It’s just me

1. If you don’t love what you are doing, the external rewards are never going to be enough

From my observations, it seems that those who appear the most conflicted as parents and as physicians are the ones who believe that everything they do can—must—be compensated. But so many tasks—nights spent sleepless with sick children, the extra mile getting a patient’s referral expedited, the demands of redirecting an adolescent’s scrambled emotions, the time spent explaining (again) the correct use of a metered dose inhaler—defy direct recompense. Whether remuneration is anticipated in the form of school marks in the 95th percentile or an improved financial bottom line, one is very likely to be disappointed in the outcome if the reward isn’t substantially linked to the fulfilment felt for a job well done.

2. You can’t go it alone

Like the village that needs to have a hand in raising a child, so the whole healing community participates in mending the sick and injured. I later learned that my caregiver Leslie’s daughter was, in fact, the first in our midst to make the impulsive and unnecessary emergency phone call. After our analysis, debriefing, and commiseration, Leslie and I were eventually able to have a good laugh about it all. And although I longed to have another physician at my side with my car accident patient, the nurses, paramedics, and receiving emergency medical officer at the other end of the long-distance line all did their best to help and guide me. Assistance and support are almost always there, if you ask for them.

3. Every day, I gain at least as much knowledge as I am able to share

I completed medical school and residency before having children, but what did I know about breastfeeding, infants with colic, recurrent otitis media, separation anxiety, injury prevention, developmental stages—for that matter, diaper rashes—before being a parent? Nothing, really. Sometimes I think there should be annual continuing medical education credits just for being a parent. Because having been through my own adolescent’s frontal lobe growth spurt, I am better able to help the next parents in line at the evening urgent care clinic who are concerned about their depressed teenage son having the car and want me to take away his car keys.

By the same token, patients have taught me exactly how atypical chest pain can be and which of the 101 side effects listed are really hard to live with. All I have to do is listen to the conversations around the dinner table and in the family van, in the clinic and the emergency room, and I am enlightened and offered answers to questions that never came up during training or in parenting books.

4. Nobody told me it was going to be like this …

Not my own parents (or I wasn’t listening). Not my medical school professors (maybe during residency some of the practising family physicians dropped a few hints, but those, too, fell on deaf ears) … and if they had … I wonder if I might have at least considered another path. I have observed the lives of those who are doctors but not parents and the lives of parents who are not doctors. Then there are all those people who are neither parents nor doctors. I find it staggering how different a life’s tangent can be based on just those parameters, even given similar starting points. In the end, though, having heaved a sigh as my child finally ceases her inquiries about the existence of the tooth fairy and moves into sleep, and having heaved a sigh (along with everyone else in the room) as a patient’s arrhythmia finally converts, I cannot actually fathom what else would, in fact, be so worth doing with my life.

5. Guidance sometimes comes from unexpected sources

There are 2 affirmations, of sorts, I recite when I feel the tidal forces of chaos and irritability threatening to overtake the person I am trying to be. One happens to be the second law of thermodynamics: All systems tend toward entropy. Or in another, telling, version: The entropy of the universe tends to a maximum. The other is the part of I Corinthians commonly associated with wedding services: Love is patient and kind.

I try to remind myself that the energy I expend contending with disorder—whether associated with injury and disease, creative play, emotional meltdowns, or any disorganizing process over which I have only partial control—needs to be replenished after a long day of doctoring or parenting or, often, both. And if the ultimate generator of that energy is not love, or if the manifestations of my efforts cannot be perceived as expressions of kindness and patience, then why bother? I walk the daily tightrope above that charging stream of frustration, fear of failure, and selfishness; sometimes free-falling into the current, dragging myself out again, apologies extended. It’s a tricky balance. Without a clear and worthy target on which to fix the gaze, it would be an impossible one.

6. Learn to hear between the lines

Parents and family physicians must be communicators; there is no choice in the matter. What we hear isn’t the same as what’s being said, of course. We prick our ears in the direction of the sound and also toward the meaning behind it.

Patients ask: “Is everything okay, Doctor?” By which they actually want to know “What do you mean?” or “Are you sure?” or “Am I going to die?”

When I am on call, my children ask their grandmother: “When is Mommy going to be back?” Which can mean “Is Mommy okay?” or “Why does she have to go away?” or “Will she ever be back?” or “Does she still love us?”

I listen. I interpret. I hope for understanding. “I’m only one person,” I tell my children—and myself. Still, I’ll keep trying to do my best.