Martyrdom & Medicine: We must write a new story for mothers working in healthcare
If you’re doing something outside of dominant culture, there’s not an easy place for you. You will have to do it yourself.” — Ava DuVernay
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“She just fell asleep”, she whispered. I heard the words but my mind was struggling to understand the statement. I had done everything in my power to get there. I tried to will the train to go faster. I ran to the house with as much speed as possible while carrying all three of the bags that routinely accompanied me on my daily commute.
My mind struggled, but my heart had already been broken. As soon as I arrived at my train stop, I knew what the result would be. None of my actions would bring the outcome I wanted.
I thought I could handle this transition. I have confronted so many complex situations in my professional life and persevered. I believed that this problem was just simply about timing and energy, which made the solution clear. I just needed to do the impossible- find more energy and create more time.
I had underestimated how often I would experience entire days without connecting with the baby that I had held for the first time only six months ago. When I learned that I would become a mother, it was unexpected. Until that moment, I had been unable to locate joy. The month prior, we buried my aunt, a woman who was my second mother and my biggest cheerleader. I felt like I was drowning in grief and this revelation saved me.
I went to the doctor for pain that I had believed was cancer, traumatized by my aun’t recent passing, and left discovering it was a growing fetus. It became very clear that her name would be Idara, the Ibibio-Efik word for joy.
When she arrived, I had settled on having ten weeks away from work to spend with her. It was a compromise between the time I wanted to foster the connection with my daughter and the time I could realistically afford without working full-time. I used some of my paid time off to create more time, sacrificing future time off for the current moment.
Honestly, I also didn’t think I could handle more than ten weeks away from all of my other babies- the patients whom I loved fiercely and were deeply committed to.
I was consumed with joy during my maternity leave but also overwhelmed with fear. As I approached the time I was scheduled to return to work, I made an abrupt transition from calm to panic mode. Questions abounded in my head,
“Who was the right person to care for her while I was away?”,
“Would she forget about me?”- It had only been a little over two months, of our bonding,
And the most chilling question- “Was I a bad mother for going back this soon?”
When I saw my life, pediatrics was always the center. I was not the woman who dreamed of motherhood since I was a child. I loved my work. I loved getting to meet new children every day in the office, I loved watching kids grow. I loved providing relief for their parents. I loved hearing from parents about how their children recovered.
Most of all, I fell in love with the intimate conversations of pediatrics and the connections with the brave souls who were navigating parenthood. However, after seven years of practicing, this would be the first time I could truly relate to those I had counseled for so long.
I was a parent.
The first few weeks after returning to work, I was running on adrenaline.
Let me take you through a day.
I would wake up around 5 am and would start getting ready for the day- checking in on the baby to see if she had woken up in between my shower, dressing up or preparing breakfast.
After a feed, I would pump any extra milk and then retrieve the stored breastmilk from the freezer and move it to the fridge for the nanny to give in between the day's solid food. My nanny would arrive by 6:45 am and I would quickly give her instructions as I headed out the door.
With my work bag, my lunch bag and my portable breast pump bag in my arms, I would start my commute by walking to my commuter railroad station in Long Island. After about 40 minutes, I would powerwalk through Penn Station and pick up the free subway magazine. Then I rushed down the stairs into the NYC subway station for my hour ride on the train station. I passed the time with the Sudoku game in the back of the magazine until I approached the last stop at the northernmost tip of Manhattan.
I would arrive at work between 8:35 and 8:45 am, unpack my items and quickly try to review the day's patients while simultaneously pumping in my assigned office for the day. Subconsciously, I also prayed no one would accidentally open the door, and observe the Do Not Disturb sign that I had created weeks earlier.
I would begin my morning session of seeing patients. As the morning crept into the afternoon, I would try to ignore the pain of engorgement since my sessions almost always ran late- eating into my lunch hour. When I'd finally finished, I had about 20 or 30 minutes to complete my divine triad of actions - pump, eat and review patient records. I placed orders and called patients back to follow up on messages- hoping they didn’t hear the loud noise of the breast pump in the background.
After completing my afternoon session, I would try to squeeze in another pump if I finished by 5. Then I would quickly assemble all of my milk and all of my bags to make my mad dash to the subway. By this time, I knew I had to be on the subway by 5:30pm to be home by 7:30pm and provide the last feed for Idara before she fell asleep. If not, my nanny was instructed to feed her with the pumped breastmilk, so she wouldn’t be hungry.
So, I would begin my almost 2-hour commute back home. If I hadn't pumped before leaving the office, I would test my balance and core strength by pumping while standing in the railroad bathroom. I would run home as soon as the train arrived at my stop.
This time the train ran late, arriving at 7:45 pm. I silently hoped for my baby to be awake, hungry and waiting for me. I didn’t call knowing that it would be unlikely that I would get to feed her and see her large brown eyes that day. So that night, when I found her nanny, with Idara asleep in her arms and an empty bottle of breastmilk on the side table, I let out a silent sigh. This was not the first time this had happened nor would it be the last.
At that time, it had been about four months of me navigating this four-hour round-trip work commute, attempting to be a focused pediatrician during my workday and in between patients, a committed breast-pumping mother.
I was trained to believe that my exhaustion would be proof of my excellence. As mothers working in healthcare, there was a silent acquiescence that we were expected to continue working as usual, even if everything else in our lives had changed.
However, when Brenda whispered those words that evening and proceeded to walk upstairs to place Idara in her crib, I just stood at the door. I was so exhausted. I was emotionally drained, physically drained, and even spiritually drained.
For some reason, I had come to an understanding that evening that this daily chaos wouldn’t improve anytime soon. There was no end in sight in the near future. Now that we were in cold and flu season, I also had more fears. I was extremely worried about getting sick and bringing an illness home to my young infant.
After Brenda came down the stairs, I paid her for the week, thanked her and proceeded to close the door.
Once the footsteps were at a safe distance, I crumbled to the floor and cried.
Okay, I didn't just cry. I sobbed. No, that's still not accurate. I bawled. It was noisy and really, really wet.
After about five minutes in this state, I did what many of us are trained to do—move on. I had to complete charts that I clearly couldn’t finish in the office. Moving past the emotions, I quickly picked myself off the floor, changed into my work clothes, and took out my work computer.
There's a quote from Toni Morrison that I battle with because it encapsulates my truth so perfectly, although I wish it didn’t.
“I get angry about things, then go on and work.”
It's interesting because looking back at that moment, I thought I was sad, but I realize now that I was angry. I was angry that this is what my life had become. I was angry because Mama Toni was right, I would just have to go on and work. I was angry that I hadn’t figured out a way to do better for myself or my child. I was angry that I clearly had failed the proverbial work-life balance, with work winning about 98% of the time.
Over the next few weeks, life continued. My baby was now 9 months old. I moved in a trance through my routine. However, I was stirred out of this trance, when the medical director of our practice called me into her office on a day when I actually had two no-show appointments. I had finished early.
My first thought was that I had failed. On the outside, I believed I had balanced new motherhood extraordinarily well. I believed I was moving through the practice as a thorough, competent physician—seeing my patients, taking my notes, and answering my messages on time. The inside was a mess, but that wasn’t anyone’s business.
Or maybe someone had complained. If “somebody” was getting fired, that “somebody” was me. As I entered the office, I silenced my numerous inner monologues and sat directly in front of her.
She asked me, “Omolara, how are you doing?” I answered as any fearful employee who wanted to keep their good-paying, 9-to-5 job would—" I'm fine.”
She asked me if I was sure. She mentioned that she had caught glimpses of how I was constantly in a hurry, not with patients but in between my patient care sessions. She recalled how she would see me hurrying when I arrived at the practice. She observed how I pushed myself during the lunch hour and witnessed the rushed sequence of movements I had perfected of packing my fifty-leven bags and flying out of the office.
“It looks like you're balancing a lot, and I know that you live pretty far”, she stated.
“It's not that far. The two hours flies by.” I reassured her.
She proceeded to tell me that although the patients and the team loved me, maybe I should consider finding a job closer to home. I hadn't even considered changing my environment as an option.
I realized I hadn't even considered making a shift because I had normalized struggle and sacrifice for so long, as a necessary evil of having a medical career.
I had never envisioned that we could choose to simplify our lives; it had never been a possibility for me because there was so much work to be done. We were trained to endure. We learned that a career in medicine is going to be difficult, but you keep going, no matter what, because patients need us. It made me believe that any attempts to remove the challenges I currently face were a cop-out.
As we continued our conversation, she mentioned that one of the former faculty members, whom I knew very well, had become the chair of the pediatrics department at a hospital only 30 minutes from my current home. She gave me his number and encouraged me to talk to him.
Until I die. I will never forget that day and that conversation with Dr Lane. I don't know what prompted her to have that conversation with me.
Maybe it was her own personal experience as a new working mother.
Maybe no one had reached out to her, even though they could easily witness how much she was struggling.
Maybe she didn't want to repeat the legacy that we silently taught each other when no one spoke up. Healthcare doesn’t care about you as a person, only as a provider.
I can only assume that I hadn't done the best job of covering up my exhaustion. In hindsight, I’m so glad I failed at that.
Three months later, I started my new job.
As women in medicine, so many of us are just trying to make it through. We are trying to contort our schedule and the demands of motherhood into the structure of the healthcare system, so we bend and sometimes break ourselves to fit. We do this, because leaving or stopping isn't an option.
This work is what we trained for, what we love, and what we believe we were called to do. In my opinion, my motherhood journey has, hands down, made me a better clinician. As a pediatrician and mother, I was able to relate to the families I cared for in a way that I never did before.
Funny enough, the demands of motherhood sometimes make my clinical work seem pretty easy in comparison. Sometimes, it's even been a welcome break (Please, don’t judge me). As my children have gotten older, there are new demands on my time and the need for more flexibility to support their activities and emotional growth.
We must remind leaders that it doesn’t get easier over time. The challenges of being a mother and a healthcare worker don’t disappear after 6 months or after infancy.
This is my call that we shouldn’t get frustrated. We should get louder.
As more mothers enter healthcare leadership roles, I look at that conversation with my medical director as an example of something crucial. We must remember our former self and see her in those we lead, especially in healthcare. We must remember the times when we were rushing to drop off kids before heading to perform surgery or when we were trying to coordinate the afternoon pickup of a sick child while in the middle of seeing a full session of patients.
We must have the courage to advocate for mothers in the rooms that too few of us enter. We must remind the tables that make the decisions and policies that although women have done this and can do it, it doesn't mean that we should.
Robyn Arzon, a famous fitness instructor, often says during my workouts: A modification is a boundary, and a boundary is sexy. I love that quote so much because I believe she means that creating modifications that protect our well-being is not weak or suboptimal. Instead, it allows us to show up stronger, safer, and more self-assured.
Many people will ask, “Why didn’t you just ask for what you needed?”
It always makes me laugh. I was too busy trying to do what I needed. I assure you, if our leaders took the time to ask us how we are doing, what we need, or offer options that we probably missed due to the hectic nature of our lives, we would happily engage.
In 2021, 16 million women were employed in the healthcare and social assistance industry, accounting for 78% of the total 21 million workers in the industry. It can be assumed that a significant proportion of those women either are mothers or will be mothers in the near future.
The issue of balancing motherhood and the ambitions we have in our careers in healthcare is not a trivial one. Instead of impromptu reactive discussions, there needs to be intentional and proactive conversations that center on how we can support women who do not want to choose between motherhood and medicine.
My experience opened my eyes to a segment of our healthcare workforce that I had previously ignored because I was not a part of it, although I am a woman. While those who marginalize others need to be held accountable, at times those of us who are marginalized forget our privileges as well. We constantly need to be vigilant about who is still not being protected as we continue to reform healthcare to be just and equitable for more people.
Motherhood has been a powerful catalyst that changed my life. I have no doubt that centering motherhood could be powerful enough to change our healthcare system.
Thank you again for supporting my work. I’d love to know your experience with balancing motherhood in healthcare. Please comment below!
Has this been something that has come up for you?
How does motherhood interact with how you show up in healthcare?
What are your thoughts about how we need to change healthcare to be more amenable to motherhood
What questions do you have for me and other readers?
To peace & freedom for more Black girls in healthcare,
Omolara
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