On Finding Work-life Balance

It was 1 a.m., and finally, the day was done. The typical anesthesia call day started with a bunch of joint replacements: Hurry, place the block, get the spinal, hurry, and repeat. Then the emergency add-ons came, one after another, finally finishing with that nasty subdural hematoma. But at last it was done and I was going to get some sleep. I needed sleep. I stepped out of the hospital into the desert night and walked to my car, thinking I should be clear for a few hours before I had to go back at 6 a.m.

I drove to the condo where I stayed on my call days, since we lived so far away. I quietly opened the door and stepped inside. I felt the pull of the pillow and couldn't wait to be tucked into bed. I had to see him first, though.

My first-born child lay sleeping in his travel crib. I was careful not to wake him - at 3 months, he still didn't sleep well - but placed a gentle kiss on his little head. He was the reason for all of it. I didn't want him to grow up like I did, always feeling inferior because of poverty and the uncertainty and lack of confidence that goes with it. I didn't go into medicine for the money but was satisfied that the career I chose would provide the security of a good job. No matter what else happened in my life, I could take care of my children - that was always my motivation, even before they were born. So I did what I had to do. I drove nearly an hour back and forth to work on the days I wasn't on call and rented hotel rooms and condos when I was. It wasn't easy but I kept reminding myself I was just doing what I had to do for my family.

As I slipped under the light cover, too tired to change out of my scrubs, I realized how exhausted I really was. It felt better than I even anticipated, having my head sink into the pillow. The beeping of the heart monitors that I had listened to for the past 18 hours lingered as an echo in my ears, but was finally fading to a faint ringing.

I turned out the light and put the pager down and, at what seemed like the exact same moment, heard my baby cry. I stumbled back out of bed to bring him to me to feed him, selfishly hoping he'd go back to sleep very quickly. Finally, snuggled up next to him, I felt a sense of peace, of contentment. Again, it all was worth it - I was doing it for him.

We both drifted off to sleep and it felt so good, lying in bed after a long, hard day with my tiny little boy beside me. This was how it was going to be and I'd cherish the moments when we were alone in the stillness.

The pager sounded as loud as the horn of a freight train. I grabbed it and hoped it didn't wake up my baby. Still asleep. Looking at the time, I saw it was 3 a.m. I had been in bed for just about an hour and that was going to be it for the night. I left Evan asleep on the bed, carefully surrounded by pillows tucked under the sheets so he couldn't roll off. I quietly poked my head into my mother's room and let her know that I was leaving again, so that she could take my place next to Evan. I could tell by the way she nodded her head that she was worried about me. Oh, what would I have done without her? She had moved from Pennsylvania when my dad died to be my "nanny," available every minute of every day, at a moment's notice. There's no way my husband and I could have managed without her. We were very grateful. She never complained, but I knew that the harder I worked, the harder she worked and the weariness was starting to show. And Evan was not an easy baby, lots of crying, little sleeping. I felt guilty about leaving her, again. I knew that I wouldn't be back, that this night was going to roll right into tomorrow. I hoped I left enough milk and told myself that I was just doing what I had to do. I didn't yet know that guilt was going to be an overriding emotion in my life from that point forward.

As I pulled back into the hospital parking lot, I realized I had been crying all the way there. I was tired and stressed and clearly wasn't being strong enough. I took a deep breath and dried my eyes. There was a job to do, my job.

I reminded myself that I'd known it wouldn't be easy, being a mom with a demanding career. I just had to "find that balance." But I didn't really know how to do that. I had to work when I had to work. I couldn't just leave when I wanted, stranding my partners to cover all the work. So I decided balance must mean working when I have to and giving the rest to my baby. Must be. I carried on like this for the entire first year of his life. I was grateful for the days that weren't so bad and tried to give my baby what he needed when I could. Even when I cut back a bit, it felt like I could never give him the best part of me. I was tired and stressed. And I certainly didn't feel balanced. Even if half of my time was for work and half was for him, I did not feel balanced.

As the year drew to a close, my husband and I started talking about where we would live after his Navy commitment was over. I hadn't told him yet that I had made a decision. I wasn't going to do this anymore. I was not going to work full-time and just give my child whatever was left over. That wasn't good enough. He deserved to be a priority, too. Now, I work part-time and still struggle with the guilt that I'm not helping financially as much as I could. The guilt dissipates quickly, though, when I am home to pick up my now-5-year-old from the bus stop and hear about his exciting day of kindergarten, or take my 3-year-old to swim lessons and get to hear "Mommy, watch this." I spend more time with my children than at work now and finally feel like I've found my balance. Balance does not mean dividing my time equally among all of my priorities. To me, it means deciding that if one priority, like my kids, is overwhelmingly more important than anything else that I need to work my life around them. And I need to not feel guilty about what I'm not doing. After all, I'm doing it all for them.

Cheryl Orr, MD, is a part-time anesthesiologist and full-time mom in South Lake Tahoe, Calif. She hikes, skis, and spends time with Evan, 5, and Clayton, 3.

This article originally appeared in the February 2011 issue of Physicians Practice.