One morning, after signing in Josephine, Charlie, and Katherine at daycare's summer session with quick kisses and hugs, I barreled back down tree-lined streets toward our friends Maggie and David's house with George in the back seat. The morning had already been cringe-worthy. In my surgical scrubs, I had literally tackled George, then age eleven, in the yard back at home and physically wrestled him into the car. He didn't want to go to football camp. When I opened the car door at Maggie and David's, George promptly sprinted for cover across their large yard. I entered the house alone.
“Oh my lord, it's been a morning,” I told Maggie and David. “George doesn't want to go to this camp.”
David, who had a good eye for fugitives, pointed to a spot in the back yard where George was sporting a badly improvised fake limp to convince me that attending football camp with such a grievous injury wasn't even a remote possibility. David softly chuckled: “I think that means he really doesn't want to go.”
Maggie's eighty-year-old mother, Lorraine, shrugged from the kitchen table and said dryly: “If he doesn't want to go, don't make him.” That resonated. A lot. I began to feel a little more centered. “You're absolutely right, Lorraine. I think we're going to skip it for today. Thank you.”
I dropped off George at his usual, nonfootball day camp. As I got back in my car, I wondered what parent in good conscience would ever force a kid to do something that terrified him. I discovered the answer to that question very quickly when Mark called to check in.
After decribing my brutal morning to him, I told him that I had decided to let George bag football camp and had dropped him off at his regular camp instead.
“You let him get away with that?” Mark asked, incredulous.
I immediately felt judged. My blood boiled. “If you're so disappointed in my performance, maybe you should leave work at noon and take George to football camp yourself.”
“Fine,” he replied. I could hear the quiet frustration in his voice. Great. I had just thrown an innocent eleven-year-old, terrified of getting beaten up at football camp, under the bus.
Later, when I paged Mark at the hospital, he reported that the lunchtime ambush had gone peacefully, in a tone that I can only describe as a tad smug. Apparently, George, whose behavior was a mystery to me at times, had not put up any fight at all. Maybe Mark had handled the situation with greater authority. Maggie's mom later confirmed the lack of struggle, saying that, when she picked him up from camp, George said: “I need to get to the mall tonight so my mom can buy me new football cleats.” He apparently couldn't wait to go back for more.
But knowing that George enjoyed camp didn't assuage my anguish about how I had handled the situation. I apologized to both Mark and George. Then George and I talked about coming up with better ways to communicate the activities he did and didn't want to do. I didn't want to react like this anymore.
Clearly, here was another area of my life that was slipping out of control. I became more determined than ever to get myself to a place where I was more peaceful—a place where I could breathe.
CHAPTER 7
Sick Leave
I am not afraid of storms, for I am learning how to sail my ship.
Louisa May Alcott, Little Women
One very sickly winter, a nasty crop of upper-respiratory illness and feverish crud swept through daycare and school. As the plague spread from child to child, Mark and I dealt with the situation in the least disruptive way we could—by taking turns staying home. It was becoming less practical and less satisfying to drag the kids to my office. And a few eyebrows had been raised when a sleeping bag was spotted in my closet.
Mark and I both worked for the same organization—a multispecialty practice of more than four hundred doctors—and we were both sensitive to the fact that our productivity was critical to our respective departments. On days when we split sick-kid duty, Mark canceled his morning patients and covered the shift at home; then I covered the afternoon, getting most of my cases finished in the morning so he could head to work.
In the previous six weeks, I'd had to miss six full or half days. Not great. Neither of us had access to advice on balancing childcare and work. We both worked solely with male colleagues who had wives taking care of business at home. All of the women staff physicians I had worked with during residency had full-time nannies holding down the home front. We'd tried that, hiring a nanny for a few months after Katherine came home, but it had ended in what felt like a disaster that involved filling out a police report. I filed that whole situation under Nanny never again.
I also still had flashbacks of dropping off our infant son, George, at the home of a near stranger in St. Paul—my daycare lady's “good friend”—on days when daycare was closed for illness or other reasons. Then, I felt that I had to do it just to survive. Now, I wanted to think of our children's needs first. It felt just awful to leave our kids with someone else when they were sick.
Physicians have no sick days, which I find ironic. We are supposed to use vacation days when ill, although the other pathologists in our group took sick days here and there and never counted them as vacation time. And I was almost never sick. That didn't seem fair either. But spring was coming, I told myself. This long bout of sickness couldn't last forever.
One day, while home caring for a sick child, I got an email about an emergency meeting in my department that had been scheduled for the next day. When I inquired what it was about, I discovered that, while I was out, my partners had called a meeting to discuss creating a new policy for “pathologists who stay home to care for sick children.”
The implication seemed clear: I shouldn't be home caring for my sick kids. I ought to be able somehow to control my kids’ illnesses; or worse, I was just a slacker. It suddenly felt to me as if the thousands of hours I'd poured into my work, including all the times I'd offered to help my partners, vaporized. I longed for my seven male partners to comprehend my situation.
I returned to the office the next day and sent out an email to my colleagues in which I gently, but firmly, suggested that the policy they were considering drafting was likely discriminatory. The original meeting was immediately canceled, and I was invited to a new, more intimate—and more threatening—meeting with my section chair and an upper-management person whom I'd never met.
When I told him about it, Mark was incensed. “But, that's just not right!” he said, shaking his head.
“We're trying as hard as we can here,” I railed. “Kids get sick! I think they think I'm sitting home eating bon bons and watching Scooby Doo reruns! I wish you could come to this meeting with me. If they heard it from your viewpoint, it might be different.” But I knew that would be ludicrous. In the 21st century, a woman doesn't bring her husband in to defend her at work.
Mark actually offered to come, but I told him I'd deal with it. Just before the dreaded meeting, I serendipitously ran into two women physician friends who were also moms. In a quiet back hallway of the main clinic, I confided in them about the proposed policy and imminent meeting. One of them, a typically proper, sweet, reserved being, gripped me by my shoulders, looked me dead in the eye, and growled ferociously: “Don't let those motherfuckers get you down. Don't let them!” The other, also instantly grave and serious, warned: “Whatever you do, don't let them see you cry.” They were so fiercely kind and passionate that our brief encounter left me feeling stronger and more centered. It also made me wonder what soul-crushing scenarios they'd encountered as mothers in medicine.
Before going into the meeting, I ran up and down three or four flights of hospital stairs to ground myself, cued up my inner “Eye of the Tiger” soundtrack, and, as directed, strengthened my resolve not to cry. When I finally walked into the meeting, I felt strangely calm and collected.
I soon grasped that my fears about the proposed policy were misdirected. My section chair and the management person actually didn't want to discuss the discriminatory policy they had proposed at all. Instead, they brought up things completely unrela
ted to the sick-child issue. Every time I tried to redirect the discussion, they sidestepped, calling into question my commitment to the job in general. Though they said it might not be relevant or even legitimate to bring up such things, they pointed out some raw quality-control data that hadn't yet been fully analyzed to put into question my competency. The data, on further analysis, actually supported my excellence as a diagnostician.
Now, errors are part of the job in medicine, and we all knew it. And I had long ago forged a direct correlation in my brain between my level of stress and the quality of my work. So I knew that I was not immune to errors. But then their comments became even more personal. I was questioned about the time I spent on the phone and challenged about how I spent my downtime, completely disregarding the fact that other partners played online games during the day between cases or left to go swimming in the afternoon or eat donuts and drink coffee in the lounge. I was definitely feeling bullied.
Then the management person, who was taking it all in, asked me: “Sarah, why don't you just go part time?”
The offer seemed patronizing to me in the moment. I knew that, if I went to part-time status, I'd be treated differently from my partners. And having to fight for my own salary, rights, and benefits seemed like the last thing I'd want to do. Besides, “going part time” was incredibly off topic. Switching to part-time status wouldn't solve the problem of caring for sick kids. Kids don't get sick only on scheduled days off. But I knew that becoming emotional, trying to fight back, or starting an argument wasn't going to help the situation. So I calmly explained my position.
“I don't know how part-time status would change my having to stay home to care for my sick kids,” I told them. “Besides, as you know, I'd be completely alone to bargain for myself if I got separated from the group like that. Right now that doesn't sound very appealing.”
By the time the meeting ended, no decisions had been made, no ultimatums given. I felt that at least I had stood proudly on my own side and spoken up for myself.
At home, just before falling asleep, my anger began to subside as I sensed that my section chair was stuck as well. He had to run the department and answer to the partners, who, I presumed, were complaining about my periodic parental absences. The next morning, as I pulled my car into a space in the underground lot at work, I felt calm. I walked slowly to my office. Something inside me had resolved to care less about the politics at work and more about what was happening to my life. I was beginning to think this situation might, in fact, be helped by asking myself: “How can I create the kind of life I want for myself and my family?”
Before the day's cases started to land on my desk, my section chair came into my office and shut the door. “You know, Sarah,” he began, “after going home, I thought about our meeting, and I need to say that I'm really sorry about the whole conversation yesterday. Our approach was wrong. We just weren't being fair. I apologize. Moving forward, there will be no new policy.”
I was bowled over. I thanked him and grinned, saying: “Here's to a spring of healthy kids!” I wasn't sure what had shifted overnight, but I was deeply grateful for this honest human moment. It felt like grace.
As if their immune systems suddenly grew hale overnight, our kids weren't sick one additional day in the spring months following the meeting. A few weeks later, however, one of my partners was hospitalized for an unexpected illness and was out of the office for two weeks—ten working days, nearly twice the number I'd missed caring for our sick children. We all cheerfully rallied to cover for him. No emergency meetings were called. He returned to work, healthy again. Nothing was said. But I doubt that I was the only one to see the irony. If we couldn't cover for each other and care about each other's lives, then what had we become?
CHAPTER 8
Feeding the Bears
I hope you live a life you're proud of. If you find that you are not, I hope you find the strength to start all over again.
Eric Roth, The Curious Case of Benjamin Button
As I detached more and more from office politics, and the whole sick-kid incident faded, I began to dream a new dream: I wanted to work less. How could I do that? My coach Michele encouraged me to “act as if” I were making only 80 percent of my income and see how that suited me. While it had irritated me like hell to have part-time employment suggested to me as an option during the infamous sick-kid meeting, I had to admit that the irritation had arisen partly because I knew that it might not be a bad option.
I didn't know a lot of physicians who worked less than full time, and I knew that many old-school physicians frowned on it. In my teens, when I asked my father about another woman physician in town who worked only three days a week and seemed to have a great family life, he said: “You know what they say—part-time doctor, part-time brain.” Then he laughed haughtily, reflecting the deeply held idea that medicine requires you to surrender everything to achieve excellence. He might feel differently now, but his words still clanged in my head.
My father was entirely devoted to his practice and his research projects. When he wasn't at his clinic running from room to room seeing patients or playing with us at home, he was in his study, reviewing research data from his projects or reading journals. He was a devoted father and a dedicated physician. With my mom mostly at home, he was able to do both with ease. His father was a psychiatrist in New York City, and his grandfather had been a general practitioner before him. I came from a solid line of caring and hardworking men of medicine—none of whom had ever faced my maternal dilemma.
Despite my worries that part-time practice might mean a practice that was somehow diminished, I persevered. By examining our finances, I quickly saw how we could live on less—fewer fancy vacations and more frugal shopping. A few months later, I boldly requested part-time status and my request for a 90 percent position was granted. This meant that I would have one regular day off every other week. In the years that followed, I slowly began to ratchet back my work at the hospital—90 percent, then 80 percent, and eventually 60 percent. Finally, I had more time to breathe.
Around this time, I had a vivid, frightening dream. There were three enormous, story-high grizzlies in the back yard. I was inside the house with my kids, family, and friends. The monstrous bears were menacingly tossing around huge propane tanks. They were pissed off. In the dream, I was terrified for all of us, especially for the kids, who were peeking curiously out the basement window at the giant bears. But the kids weren't afraid at all. All the other adults were upstairs drinking wine and having a party, so I ran up to warn them. They weren't even remotely interested either. I had the sense that I was on my own to deal with these beasts.
According to Jung, dreams are meant to help you guide your waking self into wholeness and even offer solutions to the difficulties you're facing. I broke down the dream into symbols and tried to determine what message each had for me—for Sarah, the dreamer. As I did this, I discovered that the bears were angry simply because they were hungry. They were starving, actually. I realized that the bears represented my creativity, and suddenly knew that I needed to feed my starving bears. I knew I had to further lighten my load.
Throughout my childhood, my parents had owned a cabin on Lake Pequaywan. I grew up spending nearly every weekend of my childhood there, and it held a lot of special memories for me. When my parents announced that they were selling it and planned to build a year-round home right next door, Mark and I had mixed feelings. We knew they wanted us to buy the cabin. We didn't feel ready for it, but we feared the opportunity would be gone if we didn't say yes immediately. We trusted that it would be a good thing and bought it.
Now, as I began thinking about how to lighten my workload, I realized that packing up the minivan with bag upon bag of groceries on a Friday night after a long work week to go to the cabin wasn't really working for me. Add the perils of open water—and the hyper-vigilance it required when toddlers were around it—to the work of maintaining a whole additional home, and it was clear that some
thing had to give.
My parents had built right next door. I loved the fleeting moments of dog-paddling in the lake with my mom, watching my dad explain where the frogs were hiding in the pond to my son, and just being there with my parents. But getting to the cabin and maintaining it took more than we had to give. The Sunday clean-up and packing often started at 8:00 in the morning and ran all the way into Monday. We mopped, washed clothes, put away life jackets, and emptied the fridge. And it started all over again when we landed at home with our laundry and left-over groceries.
Though it dismayed my mom, we decided that selling the cabin would definitely lighten our load. It was probably one of the first times I ever did something as a full-fledged adult that truly upset my mother. It wasn't easy to stand in our truth, but it felt so liberating once we did.
The day we closed on the cabin sale, I felt inspired to inquire about downsizing possibilities for our home in town. Working part-time really appealed to me and a smaller mortgage would certainly make that easier. We'd have less to clean and maintain, and it would force us to be leaner with our possessions. Our Realtor told us about a much smaller home priced at a third the value of our current house. It was a newer, one-level home built on slab, with a nice bedroom and bath for Mark and I that seemed like a perfect haven.
Mark was happy with the possibility of not having to put up as many storm windows every fall and impressed with how much lower our energy bills would be. I was excited by the prospect of the increased closeness that the new great room would make possible. We decided together that it would feel really good to simplify everything—from the size of our house to the size of our mortgage.
Swimming with Elephants: My Unexpected Pilgrimage from Physician to Healer Page 4