm from a small town in the very southeast corner of Arizona named Sierra Vista. I did not attend a fancy private school or a high power public school in an affluent area - I went to our local high school that (at the time) made national news for having some of the highest rates of teen pregnancy. I took honors courses that I did well in and maybe an AP class here and there at the local community college. I was in student council, participated in some high school sports, played the clarinet in the band and hung out with my friends. 

From there I went to a local state school (Arizona State baby! Go devils!) because my tuition was free as a resident who finished in the top 10% of their graduating high school class. College was fun, sometimes too much fun.... Very different from most premeds - I actually opted out of the Honors program. I majored in Biochemistry (a decision I regret now, so wish I would have picked a more interesting major), joined a couple premed groups, volunteered as a "baby hugger" at the local children's hospital. Some typical premed things. 

My husband and I often laugh at my "list" of medical schools I applied to. As embarrassing as it is to admit, many of the schools I ended up applying to around the country I did so because I'd heard of their college basketball teams (what?!?!) ::side note - I LOVE COLLEGE BASKETBALL::. I ended up putting my application into the Pritzker School of Medicine at the University of Chicago because the picture of Lake Michigan by the school's table at the premed fair looked pretty. Did not have a clue how competitive of a program it was. It actually mortifies me to type this, but it just goes to show you that I was not the "have it all together" premed student. Somehow, the admissions committee saw something in me and I got accepted.

My cheesy "I got into medical school" selfie from Fall 2005

It wasn't until medical school that I fully realized how "unpolished" my path to medical school was. I had more than a few "record screech" moments when someone found out the undergraduate program I attended. There was more than one occasion when the "I didn't know people from Arizona State actually got into medical school" comment popped up. Where some may have gotten defensive - I took it as a battle cry to show people exactly what this "state school" girl could do.

I stood up to each challenge (and there were many) in the best way that I could. I didn't graduate medical school at the top of my class, I didn't have the highest grades on my tests or get "Honors" on every rotation (damn you neurology... brains are useless ;)). But I finished with pride, matched into my number 1 choice program and am currently practicing medicine that I am incredibly passionate about.

Match Day 2010 - Heading to Palo Alto!!

At the end of the day, if you want something bad enough and put in enough grit, you can get exactly what you want. I truly believe that. Will someone who is smarter than you, more well off than you, more privileged than you get there faster? Maybe. But if you can take the early trials and speed bumps as tests of your resilience, I 100% guarantee you will be better for it. You will eventually get to the same place the other guy does, but your trials will help you weather the future storms better than those who's paths were smooth and easy. 

You don't need to have it all together, you just gotta believe in yourself. Take it from someone who knows, who lived it and is now living the life she dreamed about in that small town Sierra Vista bedroom all those years ago. 

Being Multidimensional (reposted from original blog)

Posted on September 29th, 2015

In my absence from this site I've come along in this fitness and coaching journey, I think it's safe to say I've gone all in.

Does this mean I am any less of anything else (doctor, wife, mother, daughter, sister, friend) because I've decided to take on this new business? No, actually quite the contrary. I now feel even more connected to all of those things since embarking on this path.

The one I want to touch on is the doctor piece... because, well, it's the one people keep asking the most about.

Are you still a doctor? 

Did you really need to do something OTHER than being a doctor? 

How do you have the time?

What are you getting out of this?

All reasonable questions - ones that I'd ask if in someone else's shoes. So allow me, for a moment, to take you through exactly why this business of mine is going to ensure that I am a doctor for much longer than I would have without it. 

Before I started all of this, I wasn't taking care of myself. I sacrificed my health and parts of my sanity to make sure everyone and everything around me was taken care of. On the outside it would seem that I should be the happiest person in the world. I was entering the final years of training to be a doctor, something I've worked my ENTIRE LIFE for. I had an adoring husband and a strong healthy son - happiness should be a given, right?

How could I already feel like I was on the road to burn out?

Actually admitting this to myself made me feel like an ungrateful tool. How could I whine about not being totally happy when I had it all. I MADE the decision to become a doctor, it's what I always wanted..... But why was I starting to resent it?

Because my personal life balance was askew. Whether you are at the point that you believe this or not, your health is dependent on daily exercise, good nutrition and mental wellness. These things were not a part of my life - and it affected my happiness.

How do I know this? Because the single act of taking care of myself, making time for myself, prioritizing my health has translated into a life I wake up to each day with the passion I was longing for. The happiness I was missing is present, EVERYDAY. It doesn't mean that life is perfect, that their aren't setbacks, frustrations, stressors hard times - but I'm a person who is more equipped, physically and mentally, to grow from every experience - be it good or bad.

And do you know what feels even better than discovering this for myself? Helping others discover it for themselves. Helping others, just like me, see that it's possible. It's possible to have the passion you feel guilty to admit is not present.

I've found a new dimension to who I am. And I am forever grateful that I did. Because this new dimension has given me a new passion - coaching. I no longer worry about burnout - because I know who I am, more than I ever have.

My sincerest wish, for you, is to live each day with passion. There is never a guarantee for tomorrow. Maybe you need a new dimension too. Maybe, just maybe, it's the missing piece. 

Why I Became a "Motivator" (reposted from original blog)

Posted June 4, 2015

For those of you who know me well, I'm sure this new adventure I've been on may still be a little surprising. Many of you (at least those of you who see me on more of a consistent basis) have known that I've been on my own personal fitness journey. But why did I really start screaming it out to the world?

It's because when I did, I started getting things like this, from one inspirational doctor mama:

And this from one of my closest friends:

And this from someone I had always admired.

Amazing messages like, this, from your ever supportive spouse:

I could go on and on. These messages fill my inboxes many times a day - and the professional and life resumes of the people they are coming from are quite impressive. 

It's commonly known amongst the medical community that healthcare professionals make the worst patients. We work crazy hours, feed ourselves poorly and sacrifice our own mental and physical health to make sure we are taking the best care of our patients. We justify these actions by telling ourselves that the needs of others must be placed above our own, it's our nature.

I'm not saying this is a bad quality. For our patients, we need to have that selfless nature to provide the best care. But that nature often comes at the cost of our own health and sanity - this is where a line must be drawn. How can we expect our bodies and minds to perform at an optimal level if we are not our optimal selves?

This isn't exclusive to the medical community. Anyone who is building their professional future, molding children into amazing adults or a combination of both is going to sacrifice things. But it can't be at the cost of our own personal health, YOU deserve better than that.

This is why I started speaking up.

My designation as a coach hasn't come from special training or some new skill. It's simply trying to show you how I've made fitness work in my life, to inspire you that you can too. Then motivate you along the way to stick with it. 

I'm so incredibly lucky that I get to watch the people around me prioritize their health and begin to notice definitive changes. It brings daily fulfillment to know I've affected someone in such a positive way. You can be that person for someone in your life. Chances are, if you've started your own journey, you already are. 

Join me. Let's change the paths of people's lives together. It feels pretty great.