EP217: Motherhood and Medicine: A Tribute

Motherhood and Medicine: Burnout, Balance, and Building a Village

In a Mother’s Day compilation for The Girl Doc Survival Guide, Christine announces her book Love Language releasing August 4 and dedicated to her mother, then shares reflections from multiple episodes on being a physician and a mother. Dr. Tom Helm notes a family legacy of physicians and observes medicine’s shift to  female trainees, while acknowledging the difficulty of combining family and career. Dr. Ilona Friedan and others describe how parenting can feel harder than clinical work, the lack of a “manual” for childcare and compromises, and the myth of having it all at once. Dr. Oksana Babenko frames burnout as widespread and individualized, emphasizing autonomy, competence, and relatedness. Guests stress self-kindness, self-care (including exercise), asking for help, supportive colleagues, outsourcing and childcare “villages,” supportive partners, and accepting that doing one’s best is necessary.

00:00 Mothers Day Intro

00:28 Generations of Women Doctors

01:25 Becoming a Mom in Medicine

03:28 Burnout and Basic Needs

04:11 Physician Mom Realities

06:40 Self Compassion and Limits

07:45 Personalized Burnout Recovery

09:01 Self Care and Exercise

09:45 Ask for Help and Coverage

10:34 Build Your Village

11:50 Supportive Partner Matters

12:40 Best Is Good Enough

13:08 Closing Thanks

Transcript

Christine Ko: [00:00:00] Welcome back to The Girl Doc Survival Guide. Today I am doing a compilation in honor of motherhood since Mother's Day is coming up. Also, I'm happy to announce that I have a book called Love Language coming out August 4th, and I'll put a link to it in the show notes if anyone is interested in pre-ordering. I would be grateful and honored if you would do. I dedicated it to my mother and wanted to reflect on motherhood and being a physician. Here is Dr. Tom Helm from episode 205.

Thomas Helm: One really unique aspect for me is that my paternal grandmother, my mom, my wife, both daughters, and my daughter-in-law are all physicians, so I've looked at the physician career from lots of different angles and over a very long time span, and that's given me a lot of interesting perspectives. Just last week I was giving a presentation at the University of Pennsylvania, and it was pretty much flipped over [00:01:00] what it was when I was a medical student. I did a rotation at Mayo Clinic and Cleveland Clinic as a med student, and it was about 80 to 90% men and about 10 to 20% women. And now it was exactly the opposite. There were more female residents and fellows, and I think that's very exciting. I think it's very hard for women physicians if you want to have a family and embrace your career.

Christine Ko: Here's Dr. Ilona Friedan from episode 172, talking about her personal experience as a physician, knowing she wanted to become a mother. 

Ilona Frieden: I think that being a parent is definitely more challenging than being a physician. It was for me. Women in my generation, we were really the first sort of big bolus of women coming in for the first time into medicine. There, there had been 5% of the class, 10%. Ours was like 25% of the class for the first time ever. [00:02:00] Most of us knew that we wanted to get married and have children. We didn't really think we had to give that up, and we didn't want to, and we didn't plan to, but we had no idea how to navigate that. I still find that it's still every person for themselves in terms of the solutions you make for childcare in terms of the compromises you make. There's no manual for it, and everyone is doing the best that they can.

Christine Ko: Personally, I agree. Being a parent is definitely more challenging than being a physician. There's a lack of control in my role as a mother that most of the time doesn't really exist the same way in the workplace, just because you can't predict when your child might get sick or have a difficult time or just have needs that are unpredictable, and trying to balance is hard. I've said before that actually I've come to believe that [00:03:00] balance doesn't exist, and it's just sort of a matter of prioritizing one thing over another sometimes. But it can really lead to burnout, especially if we don't talk about these things and don't reflect on them and realize that everyone is having similar experiences, at least I think so, and that burnout can be a real problem. Here is Dr. Oksana Babenko from episode 200.

Oksana Babenko: Burnout is a pandemic in health professions right now, right? Or has been for a while. Individuals can forget that they have needs, right? Three needs of autonomy, competence, and relatedness are basic psychological needs. They're like nutrients. If we do not support consciously and intentionally these needs we will not experience [00:04:00] psychological wellbeing. Rather than running to solve the problem right away, we need to take time to understand the space because the world is complex.

Christine Ko: In the vein of trying to understand the space, here are Dr. Eliza Chin, as well as Dr. Latoya Luces-Sampson, Dr. Jane Grant-Kels, and Dr. Luisa Kalil about their experiences as physicians and mothers. These are in episodes 173, 174, 181, 183, and 186. Dr. Eliza Chin first.

Eliza Chin: I remember those early years and how just physically exhausting it was. Part of it was my husband was still in training at that time when my kids were young, so I was often on my own, with two kids and only one pair of hands. But being a physician mother was different. You couldn't turn it off. You couldn't stop being a physician. When [00:05:00] you came home, you often still thought about your patients. Sometimes there was follow-up, there were phone calls, and you couldn't also turn off being a mother when you were at work. 

It's always this elusive something that we chase after. I still struggle with that, honestly. Even now, although it's not so much balancing family, maybe it's balancing career and life in general. One of my mentors, Dr. Leah Dickstein: one of the pieces that she wrote about is, It's okay. You can't have it all at the same time. There doesn't have to be a cookie cutter approach. We really can carve and forge that path that we want. Whether we work full-time, whether we stay at home, whether we do a mix of both, whether we shift and change over the years. Really the opportunity to make those choices is wonderful.

Christine Ko: Dr. Latoya Luces-Sampson.

La Toya Luces-Sampson: Your whole job, your whole being is about excellence. That's how you got where you are. Coupled with one of the goals of residency is to teach you [00:06:00] to ignore your body, to ignore your health, to ignore any pain. There's still a lot of external messaging and socialization that tells us, even if you're working, you are a good mom if you do everything that is expected of mothers. So it is everyone and everything, everywhere you turn. If the definition in your head is one thing, steeped in the patriarchy; if you are always in this self-sacrificial, give everything of yourself mode, there will literally be nothing left. It's a recipe for disaster. The fantasy is a lie. Something has to give. And that's always true. 

Christine Ko: Dr. Jane Grant-Kels.

Jane Grant-Kels: Women are not kind to themselves. And I think that says it all. I wish that I would have been able to enjoy the journey more because I was so intense about trying to be a good mother that I didn't enjoy the journey. I can [00:07:00] tell you sitting at here at my age that it is a journey and unless you believe in reincarnation, this is it.

Christine Ko: Dr. Luisa Kalil.

Luiza Kalil: Of course I wanna be a good mother and a good wife and a good physician, and also a good daughter. Sometimes it's not possible to give a hundred percent to everything you're doing all the time. As physicians, we are always trying our best, and we study so hard that we always try to be as perfect as possible. We're humans, so no one is perfect. We have good days and bad days, and it's okay. It's hard for us to admit that we are going to fail sometimes, but we do. There is no recipe in the end, I think. 

Christine Ko: Here is Dr. Oksana Babenko 

Oksana Babenko: The problems we are dealing are complex. We need to take the time to understand the space, stay curious and open-minded, not to take things for granted, [00:08:00] ask why, and talk to people. At some point we need to stop and think, Okay this is something which is non-negotiable for me, right? If this helps me with dealing with symptoms of burnout, right? Because at the same time, my burnout is different from your burnout. In the sense that how I arrived at my burnout and how you arrived at your burnout is a totally different story. And the response should be more individual. Not like one size fits all.

Christine Ko: Dr. Latoya Luces-Sampson.

La Toya Luces-Sampson: Trust yourself and take care of yourself as a right, as a human being. When you do care for yourself, when you do make sure that you're happy, everybody else benefits. Everybody, including your children, including your patients. Like I remember at the peak of my burnout, I was so unhappy, everybody could feel it, including my patients. So it's not just this selfish thing. Everybody that is around you is gonna benefit from you putting [00:09:00] yourself first and caring for yourself.

Christine Ko: One thing that I personally think is very important in taking care of yourself is exercise. Dr. Ko talks about exercise as well.

Oksana Babenko: Exercise is not only physiological response or physical that they feel great about a workout, but also we exercise our brain in our head, how to think about challenges and view them and approach them and deal with them.

Christine Ko: Just as a few tips, I would recommend that even just four minutes a day, Tabata, is possible. 20 seconds on, 10 seconds off, eight cycles, four minutes. Or, the seven minute exercise that the New York Times put forth, so it doesn't have to be a lot of time.

 In addition to taking care of yourself, remember to ask for help. I loved it that Dr. Tom Helm says that he really tries to cover for others.

Thomas Helm: One of the things I really love about my current job is I can kind of [00:10:00] cover clinics or help out when there's a need, and I really wanna empower the younger stars to be able to have the reassurance that someone's got their back and that someone can cover. That's one of the beauties too about Dermpath, that I can always do the slides a little bit later. I can help out in a clinic. So that's something I've really enjoyed. The culture here in our department is very supportive for that, 

Christine Ko: So increasingly, hopefully, the system will be there with ready solutions. And here's Dr. Latoya Luces-Sampson commenting on getting a village.

La Toya Luces-Sampson: Not only can you not do it all alone, you were never supposed to. Having a village, and it could be paid or unpaid, is an essential part of motherhood and doesn't make you a failure. You can delegate the work of motherhood and keep the connection with your children. So if that means cooking for your family is something you love and [00:11:00] makes you feel full and whole, then do that. But if you're like me and you hate cooking, then get somebody else to do it. Outsourcing. I'm very heavy on it. And usually getting support with childcare is where I focus, so much so that at one point people thought that I worked for au pair agencies. I'm like, no, I don't. Just, as physicians, it is one of the best forms of childcare because of the flexibility, the hours, and the cost. Get the support where you can. Getting the support before you do all mindset work, I feel, is really essential. Because a lot of people cannot even think straight. They can't see past the next.

Christine Ko: Support is really important, and Dr. Luisa Kalil says,

Luiza Kalil: I have really good people to help me. 

Christine Ko: Also, Dr. Jane Grant-Kels emphasizes the importance of finding a husband who is supportive.

Jane Grant-Kels: For those of your listeners who are women, I don't mean to [00:12:00] sound too much like a female chauvinist, but you have to break your husband in a little bit. Some things, if you have the money, can be paid to do. For example, you don't have to wash the floors or cut the .. You do have to be with your children and help them with their homework and love them and put them to bed and all the things you wanna do anyway. If you ask my grandchildren, and if you ask my children what the most important decision of your life is, they will parrot back to you who you marry. Not where you go to school, not what kind of car you're gonna buy, not what you're gonna choose as a career, as long as it's legal, but who you marry because that makes or breaks whether you're going to be happy or not.

Christine Ko: And I'll end with wise words from Dr. Luisa Kalil who says that our best should be good enough.

Luiza Kalil: Balance doesn't mean being perfect every day. I make my choices and sometimes I have to be okay with the fact that sometimes family needs more of me. Sometimes work [00:13:00] does, and for me sometimes just trying to have balance means that I'm trying my best and that should be enough.

Christine Ko: Thank you for listening. Please consider subscribing and sharing and just thanking the mothers and the others in your life. Thank you.