Sunday, February 17, 2013

a little overwhelmed: balance blues

so, that whole work/life balance thing . . . 
as i mentioned, we had a grand rounds speaker this week [dr. greg poland] come to speak on work-life balance.  i was excited that the topic was being addressed, though i've always been rather proud that pediatrics as a specialty tends to be a bit more progressive than others in this arena.  still, life during medical training is never a cakewalk, and the clinicians that duke attracts tend to be research/clinical/teaching superstars.  and to be perfectly honest, despite having evolved beyond the era where doctors were considered superhuman [and thus held to superhuman standards] i can think of several attendings i have worked with to whom 'balance' is probably still a dirty word.

the talk was interesting -- though dr. poland didn't bring up anything i haven't thought about before.  a lot of what he said seemed to be derivative of the writings of my favorite life-improvement gurus:  leo babauta, of course, with a dash of gretchen rubin and laura vanderkam thrown in for good measure.  but i do think that medicine -- and academic medicine in particular -- could use a healthy dash of zen habits-style wisdom, so this in itself wasn't such a bad thing.

he started with a slide show meant to emphasize the struggle that many physicians go through in devoting too much time to their work at the expense of . . . well, to put it bluntly, the rest of life.  i was glad that he brought the topic into conversation.  he then started going into his own career, and how things were before.

that's where i got excited.  perhaps someone was finally going to explain how it was possible to really REALLY have it all in medicine -- be there 100% for family, while paying attention to mental and physical health/fitness, and still making a great impact at work.  he presented a great slide that detailed his before schedule:  a grueling cycle of getting to the office at 6:30 am, heading home for a quick dinner with the kids [who was cooking? who cleaned up?] and then heading back to the office until midnight.  he admitted that with this regimen, the one who suffered the most was his wife, who was often alone -- and eventually he burned out from working this way.

he then went on to explain the dangers of overwork, and in contrast the importance of taking time for ourselves and our families, from residency/fellowship to far beyond.  he [and his daughter, who did the presentation with him] spoke of the dangerous alternatives:  high risks of depression, mental illness -- even suicide.  to my horror, they even discussed the inevitable ill effects on the offspring of 'unbalanced' physicians [and i don't think they even meant 2-doctor households!] -- including high rates of anxiety, depression, and eating disorders.

i heard what he had to say, and i was [and still am] completely on board with the idea that some sort of 'balance' is essential.  overall, i am glad the topic was brought up for discussion.  but what i kept waiting for was the how.  i expected that since he presented his before schedule, that we'd be rewarded at the end of the presentation with the [awesome! life-changing! secret-to-this-whole-thing] after.  

but after never came.

he did later admit that he still gets to the office at 6:30 am.  he didn't mention whether he was still working late into the night, but i'm guessing that now that his children are grown he just has more free time.  he did discuss a few strategies -- lots of templates, automation, outsourcing A LOT and eliminating wasteful time -- but i am not sure how many of these are applicable for those in my position.  i'd love to outsource the pile of prior authorizations i get at work and a lot of the pages i get that could easily be handled by a diabetes educator, but as a fellow that's not an option for me.  at home, it would be awesome to outsource the laundry, the grocery shopping, and some food prep [and eventually MAYBE I WILL] but right now that's just not feasible.

sadly, i think this talk is one of the reasons i've felt frustrated all week.  frustrated that despite trying so hard to DO all of these things -- be wife/mother/doctor/runner/writer-extraordinaire -- i just can't do enough to make me really feel like i'm doing an amazing job in even one of these arenas.  i can't get myself to motivate to study at night.  i did only 60% of my long run today.  i didn't get to spend nearly enough time with annabel this weekend [i was on call].  i don't feel like josh and i get enough quality time together.  i don't feel like i get to read enough and i'd love to have more time to just sit down and relax.

i do usually get enough sleep, so . . .that's something.  and yes, omdg:  i'm still flossing :)  so there's that.

i just don't feel like there is a lot of extra hidden time [or energy] to 'find' to do the things i listed above [in a day or so, perhaps i'll write out my schedule.  maybe you all can troubleshoot!].  so is this belief in 'balance' as an achievable reality as damaging as it seems to be, or am i just confusing 'balance' with perfection?



at least we have the most perfect baby in the world

lots of things to contemplate.

notes added after the fact:
1) this post was written after a very busy call weekend when josh also happened to have bronchitis.  so, not the ideal situation for making life feel easy.

2) i did email the speaker [he invited us to do so] to ask him for the 'after'.  i'll definitely report back if he responds.

3) i realize part of the answer is that i just need to get out of my head more and live IN THE MOMENT.  but sometimes that's easier said than done!

okay, back to work!