Susan M. Ripley MSc MD CCFP

Her father, a doctor; her mother, a nurse. The eldest of 5 children, she remembers helping the youngest get changed and dressed. Her father at rounds early in the morning, home late in the evening, often on call; but when home he’d play with her, with her brothers and sisters, as strenuously as he’d work in the hospital. Her mother with each of the children, through each of their stages, the patience of attending to them, perpetually.

Dr Ripley had graduated and practised for a few months before she became pregnant with her first child. She worked in Halifax hospitals, her main responsibility a 36-bed Community Health Unit, but was also part of a call group responsible for over 300 beds. As her pregnancy progressed, she took more call: to establish momentum, to master the learning curve, to solidify the identity and skill of the physician. She then added obstetrics call to her responsibilities. And then added emergency room shifts. A month before her due date, she was on a ward at 2:30 in the morning, and she asked herself what anyone would at such an hour: What am I doing here? And the pager going off, again.

At 39 weeks, she stopped working, a first year established as a practising doctor. Her healthy son was born on time.

She thinks there is nesting of 2 kinds: a medical nesting, for the nascent doctor, and the nesting of the mother. Her son is now 14 weeks old, and it has been 14 weeks of call: he still sleeps irregularly, getting up 4 to 5 times a night. In the early days of sleeplessness, there was that same 2:30 moment, albeit more light-hearted: “I’ve done a lot of call. I know what it feels like.” But a week straight was the most she’d done in medicine. It is perhaps the same endurance. Early in her training, a mentor once told her, “People call when they reach the threshold of what they can do themselves.”

Perhaps the same intimacy: Dr Ripley stands near her son’s crib, stands and stands; she sits next to a palliative patient’s bed, and sits and sits. The bond is predicated on time, on the strenuous use of time. She had wanted a child for years, had wanted to be a doctor for years. In a few months, she plans to return to work, will carry a pager. But last night, her son only woke up once.

• Copyright© the College of Family Physicians of Canada