Medicine & Motherhood

By Dr. Dawn Barker

Until recently, it was easy to reply when an inquisitive acquaintance asked, “What do you do?” I would answer that I was a child and adolescent psychiatrist. Easy.

The most difficult part was trying to explain that yes, a psychiatrist is a medical doctor, and no, I’m not a psychologist and there is a difference. But when faced with the same question these days, I struggle to answer. Of course, I am still a psychiatrist, and those certificates on my office wall are still valid. But my role now is so much broader and difficult to define.

Almost two years ago, I stopped work to have my first child, with a plan to take a year’s maternity leave. I was surprised when many of my friends and colleagues were shocked that I was taking so much time off. I replied with my standard child psychiatry spiel about the first year of an infant’s life being critical for secure attachment development, but the reality was that I wanted to stay at home with my new baby. I looked forward to having a year when I didn’t have to deal with acutely distressed patients, and the equally distressed hospital system. If I was going to be woken at night, I wanted to deal with my own child’s need rather than someone else’s. In fact, I wasn’t sure that a year would be long enough.

Before that first year was up, I was pregnant again, and I officially resigned from my position at work. I have recently had my second child, and now haven’t worked in medicine for almost two years. I always thought that society frowned upon women who went back to work when their children were young; instead, it seems that the opposite is true, and professional women are somehow expected to return to work quickly and hand over the raising of their children to someone else.

So what do I do now? I have been writing: I’ve written a novel and won a publisher’s manuscript development competition; I’ve kept a blog of my parenting experiences; I’ve written a few articles for magazines. Would I call myself a writer? I still can’t help but feel embarrassed to say that. It doesn’t seem like a ‘real’ job. I’m not earning a living from it, so I can’t really say it’s what I ‘do’.

Do I say that I’m a mother, or a housewife? In reality, that is what I do every hour of the day: I look after my family physically and emotionally, and I run a household. But I hesitate to define myself as a homemaker. I want people to know that I can do more than that, even though I know that raising children is difficult and tiring and incredibly important – but it is undervalued in our society. There seems to be more value placed on professional women returning to the workforce and employing someone else to look after their children.

There are days when I wish I was at work, having a coffee with other adults while we discuss a challenging clinical case, or reading a magazine while I eat lunch without a toddler trying to escape from a high chair next to me. Then I remember – that rarely happened when I was working. I was just too busy. It’s then that I remind myself: even the worst day at home with two young children is nowhere near as bad as the worst day at work.

Doctors should be the most supportive of professions when it comes to our colleagues becoming parents. We work every day with patients in difficulty and know the importance of a strong family, and yet our profession is one that makes it very difficult to balance both a working and parental role. Part time work is difficult to manage, clinical meetings and ward rounds are often held very early or after hours, and the on call work can be brutal. But we are more than doctors; we are mums and dads and wives and husbands, and we shouldn’t have to pick one or the other. We can’t do it all, and maybe we should stop trying to.

So when people ask me what I do now, I tell them that I am a psychiatrist who has taken a few years off to raise my family, and I also write on the side. And that’s an identity that I am happy with.

About: Dawn Barker is a Child and Adolescent Psychiatrist, writer and mother, based in Perth, Western Australia. She blogs at psychiatristparent.wordpress.com

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Physician Excuses For Not Making Your Ideas Happen

If you're a physician that wants the freedom to control your career and lifestyle, you're going to have to act.

Here are the most common excuses that physicians give for why they can't actually take control of their career and lifestyle and actually do what they want. (You'll also notice that it's the same list that everyone else has.)

It's quite a list and there are plenty of pegs for most physicians to hang their hats on and, indeed, most docs will never have real control or freedom. But, as the wise man once said, the world needs ditch-diggers too.

If you're risk-adverse and choose security over opportunity every time, here's your list courtesy of 99%:

1. I DON’T HAVE ENOUGH TIME.
Extra time, like money, rarely just materializes out of thin air. We have to work for it. If “finding creative time” is a struggle for you, consider getting proactive about carving it out, and doing the most important work first.

2. I’M AFRAID OF FAILURE.
If we really push ourselves, we will fail more than we’ll succeed. But that’s how we gain experience, how we learn, how we grow. The greater failure is to never risk failure at all. Choreographer Twyla Tharp: “If you do only what you know and do it very, very well, chances are that you won’t fail. You’ll just stagnate, and your work will get less and less interesting, and that’s failure by erosion.” 

3. I’M NOT INSPIRED.
Inspiration comes from action, not the other way around. Our friends at Red Lemon Club shared this insightful tidbit from leadership guru John C. Maxwell: “"The whole idea of motivation is a trap. Forget motivation. Just do it. Exercise, lose weight, test your blood sugar, or whatever. Do it without motivation. And then, guess what? After you start doing the thing, that’s when the motivation comes and makes it easy for you to keep on doing it."

4. I NEED TO FIND BALANCE IN MY WORK AND HOME LIFE. 
Living a full, balanced life is a wonderful goal. But does that mean doing less work and having more leisure time at home, or doing better work and feeling more fulfilled? Seasoned non-conformist and entrepreneur Chris Guillebeau makes the case for better work and bigger dreams, arguing that balanced people don’t change the world.

5. I CAN’T OVERCOME MY INERTIA.
Getting started can be hard. Once you’re sitting still, once you’re in your comfort zone, the easiest thing to do is just stay there. As serial entrepreneur Andy Swan has written, one of the most common mistakes when we’re just beginning a project is to “set lofty goals from a resting start.” With images of fame and success dancing in our heads, we set the bar too high, fail to make the grade, and quit because we’re discouraged. Instead, build momentum by starting with small, achievable goals, and work from there.

6. IT’S NOT ORIGINAL ENOUGH.
Originality is immaterial. Filmmaker Jim Jarmusch puts it like this: “Nothing is original. Steal from anywhere that resonates with inspiration or fuels your imagination… Select only things to steal from that speak directly to your soul. If you do this, your work (and theft) will be authentic. Authenticity is invaluable; originality is non-existent… Remember what Jean-Luc Godard said, ‘It’s not where you take things from – it’s where you take them to.’” 

7. I’M AFRAID OF THE COMPETITION.
If someone else is doing something similar that needn’t be a reason to give up. In fact, it’s a great reason to get more excited. As Seth Godin has said, competition validates your idea by creating a category. It also lights a fire under your ass. 

8. I GOT MY EXPECTATIONS TOO HIGH JUST THINKING ABOUT IT…
It’s easy to get high on the idea of executing your idea. You daydream about how great it will be, the recognition and acclaim that will inevitably follow its launch. You build it up so much that the reality of actually executing the idea starts to seem unappealing. Ze Frank calls these un-executed ideas “brain crack” – it’s a dangerous addiction. 

9. IT’S NOT THE RIGHT MOMENT TO DO IT.
Occasionally, this excuse has the merit of actually being valid. Twitter creator Jack Dorsey had the idea for the service back in 2000. Unfortunately, the technology that would help Twitter thrive wasn’t in place yet. But how did he recognize this? Dorsey did a small-scale implementation of the idea that flopped. Even though it failed then, the exercise crystallized the idea in his mind, and Dorsey was able to revive it later when the timing was right. 

10. I HAVE TO PLAN EVERYTHING FIRST.
At this year’s 99% Conference, author and entrepreneur Frans Johansson argued that humans are very bad at predicting which ideas are going to be a success. Thus, nearly every major breakthrough innovation has been preceded by a string of failed or misguided executions. The moral of the story? Spend more time doing, and less time planning.

11. THE PRODUCTION IS TAKING TOO LONG.
Nobody ever said creative execution was sexy. In fact, it’s grueling. Author Junot Diaz battled writers block for 5 years before finishing his Pulitzer Prize-winning novel. Inventor James Dyson built over 5,000 prototypes before he found the right design for his vacuum. And the list goes on. We must find joy in the process of execution, not just the end product.

12. MY IDEA ISN’T POLISHED ENOUGH YET.
Charles Darwin spent 20 years developing his theory of natural selection, and planned to eventually publish his research in a multi-volume tome. But in 1858, he received a letter from the naturalist Alfred Russel Wallace essentially summarizing the theory he’d been cultivating over decades. Darwin scrapped his plans for a tome and quickly published his now-famous abstract, On the Origin of Species. Without Wallace nipping at his heels, though, how long might Darwin have gone on perfecting his world-changing theory? Sometimes it’s best to launch a project before it’s “perfect.” 

13. I NEED TO DO MARKET RESEARCH.
If you think about real, game-changing inventions and discoveries – the electric lightbulb, the double helix of DNA, the airplane – almost none of them had the support of the masses in the early days. Being a visionary means being able to see what other people can’t even imagine. That’s why companies like Apple don’t do market research. 

14. I HAVE YOUNG CHILDREN.
This excuse reminded us of a great piece from writer Rebecca Cantrell, who struggled with the impact her newborn had on her writing. Though initially she lost her will to work as she focused on child-rearing, Cantrell found – in watching her son’s willingness to experiment and fail and never give up – that the experience actually inspired her and improved her writing practice. 

15. I’VE GOT TO PAY THE BILLS.
Here's the big one for most physicians. Going with the status quo, we tend to give high priority to things like wealth and stability. And once we have them, it’s extremely difficult to imagine life without them. (To wit: “The three most harmful addictions are heroin, carbohydrates, and a monthly salary.”) But should these things come at the expense of pursuing big, bold ideas? Paying the bills won’t necessarily earn you a legacy.

The enjoyment of control and freedom isn't something that's ever going to be handed to you. You'll have to earn it through action.

Physicians & Lifestyle Design

In the last couple of posts we've discussed the idea of taking responsibility for yourself and "building your own ship" and we've also gone through a few common reasons why physicians aren't the best at career modification.

In this post, I'd like to spend a little time introducing you to the idea of "lifestyle design," something that has become a bit of a buzz-phrase in the business world but as far as I can tell hasn't penetrated the world of medicine just yet (for a lot of reasons).

I'll begin with a personal story...

When I jumped off the academic track in 2006, I wasn't exactly sure what I wanted to do as a career but I knew I wanted something unique.  My idea was to design a career that was flexible, fun, adventurous, and meaningful, all the while paying my bills and being a responsible spouse and parent.  Simple, huh?

I spent months thinking about how to do this as a physician.  I searched websites and blogs.  I spoke with mentors and colleagues.  I read the literature, all to no avail.  There seemed to be no conversation about a career like this in medicine.  I mean, there were a few articles about volunteer opportunities or non-traditional careers, but nothing really like what I was trying to create.  

What I found, though, was that while the medical community was silent about how to develop a very non-traditional and interesting career, the business world had already awakened to the idea.  Within the world of business, the idea of becoming a "free agent" and overhauling your career through "lifestyle design" was beginning to pick up steam. 

Around this time I picked up a copy of the book Free Agent Nation by Daniel Pink.  I'm not sure how I found this book, but it became a sort of manifesto for me.  In this book, Dan explains how more and more individuals were escaping their cubicles to become independent free-lancers and living their lives with increasing flexibility and empowerment.  It was a great read and it hit me at a very important time.  Through this book I realized that I was not alone in my desire for more autonomy, and that a lot of workers who had already yanked themselves off the grid were thriving.  I was hooked.

The second book I read was a book that has become a bit of a cult classic already, Timothy Ferriss' text, The 4-Hour Workweek .  This book is a basic introduction to how Tim built a stream of residual income and then used his extra time and money to explore his interests and live a more interesting life.  It was Tim's book that introduced me to the term "lifestyle design," and while the phrase might seem a bit hokey, it's a very powerful concept.  Basically, what Tim discusses in his book is the idea that it is possible to live an incredible life if you prioritize correctly, live frugally, and develop your entrepreneurial side.  Some have criticized the book recently, explaining that no productive person-- not even Tim Ferriss himself-- really only works four hours a week-- but I would argue that that's not really the point.  The catchy title sells books, but it's the mindset Tim describes that is the reason why the book is an important introduction for individuals who feel helplessly caught in a hamster wheel at work.  Tim's point is that you can-- through ingenuity and hard work-- leap off the hamster wheel and into something much better.

So how does all this apply to physicians?

Well, when you have a career discussion with most physicians, it often boils down to whether or not that individual wants to continue practicing clinical medicine or go into a nonclinical job.  There's nothing wrong with either, mind you, and I have friends who have great careers in each; however, for me and for many other physicians, I suspect, this approach is just too simplistic.

The fact is, I like clinical medicine.  I've spent a of of time getting good at what I do and I'd like to continue to be able to help people by providing good clinical care to patients who need it.  I also like many aspects of the nonclinical opportunities available to physicians-- things like consulting, writing, medical device development, and many other niches really appeal to me.

My main question is not whether I want to practice clinical medicine or jump into a nonclinical career, it's how do I design my life to be able to practice medicine, participate in the nonclinical activities I enjoy, and still have the flexibility to pursue life outside of medicine?  Discussions about clinical versus nonclinical are at their core too reductionistic for most modern physicians.  What most modern physicians really need to be having are overarching discussions about how to design a lifestyle that incorporates the multiple facets of their career interests and also does not overlook the ultimate (and most likely unspoken) goals they have for their lives. This is a much deeper conversation, but one that is desperately needed today in this time of significant upheaval in our healthcare system.

So where do you begin if you're a physician and you are interested in exploring this idea of "lifestyle design?"

Well, don't go to the career advice section of your specialty journal and certainly don't go to the HR person at your hospital or academic institution.  

In my opinion, you should begin by checking out the conversations going on in other fields.  There are some incredible websites built around some really creative and interesting people who are living fascinating lives and teaching others how to do the same.  Check out the following as a starting point:

• The Blog of Tim Ferriss: Experiments in Lifestyle Design
• The Art of Non-Conformity Blog
• Thrilling Heroics with Cody McKibben
• The Blog of Corbett Barr

Once you immerse yourself in this culture you begin to see possibilities that you never would have realized before.  What's more, as a physician there are even more possibilities available to you than for the typical person, if only you'll step out and take a little risk.

Over the last few years this idea of lifestyle design has been a focal point of my thinking when it comes to career moves and ultimate goals.  I've invested a lot of time, cash, and sweat into learning how to build a unique career, and my hope with Freelance MD is that we can use this website as a vehicle to help other physicians, just like you, succeed in designing a lifestyle and career they truly enjoy.