Over the years, I have come to the painful realization that I am not perfect.

Ok, all you other surgeons, close your eyes and ears, because to admit to being less than perfect is a sign of weakness (like asking for help). Don’t read this, patients, because you wish even more than I do that I were perfect (especially when I’m operating on you). But it’s true.

Long ago, I remember feeling that perfect was achievable. In my innocence, I pictured myself with a high-flying academic career in a big city neurosurgical teaching program. I would have a handsome husband with a powerful career of his own, 3 perfect children, and a home straight out of Southern Living. (I even subscribed to the magazine.) Of course, I would need no help taking care of the house, because I would do it all myself. I would have no surgical complications, and every patient would love me. I would be Harvey Cushing and Martha Stewart, all rolled into one!

I think it began to sink in that this was a little unrealistic just before the start of residency. My husband and I had just returned from our honeymoon. I had left myself 4 days to move halfway across the country and set up housekeeping before our first day as interns. With one night left, I found myself staring in horror at boxes still sitting implacably all over our new house. Yikes!

Through our years in residency, we added a baby and a hefty dose of realism to our lives. Thoughts of Southern Living fled from my mind. Indeed, thoughts of homemade baby food, beautifully decorated nurseries, and hosting book and supper clubs also vanished. I felt lucky to keep the bills paid on time, the vaccinations on schedule, and the house clean enough to walk through (with my husband doing a lot of the work himself). Despite all this, we both somehow made it through residency with our marriage intact.

Now it is more than 15 years since that idealistic, newly married intern walked through the door of a new life.

Looking back, I’m proud of much that I’ve accomplished. I have a thriving practice and a family that seems pretty well-adjusted, despite all the gruesome patient stories told over the dinner table. I’m a lucky woman.

I’m not so proud of how I’ve balanced work and family over the years.

Anyone who goes into a demanding surgical subspecialty knows what it will be like. There will be sacrifices and long call nights. There will be stress and tears. There will be time away from family. Anyone who loves a surgical subspecialist knows this, too. My husband knew this when we started dating in medical school. But he also knew how much my career meant to me. He knew I wouldn’t be happy without it. He married me anyway.

The decision to marry this wonderful man has been the saving grace of my life. He has done so much with so few complaints. In an culture that is still macho in many ways, he has done a lot of laundry and a lot of childcare. He takes our son to school and picks him up. He helps with homework and goes to pediatrician visits. He has been the hands-on parent where I have not. Without him, our family would have disintegrated.

Not that I haven’t done anything, in my own defense. When I’m not at work, I’m all about home and family. I have made it to every band concert and the majority of my son’s sporting events. I actually made it to every single football game this season, even though they were on Thursdays. For several years, when my son wasn’t eating well, I made dinner from scratch almost every night. Some nights dinner was late, some dinners were frozen from earlier weekend cooking sessions, but they were done. I supported my husband when he wanted to make a radical career change, without questions or criticism. I have tried. I have tried HARD.

But I admit, I have spent long hours at work. Because I’m busy at work, I don’t fully appreciate the long gaps they feel at home. And I admit, I have taken my husband for granted a lot, which is wrong. I have leaned on our marriage hard, drawing strength from it to keep doing this incredibly difficult job. I worry sometimes that I may have weakened it too much.

Almost exactly a year ago, I wrote an anguished post about a day in my life. Seeing it in writing and hearing all the feedback made me see that I had to have better control. Since then, I have worked very hard on finding a better balance.

I have now hired a cook to come to our house and make dinner every weeknight. She does the grocery shopping and some of the cleanup. That may seem pretentious, to have a private cook, but it’s worth it to me. We also have housekeepers come twice a month, but this is not new. I have hired another physician who helps me with the patient load in the office (although not in surgery). I have committed to taking a big family vacation every summer and every winter (at least a week and a half). I spearheaded hiring a new practice administrator, who has done such a good job that I no longer stress about every detail of running the office. Things are better, although the patients are no less sick, and the job is still demanding.

I now have a Facebook page that allows me to communicate with friends and family more efficiently. My husband and I had our first “date night” last month – dinner and the new Harry Potter movie. It was wonderful and relaxing. We plan to do this every month now.

I actually asked my husband and son what they thought about my work-life balance to get their perspective for this post. Those two peas in a pod both looked at me blankly and said, “What balance?” We all laughed, and I sighed.

As I have finally admitted, I am not perfect. I am, however, doing my best. They know how much I love them, and they know I am trying. We have a saying in surgery: “‘Perfect’ is the enemy of ‘good’.” I don’t want to be Martha Stewart Cushing anymore. I just want us all to be content.

“gcs15″ is a neurosurgeon who blogs at Mothers in Medicine.

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