“Is this your starring role? Or just a cameo? Who are you living for?”- New Politics
Every time I hear these lyrics, I feel an urgent need to reflect on my life decisions, particularly my decision to become a doctor. In the midst of a pandemic complicated by much needed societal discourse on race and privilege, that decision is more relevant than ever. Before I even entered college, my father was encouraging me to pursue a career in medicine. “Remember what I gave up for you Baba,” he used to say.
My dad is an Iranian immigrant who raised my three sisters and I under the weight of his decision to live in the United States. He wanted us to benefit from the wealth of educational and career opportunities that exist here.
For us to become physicians would validate the difficult choice he made.
I resisted as much as I could at first, but ultimately found something authentic drawing me towards the medical profession. A passion for social justice and a desire to help those in crisis ultimately landed me in Emergency Medicine. So here I am, a female physician, wife, sister, daughter, friend, and mother looking myself in the mirror and asking “Who am I living for?”
The past few years have been rough at times. Becoming board certified was my number one priority out of residency, but having a baby just before I graduated from my training program led to a delay. Supporting my husband as he learned how to be a dad also proved to be more challenging than I expected. Then, my hospital was understaffed and I was working more hours than I wanted. It also turns out that trying to make sure your toddler doesn’t grow up to be a psychopath consumes a large amount of time and energy. Which
brings me to now. I am transitioning into a new work situation and have cut back on my clinical hours considerably. So how can I better prioritize myself going forward?
This is a surprisingly difficult task for many female professionals, particularly physicians. Our jobs often necessitate that we put even our most basic human needs secondary to our patients. Have a full bladder? You have to hold it because a cardiac arrest is arriving in the ambulance bay and a stroke code is currently being activated in triage. Hungry? Grab a few almonds because three patients just checked in: one with chest pain, one with a severe sudden-onset headache, and one that appears to be in septic shock.
Beyond the clinical setting, our natural tendency to attend to our children and/or loved ones before ourselves only reinforces the habit of not thinking about our own well-being.
Yet I routinely counsel my patients about the importance of looking after themselves. When they state “I can’t afford this hospitalization...”, “Do I really need these medications?”, or “I don’t have time to wait for those test results...” I respond, “Nothing else matters if you don’t have your health. You cannot take care of anyone or anything else if you are not well.” Why has it been so hard for me and other women in the medical field to heed this advice? Well, clearly, our attention is being pulled in multiple directions. Furthermore, when you are taught how to triage, you don’t include yourself in the equation. Some of us have also developed the habit of delaying personal gratification. “I just have to finish studying for the MCAT, finish this rotation, graduate from residency, complete my board certification, have a baby and then I’ll take care of myself...” In the meantime, how many young lives have we seen end prematurely due to unexpected SAH, terminal metastatic cancer, or severe multisystem trauma? What will it take for us to recognize that our individual well-being matters, here and now?
But then, what does putting yourself first even look like?
To answer this question, we have to sit back and identify our values. One of the best ways to do so (full disclosure: I adore Palliative Medicine) is to imagine yourself on your own deathbed at the ripe old age of 90. What will bring your heart solace in those final moments? When your time is up, will you find contentment in the knowledge that you placed 100 more chest tubes than the average ER doctor? Will you be comforted by the process improvements in your ED that resulted from your hard work as department chair? Will your research projects that improved patient outcomes bring peace to you? Will you know that you watched enough sunsets with your loved ones or shared enough laughs over sit-coms? Will your soul rest with ease because you guided your children through life’s challenges? Will you grieve the time not spent painting, reading, snow-boarding, hiking, connecting with friends, or caring for your body? I present these questions in a work versus everything-else manner only because that is often the conundrum facing us.
How do you have it all? How do you attend to one without sacrificing the other?
The truth is that there is no one-size-fits-all answer. Some women seem to possess this unusual abundance of energy and a massive cognitive skill set that allows them to balance their personal goals both inside and outside of the work-place with perfection and grace. I have watched these women for years with envy. However, what I am starting to recognize is that these women, while exceptionally smart, are not benefiting from unobtainable powers. They have simply answered the questions above and are living their lives accordingly. They know what feeds their souls and they have put themselves first - not in a narcissistic or petty way but in a living-every-day-consciously kind of way.
In other words, we need to have some tough conversations with ourselves. What makes our lives worth living?
The answer is unique to you and holds the key to fixing so many of our world’s problems (including this nation’s failing healthcare infrastructure). We need to model for our patients the behaviors and life choices that we instruct them to make. We need to feed our souls. Which is why I say to all female professionals out there, particularly women in medicine, time’s up: own your value! Because YOU - YOUR thoughts, YOUR ideals, YOUR talents, YOUR body - matter.