I am a critical care physician for children, which means I often have to deliver bad news to grieving families. I cannot develop these deep relationships that involve life and death then pretend those emotions and family stories do not enter my life. When I see an ill child who shares a trait with one of my children, such as same age, hair color, or smile, I have unintentionally allowed my life to enter my work. My work is my life and my life is my work. The concept of needing a balance between the two ignores that the fluid lines between work and life are frequently blurred.
I was riddled with remorse while on maternity leave with my first child when I wrote and submitted my first research grant. I read articles on my smartphone while feeding. I did not nap when the baby napped as the mantra demands. I napped when I hit a writer's block. I awoke at 2:00 a.m. while the baby was sleeping because I was motivated by an idea that entered my sensorium. I approved grant submissions, phoned-in to research mentorship meetings, and submitted abstracts to national conferences. I also spent countless hours staring into the eyes of my child. When I returned to work, I was energized and felt rested, yet the constant chatter from my colleagues included statements judging how I enjoyed my maternity leave. I must not have bonded with my child. How could my work-life balance be so off?
During my second maternity leave two years later, I made a promise to protect this valuable, precious time. I disabled work email from my smartphone. I canceled all work-related meetings and did not submit any manuscripts or grants. I took my little girl everywhere and filled my day with child-centric activities. I returned to work energized and rested, yet I was still immersed in guilt despite following the rules of maternity leave to a tee. This time the overwhelming doom arose from the mountain of tasks ahead of me. It took three full days to manage emails and re-establish regularly scheduled meetings. I was swamped by clinical commitments. I returned home exhausted and with limited capacity to be an active parent. My work-life had swung completely into chaos. I asked again, how could my work-life balance be so off?
Two years later, I enjoyed the birth of my third child. I made no promises to myself. I put no restrictions on what I could and could not do while on maternity leave. I allowed myself to just be. I wrote when motivated, slept when tired, and parented when it seemed fitting. My days were fluid, unencumbered, productive, and loving. When I returned to work, I was energized and guilt-free.
As physicians, we make hundreds of decisions daily (1) and I would venture to guess that most decisions are good ones. Finding the key to work-life balance for me was having trust in my skills as a critical care doctor; acknowledging that these decision-making skills guide me in all my life decisions.
As a woman in academic medicine, the burden to fulfill parental and work obligations is heightened. Despite women comprising 47% of medical school classes, women make up 38% of full-time faculty, 21% full professors, and 15% of department chairs (2). This "leaky pipeline" adds an additional layer of external pressure put on women in academia to excel. It also can lead to a sense of isolation as women ascend the academic ladder often alone, even more so if she is an under-represented ethnic minority (3). The internal pressure to be an actively engaged mother can be equally crippling, especially in a field dominated by men who may not have the same pressures to perform at home. Even as women have increased their presence in the workforce, they continue to shoulder greater responsibilities at home (4).
I realized it was meaningless to separate work and life. Writing that grant while on my first maternity leave gave me the motivation to dive into work when I returned. Accomplishing something while I was supposed to hit the pause button on my career, made my life better. Spending uninterrupted time with my middle child is what I needed to know that quality, not quantity matters most to me.
My work-life balance is not off. I am a better physician because of the joy my life brings to my work and I am a better parent because of the joy my work brings to my life. Once we admit this reality to ourselves, we will relieve ourselves of the burden of fighting the internal battle (5). I am in balance because my work and life do not compete with each other, they are synergistic.
I have accepted that the modern career physician does a disservice to the profession and to society by striving for the all-too-elusive idyllic work-life balance. It is time to redirect that energy into infusing life into one's work. The next generation physician will have no other option than to be a clinician and researcher simultaneously. And of course, to prevent extinction, some of us will need to be parents too.
This blog was shortened from the original version of this article "Work-life balance is an illusion: replace guilt with acceptance," by Tessie October which first appeared in Frontiers in Pediatrics. Dr. October works in critical care medicine at Children's National Health System in Washington, DC.