Physician Vs. Parent - Which Comes First?

If you’re a physician parent, no doubt you’re familiar with the helplessness associated with the phone call informing you that your child is sick - and needs to be picked up within the hour. You know, the one that coincides with when you were about to start a procedure or a time where there’s no backup available to take over your responsibilities. Murphy’s law.

Many of us have nannies exactly for this reason, or if we’re lucky, family. Personally, I have a long list of sitters that I call while I cross my fingers, hoping one will be available at the last minute. Yet, I struggle with the thought that this should be the case. When my kids are sick, they’re miserable, and at least for now, they want their mommy. Leaving them with someone else on those days doesn’t sit well with me, no matter how I justify it.

But then again, neither does canceling a biopsy on a patient who has been stressing about cancer or has planned their schedules/lives to accommodate recovery from a procedure. In medicine, we’re taught that our patients always come first, and as parents, we’re taught that our children always come first. How then, do we deal with situations where both need us?

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Flashback: A few years ago, my son fell, resulting in a nasty laceration and a large goose-egg. I wanted to call my husband, a surgeon, but knew he was operating. We had developed a paging code system exactly for these types of situations. As I dialed his pager number, I debated whether to use the code for, ‘Emergency: Drop everything and call me,’ versus ‘Need to talk to you but not a total emergency, call me as soon as you can.’ Although I desperately wanted to use the former, I decided on the latter, as he was in a trauma case that required his full attention.

In the meantime, I attempted to keep an ice pack on my screaming 1 year old, while wondering whether he would need stitches or whether the Dermabond we stocked in the house would be sufficient. I thought about how, at that moment, there was a good chance that the ER was paging my husband about sewing up someone else’s laceration. Worse, I pictured going to the ER and having one of my husband’s interns to sew up my child, while my husband was nowhere in sight.

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I could come up with a number of similar instances, as I’m sure most of you who are reading this could. We all struggle with the balancing act of being a ‘good’ parent and a ‘good’ physician on a daily basis. Some examples that come to mind:

• Not being able to take time off in the middle of the day to attend an event at school

• Missing a child’s sporting event because things at the hospital ran late

• Not being able to commit or make promises to do something because you're on call

• Putting off pushing while you are in labor until the clock strikes midnight so that you have an extra day of maternity leave (this may or may not have happened...)

Working parent guilt is certainly not unique to physicians. If we’re lucky, we’ve come to terms with the guilt by ensuring that when our children aren’t with us, they are with people that we trust and doing things that they enjoy. It may not always be ideal, but most of the time, I’m able to justify my decisions by recognizing that I’m a better parent when I work and knowing that if I were in the patient’s position, I would want a physician who put me first. When I’m really feeling guilty, I reconcile these feelings by noting how resilient my children are and how they are proud of what I do.

That being said, there are times where I still resent the sometimes impossible positions that our roles as physicians put us in, forcing us to choose between our children and our patients. After all, our patients are also someone else's parent, child, or loved one. As someone who’s always looking to address issues in life in medicine, this is one that I don't have an answer to, and one that I know is never going to go away.

Ultimately, we have to make the decisions we can live with. For my husband and I, the decision about which comes first is made on a case by case basis after considering a number of factors - which is the more pressing concern, what backup is available for either party, and what feels right. In those cases where we’ve decided that the kids need one of us, as a dual physician family, there’s a whole separate discussion about whose patients are going to take the backseat that day, but I’ll leave that for another day.…