My future as both a mother and a physician


My parents were married at the College of Physicians.

They picked a location that was not tied to either of their family’s religions but still sated a ceremonial need. A justice of the peace filled the role of a rabbi or priest, and they got married under the only doctrine they both held sacred: the Hippocratic Oath.

I never knew that this was an unconventional wedding location. I used to watch their wedding video with the rapt attention children usually reserve for cartoons. I’d stand two feet away from our box-like TV and stare at all the people dancing on the screen. It wasn’t a fascination with having a white wedding that captured me so much, it was the joy that I saw reflected in my family. Even more than that, I loved the time-warp that the movie presented. I saw my late Catholic grandmother squeal with joy as she was lifted off the ground in the hora. I saw my much-older cousins, then the same age as me, laughing and dancing on adults’ feet like I wanted to do.

I watched the movie last year and was overcome by the same nostalgia that I’d had as a child.

But, this time, my eyes were drawn to my parents. Two young doctors about to start a family.

The wedding video extends throughout the ceremony as well as the reception, both held in the College of Physicians ballroom above the Mutter Museum. What it does not show was any footage of the museum that was open to the guests. In the atrium were bones and preserved skin and exotic medical marvels that Dr. Mutter had collected in his time as a surgeon. The guests could peruse these in between the “YMCA” and Boys II Men.

What I learned recently is that 50 percent of female physicians marry fellow physicians. I also learned that of all female physicians, the ones married to other doctors are more likely to take more time off and bear the brunt of child-rearing than female physicians married to non-doctors.

One of my small group leaders at Jefferson went to medical school at a time when only 10 percent of graduating physicians were women. She became an endocrinologist. When we first met, I was enamored with her as a female pioneer and was quick to ask why she had chosen endocrinology. Her response shocked me more than I am proud to say.

She said that she chose endocrinology because her husband was going to be a surgeon, and someone needed to be home with the kids. My hope of finding a new feminist icon crumbled to the pressed carpet of the room.

At that moment, I thought of my mother who — like my father — has nine years of graduate education, but far less than he does. My father is a cardiologist, and my mother is an infectious disease physician and the director of her clinic at a major medical center. They both are amazing. My father works seven hours per week more than my mother, and gets paid more than twice what she does.

This pay gap exists as a confluence of a number of things. My mother took ten years working part-time so she could comfortably breastfeed and raise me and my two younger siblings.

Because I was born when she was still in her fellowship, she was afforded only three weeks of maternity leave.

Another reason for their salary divide is that infectious disease physicians inherently make less than cardiologists. She sees just as many patients as my father and cares about her job just as much as he does, but most of my mom’s patients are on Medicaid and live in poorer areas of the city. She also performs very few billable procedures because there simply are not many to perform in her field.

Like many professions, this pay gap is nuanced and arises because of a multitude of reasons.

Even so, it makes me worry about my future as both a mother and a physician. I hope to be able to be there for important parts of my kids’ lives. But I also hope to love my career and not burn out from working too hard.

Every specialty I turn to tells me that I can’t have both. I don’t want to do ophthalmology because I want to be able to take a lunch break. I can’t choose surgery because I would never be able to go part-time. And, even though I am interested in women’s health, I don’t want to be backed into choosing OB/GYN simply because there I will be guaranteed adequate maternity leave.

This decision is rapidly approaching for me, and I am still very lost.

When I watched my parents wedding video, I didn’t think about the stresses that they faced as physicians. I only saw joy and love on the TV. I saw mom putting on her taffeta gown with puffed sleeves and her bridesmaids dancing in dresses made of the same fabric that for years also made up our living room curtains.

Every time I’d watch, I’d call out to my mom, usually sitting at the kitchen table behind me. I’d smirk and with an incredulous tone, ask her why I was not invited. She would laugh and point to her belly, and tell me, of course, I was there.

I recently learned, in my second year of medical school, that the eggs inside of women are all formed when they are inside their mother’s ovaries. All of the eggs that a woman will ever have were formed by the time she is a 20-week-old fetus inside of her mother. That means that I once grew inside my grandmother, the woman held high for the hora at her new Jewish relatives. It also means that my future daughter, at one point, grew inside my mother as well.

If my daughter becomes a physician, I hope that her options are more numerous than mine. More than my mother’s and more than my small group leader. I hope to be a part of that change.

Madeleine Norris is a medical student.

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