August 2003

This month's column focuses on practical strategies for dealing with the myriad demands of family and career. The hard reality is that everything you choose to do comes at the expense of some other activity in your life. Although the examples I give are personal, they illustrate the general principles that are meant to help you figure out what works for you and your family/career.

Many articles on family/career issues focus on the concept of "balance." This always seemed like a gross oversimplification. Given the multiple duties parents working outside the home deal with on a daily basis, you'd have to be an octopus to be able to "balance," let alone "juggle," everything. Instead, giving the constantly changing demands of family and career, "dynamic equilibrium" seems more appropriate. I have had to cancel meetings because my children were sick and childcare was not available. Other times, I have had to stay late at work and miss putting my children to bed because of a sick patient in Intensive Care. But as we'll discuss below, maintaining a clear view of my overall priorities and goals not only helps me to ride out the bumps, but also helps my family and co-workers to understand when one facet of my life takes up a greater percentage of my time than usual.

Setting Priorities and Making Choices
One theme I have stressed over and over again in this column, is the need to clarify your personal and professional priorities. To be successful, you must define "success" for yourself. Knowing your priorities will also guide you in structuring your life. Most parents with young children are sleep-deprived. If you are going to maximally utilize the few hours of effective functioning available, you must know exactly what you want. Only then can you develop efficient strategies to achieve those goals.

I am a pulmonologist. But for the last four years, I have also been the mother of two daughters. In terms of absolute priorities, they come first. And I try to show that by being there for them. My children know that it is very important to me to read them a bedtime story and put them to bed. But they also know that I am a doctor, and that if I miss that activity, someone must be very sick in the hospital. There have been times when my husband or I have come home just to say goodnight and then gone back to the hospital. Except for one instance, one of us has managed to be at every school performance or activity. As much as possible, we eat together as a family. But that doesn't mean a home-cooked meal every night. If preparing meals is an odious burden, have weekly takeout or pizza nights. Can't stand the thought of doing laundry? Take it to a service or negotiate with your nanny/babysitter to help out (understanding that watching the children comes first).

Learning to Say No
In terms of work, "success" for me has always meant research productivity and grant support. Since having children, I am no longer willing to spend 80-100 hours a week working in the lab and office. I had to begin to say "no" to additional administrative responsibilities, and limit my committee memberships. I traveled less. I stopped my academic clock for two years for childcare reasons. While this relieved some of the pressure in terms of promotion, this was difficult to explain on my CV and grant applications. Inevitably, the slowdown came with a cost in terms of decreased political and scientific visibility and decreased lab productivity. It was a cost, however, that I deliberately accepted, as I was confident of my professional identity and goals.

Finding Good Help
I naively assumed that finding good childcare would be as "simple" as hiring a good technician or administrative assistant. It turned out to be a very painful and guilt-ridden decision not to be a stay-at-home mother, since it meant that I had to trust a significant portion of my children's upbringing to a caretaker. It is not simply a matter of finding a babysitter. It is a matter of finding someone to whom you will entrust a tiny creature whose life matters more than your own. If you work outside the home full-time, at least half of your children's waking hours will be spent with this person. Thus, you must find someone or someplace that will provide the kind and quality of care equal to what you could do. Unless you are lucky, this is likely to be expensive. But trust, reliability and kindness are priceless qualities.

Good childcare will not replace you as a parent. I am and always will be my children's mother in their hearts and minds. But they have fun with their nanny and feel safe with her. Knowing that my children are safe and happy brings a peace of mind that enables me to focus and be productive at work.

Learning to Delegate
It is also important to have good administrative and technical help. Look around you at people who are in positions of authority. Invariably, they have a secretary, technical and/or postdoctoral help in the lab. Decide what requires your personal attention and what does not. Technicians and postdocs can help with aspects of grantwriting and manuscript submissions. Secretaries can help with drafting letters and memos. A housekeeper and/or cook can free up valuable time that you can then spend on other more valued activities.

Keeping Yourself Healthy and Happy
I cannot stress this enough. In order to give, you must know what you need. You must make time for yourself. There is a children's book entitled 5 Minutes of Peace that features a frazzled mother (elephant) desperately trying to have some quiet time to herself. Everyone, my children, my spouse, my co-workers suffers when I am tired and frustrated. I may have to get up a half hour earlier in the morning to go running, but it is worth it! During those 30 minutes, I focus on planning my day, solve problems in the lab and figure out what to make for dinner!

Do NOT forget your marriage! Find a babysitter, exchange babysitting time with friends but find ways to spend quiet time with your spouse as well.

Other Ways to Make your Life Easier
There are some decisions that I made that in retrospect have turned out to be enormously helpful. First, I live close to my work and children's schools. This has turned out to be a true boon in terms of scheduling and freeing-up valuable time to attend school functions or for the occasions when I've had to pick them up unexpectedly early. My neighbors have turned out to be another unexpected resource and have helped to pinch-hit. Their generosity and desire to be helpful have been invaluable for those few times when both my husband and I had work/family issues that conflicted with childcare needs. Next, I married an amazingly supportive spouse. He is also a pulmonary/critical care physician, who understands and supports my goals. He does not view housework as "women's work" and shares in the day-to-day chores involved in running a household. To be honest, I never considered these qualities before I married him. And yes, I sometimes have to ask and remind him of how to help, but the fact that we are a team makes my life that much easier.

Being Flexible and Finding Time to Laugh
Having a multifaceted life inevitably leads to occasional feelings of being overwhelmed. At times, it seems that everyone wants a piece of you or wants you to do more. The constant pressure to be more productive and bring in grant support, your children crying about your going to work everyday, the sick patients demanding your compassion and care, the section and division chiefs wanting yet another document filled out or project undertaken. If you have to, go to your office and close the door. Sit down and breathe deeply. If at all possible, find something funny in all the craziness. Laughing can provide the activation energy sometimes needed to get over the hump.

More often than not, things do work together. And it isn't just about you giving all the time. Viewing life as a dynamic equilibrium means that there is positive feedback as well. The different aspects of my life often complement each other in a positive fashion. I have learned an enormous amount from my colleagues and patients about myself and life that I hope makes me a better parent. And becoming a parent has taught me a compassion for my patients that no textbook ever could. As I said in the beginning, my daughters' happiness comes first. The joy in their eyes fills me with a positive energy that I savor everyday.

Dedicated to Drs. Douglas Conrad, Alice Boylan and Charles Daley.