Maybe it’s time for physicians to lean out


A few years ago, my colleagues and I started a non-profit called Women in Anesthesiology.  I started medical school late and had two children in residency (earning the delightful label of elderly primigravida or, if you prefer, geriatric pregnancy). My co-resident and I noticed few women in our department, and even fewer in leadership.  We charged forward, starting a local, then national group.  At the same time, a separate Facebook entity called Physician Anesthesiologist Mom Group (PAMG) grew from a few hundred to over 2,300 members, while the Facebook Physician Moms Group (PMG) skyrocketed to over 63,000.

The time is right. Everywhere we look, we see public discussion of women in the workforce and large institutions are addressing the issues of equity and equality. The #ILookLikeASurgeon, #whatadoctorlookslike, and #IamBlackwell hashtags are social media’s contributions to changing the image, understanding, and bias associated with medicine and women.

Sheryl Sandberg’s Lean In (both the book and the website), the Huffington Post, and the New York Times are all throwing their media weight behind the idea that though it may be a challenge, now is a great time to be a professional woman. And, if it’s not a great time, then at least it’s not supposed to be a lonely time.

However, I was a little lonely two nights ago when I stayed up while my five-year-old daughter puked every 20 minutes from 2:15 a.m. to 7:30 a.m. She then passed into a deep and restful sleep for two hours, woke up, had two cups of mint tea with honey and wanted to play. I (ex-elderly primigravida here) couldn’t play and couldn’t sleep at 7:30 a.m., two hours past my usual wake-up time. I sat outside and drank coffee while my usual list of tasks buzzed around my body, said hello to its old pal insomnia and finally settled in its usual place, right around where my heart is.

After the day finally came to its blessed end, I sat on the couch and sent several detailed texts to my husband and nanny regarding what the kids’ exact schedule is for the next four weeks, including therapies, camps, and dentist appointments. I’ll be out of the country for ten days, visiting my 80-year-old father who recently had a heart attack. But he lives 23 hours away by plane, so ten days it is.

I was reminded of a post in a Facebook group, detailing both the poster’s mommy guilt and her guilt over complaining, while her life was so good compared to others.  Guilt over guilt! Well, as my best friend always says, suffering is not relative.  You are allowed to feel sad that you haven’t seen your kids in two full days just because of your schedule, even if others have gone longer.  I cannot convince my kids to eat all their food by telling them about the famine in Somalia.  We all just get depressed when I do that.

If you’ve seen the movie Bad Moms (written by two men), you know that it hit a cultural nerve. Current popular culture seems to have glommed on to the idea that no one can have it all.  Now, I hear, “You can be a mom, a doctor and a wife, but you have to pick which two you’ll be good at.”  Work-life balance seems less like a goal than a lesson in treading a tightrope. And sometimes, I feel like if I lean in anymore, I may just fall over.

The thing is, I like my job, and I am moderately ambitious. I love my kids, and I miss them. My husband still makes me laugh, and he smells good.  And to survive my life choices (job, marriage, kids, mortgage) intact, I’m going to have to lean out a little.

Having it all, all of the time, is a well-understood myth. No one has it all, whatever their “all” is. So, I’m shooting for 80 percent.  I’m saying “no” 20 percent of the time, I am exercising three days a week instead of four, and I’m not giving up carbs, only 80 percent of them (OK, 50 percent of them).  It is insanely freeing to give up on perfection as a goal. I still have anxiety about producing at work or showing up at school, but much less so than when I’m trying to do 110 percent of my own abilities. I think the best thing about leaning out is that I set both bars: my perception of me at 100 percent and my goal at 80 percent.

No interviewer says, “We hope you consider giving at least 80 percent.” But here’s my takeaway for overachievers everywhere: Shhh. Your 80 percent is enough, most of the time.  Having cortisol rushing through your bloodstream at all times doesn’t have to be your normal.  The quality of the 80 percent that you do choose to do may be improved, because you are having more fun and enjoying your life a little more.  It’s a trope for a reason: I won’t look back at my life wishing I had spent more time in meetings and less time with my family and caring for myself.

There are some nights that are going to be filled with puke and list-making; I can’t avoid them, but I can avoid making myself feel a failure about it.  So, I am going to continue to lean out a little.  I hope you will join me, even if for only 80 percent.

Rekha Chandrabose is an anesthesiologist.

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