How to handle family and parenting stress as a physician [PODCAST]

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“Being a parent in the middle of a pandemic is not easy. Sheltering in place with canceled daycare, school, and college, while also being a doctor or other healthcare worker, working in high-risk, high-intensity situations, presents many challenges.  It also presents many opportunities.

It is possible to choose thoughts about being a physician and a parent during the COVID-19 situation that can help it feel more like an opportunity and less like a struggle.”

Jessie Mahoney is a pediatrician and can be reached at Pause & Presence Coaching.

She shares her story and discusses her KevinMD article, “How parenting in a pandemic is an unexpected opportunity.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Jessie Mahoney. She’s a pediatrician and a physician coach. She wrote the KevinMD articles “How parenting in a pandemic is an unexpected opportunity” and “Self-care is not selfish: It’s imperative to save the practice of medicine.” Jessie, welcome to the show.

Jessie Mahoney: Thank you so much. Honored to be here.

Kevin Pho: So we’ll get into those articles in a bit, but first, tell me your story and your journey to where you are today.

Jessie Mahoney: So my story is, I actually grew up in Berkeley, and I went to Dartmouth for college on the East Coast and then came back to San Francisco and went to UCSF for medical school. I went to medical school a long time ago, and during my time in medical school, I actually had a baby, which I think has sort of dictated a lot of my career. And so I like to just bring that up. That was at a time when it really wasn’t a thing that people did; now it’s much more common. My med school baby is now 24.

And so when I graduated from UCSF, I went to residency with a baby and promptly had another baby in the midst of residency. So by the time I got to the end of my pediatric residency, I was really very focused on wellness and how you can balance parenting and physician wellness and having a sustainable career where you could make a big difference. And so that’s sort of been the focus of my career all along. I spent much of my 17, 18 years in medicine really advocating for physician wellness.

And I like to think of it not so much as a balance, you know, work-life balance, but I really do believe that medicine and life intersect 100 percent. And maybe, as you mentioned with this idea of parenting in COVID, you really can’t separate them anymore, right? It’s not like your kids are at daycare and you’re at work. Everything is just melding into one, and all of the stresses and joys are also melding into one. And so that, to me, is really a big piece of it.

And then a few years ago, I encountered just a lot of stress in my own life, and I turned to not just coaching but also yoga and mindfulness. And so I became a yoga instructor, and I teach yoga and mindfulness, primarily to physicians now. And I worked with a coach myself for six months to sort of help get through some of the challenges of being a full-time pediatrician with multiple leadership roles and three children all at the same time, and then some personal and family health crises. And what I discovered about coaching is that it was really sort of a secret sauce to making everything work. And I think it’s the secret sauce for a lot of the struggles that physicians have.

And so I generally work with people who are, as I like to say, successful on the surface and struggling underneath. That might be all physicians, and it might be everyone in the world, and we often aren’t as open about those struggles. But I think that’s a huge piece of it. And so just being able to help other folks through coaching, it’s just really life-changing. And whether I work with parents or relationships, we all have issues. You know, as physicians, we like to think we’re not vulnerable, and perhaps COVID has really allowed that to be seen at a broader level. And really, people’s family lives have come onto the front burner, whether it be through Zoom or telemedicine and all those things. But I think it’s really opened up the conversation around wellness and self-care, and a lot of the parenting challenges as well.

And so recently, I actually have transitioned in my career. After almost 20 years of primary care pediatrics, I’m doing almost exclusively coaching, and I actually am coaching fellows at Stanford as well, sort of helping people get on the right path at the beginning of their career around mindset and how to balance life, whether it be as parents or as spouses, and also in just incorporating physicianhood and lifehood together, if that makes sense. And I’m figuring out what part of clinical medicine I’m still going to do and what that looks like. So it’s a real opportunity to discover what I’m about and what my passion really is.

But what I’ve discovered is that doing this work to help physicians is really a passion. It’s kind of like this idea that when you put your own oxygen mask on, you can provide better care for other people. And I think that when we help physicians, we help everyone else that they take care of. And so that’s really where I believe the power in coaching is. And from the parenting perspective, when you help a parent, you’re helping the entire next generation. And so the ripple effects of all of that work, as I’m kind of just tying it together, are amazing. And so that’s where my pediatrician hat comes on all the time. You know, it always just plays into that sort of, we want to be, one, a good model for the next generation, whether it’s the next generation of doctors, our patients, or our children.

Kevin Pho: Now, I know during a pandemic, it’s a tremendously stressful time for a lot of physician families. Let’s start with the parenting aspect. I want to go into the first KevinMD article that you wrote, “How parenting in a pandemic is an unexpected opportunity,” and I want to start with reading you an excerpt. You write, “Being a parent in the middle of a pandemic is not easy. Sheltering in place with canceled daycare, school, and college, while also being a doctor or other health care worker, working in high-risk, high-intensity situations, presents many challenges. It also presents many opportunities. It is possible to choose thoughts about being a physician and a parent during the COVID-19 situation that can help it feel more like an opportunity and less like a struggle.” Now tell me the story behind that article and why you decided to write it.

Jessie Mahoney: The story behind that is, and as you read it now, it just resonates, I think we so often choose stories to tell that don’t serve us. And so there’s this idea that, you know, there are terrible things happening outside us, and we can’t manage it all, and we’re overwhelmed, and all of the things that are missing in our children’s lives. And at the beginning of this pandemic, that was really the story, you know: What are they going to lose out on from daycare, and what are they going to lose out on with all these things? And really, when we encounter challenges and difficulties, it’s such an opportunity for growth and learning.

And maybe now, many months into it, people are starting to see, you know, there are silver linings. But I would say that there was so much opportunity in rethinking our priorities and rethinking all the things that maybe our children were doing, and all that I’ve heard from so many, all the activities that they thought that they needed to have. And now they’re having this tremendous benefit of more family time and just more creative thinking about what’s really important and where we want to spend our time. It’s sort of like that power of the pause to rethink.

I also think, you know, when kids see parents struggling and being vulnerable and working through challenges, that’s just an incredible learning opportunity that we often don’t show our kids, right? We go to work, and we don’t tell them how difficult our day is. And some of the work around kids and anxiety gets back to this idea that if they don’t see us work through and solve these problems, they don’t learn those skills to do it. And so COVID presented this incredible opportunity to be vulnerable as a family and talk about how you deal with challenges, whether it’s canceled things or how you’re going to deal with the worry of going off to work and what might happen, and who else is in their lives. And it’s a real chance to just look at our world and what’s happening and have real and open conversations.

I also think that the family connections that came out of it are just incredible, right? People really started to open up and be more vulnerable and connect and appreciate the time they had with their kids and their relationships and what was more meaningful. So that’s the gist of the opportunity. Of course, there are challenges, but in challenges, there’s often tremendous opportunity.

Kevin Pho: And what’s your number-one tip that you could share with physician parents, especially during the pandemic?

Jessie Mahoney: I would say, I’m going to give you two. One is compassion, and compassion all around. So compassion for the kids. You know, there’s a lot of discussion about routines and disruption and behaving maybe not the way we expect. And compassion for ourselves as parents, that we can’t do it perfectly. I’ve actually told several of my clients, “No one’s ever parented in a pandemic before, so we don’t know what perfect parenting looks like.” So compassion for all of us, that we’re all just doing our best and that everyone’s in it as a family together. And I think that would be the first thing.

And then the other one is just this kind of acceptance and allowance of one another, which ties into compassion. But so many things I see, whether it’s with spouses or with kids, you know, they’re behaving in a way that maybe we don’t want them to, or the situation isn’t as we want. We don’t necessarily want, you know, whatever is happening to be happening. We don’t want the prom to be canceled. We don’t want whatever it might be, or we’re really struggling with finding daycare. But when you accept and allow it rather than fighting reality, that just makes the process so much better.

And so we don’t have to like it. We don’t have to like what our spouse has to say. We don’t have to like what the kid is doing. But one of the things we say a lot is, “It is what it is.” And so that’s a mindfulness practice. It’s just accepting what is happening in this moment and very much practicing not resisting it. So it doesn’t mean that everyone’s behavior is perfect and that we don’t do our best to make changes, but this fighting reality really makes the situation that much worse.

Kevin Pho: Now, during the pandemic, there’s also a tremendous amount of stress between spouses as well. What are you seeing through your coaching practice?

Jessie Mahoney: A lot of stress between spouses, I think, is what’s really coming up. We talk in coaching about manuals that we have for each other. And so our manual is our expectation of what our husband or what our wife should do as a husband and wife. And interestingly, we actually all have ideas about what our husband or wife should do in a pandemic, and what they should do if they’re home all day, or what they should do if they’re working in a certain scenario, and how they should be reacting to it. And so I think it’s just brought up a lot of the underlying issues of people realizing that they had these ideas, preconceived ideas, of what people should do, and when they’re not meeting them, what does that mean?

And so I see a lot of people discovering these thoughts that they have and then needing to do the work to sort of accept and allow the person that they are with to respond to things the way that they do, right? So we often want them to be someone that they’re not, or we make their behavior mean something that it doesn’t. And when we have anxiety and uncertainty and so much out of our control, we tend to put even more power on these other relationships and get more angsty and feel like they’re so much more important. And in a sense, they are more important, but also, as we spend more time together, the irritation level rises.

And so I find that it’s really important to just sort of step back and realize that you are with whoever you’re with, and you can’t change them, right? And so just really appreciating what you both bring to it, and a little bit, I guess I would say, flexibility, but it’s not really flexibility. It’s just sort of honesty of, like, we are all who we are. And many of us as physicians are fixers, right? So we see that our spouse should do it differently, and we want to fix it instead of just sort of letting them come into play. And I think as co-parents, that’s particularly true. I see a lot of parents who want their co-parent to change and to do it the way that they think they should, and that’s creating a lot of angst and tension.

So I think when we come at things from this place of anxiety, we all show up in a space that’s just not as accepting. And so this idea of compassion and acceptance, and grace and space, is one of the other things I like to say, right? Just realizing that under all of these extraneous circumstances, the more grace and the more space and the more mindfulness you can have in both parenting and spouse relationships.

There’s a Viktor Frankl quote about how there’s a space between the stimulus and the response, and that’s where your power is, right? That’s this mindfulness. That’s the pause. And that’s actually part of my thing about Pause & Presence, right? Take the pause, and then show up with presence. And so whether you’re, you know, having parenting struggles or relationship struggles, can you just take advantage of that pause and take a deep breath, and then show up with presence in a way that you are consciously showing up for all of your loved ones?

Kevin Pho: Well, I think you’ve given us such great tips when it comes to parenting and relieving the stress between spouses. Now, at what point does a parent need help to take that next step and either seek a coach or a counselor?

Jessie Mahoney: Well, I would actually say that I think all parents and spouses need help. And as physicians, we don’t like to think we need help, and so most of us don’t reach out for help until we desperately need help. And so I would actually encourage us all to kind of be vulnerable with others and realize that we need help and we can learn from other people. I think that’s an incredibly powerful message. And if you’re struggling, I would say none of us should be struggling. We often just feel like we can fix it ourselves. That’s the other thing. And so you don’t have to fix everything yourself, and there’s no shame in asking for help.

And so if you are not showing up as the person that you want to be showing up as, and I have a lot of parents that are angry and irritable and yelling and stressed and not sleeping, etc., you can start with some self-care. And if you’re not practicing self-care, even just taking a deep breath or being mindful or going for a walk, it doesn’t have to be complicated. But if that’s not working, reach out and check in and ask for help, and do kind of a double check, like, “Have I tried to fix this, and it’s not working?” Then you want to try something different, right?

Lots and lots of kids and parents are suffering from depression and anxiety and such, and to me, the biggest problem is that we don’t reach out. And so reach out, check in with someone, and say, “Do I need help?” right? It’s really hard to sort of say when you need help, but I think if you think at all that you need help, you 100 percent need help. And the physician tendency is to think that you don’t need help, right? And so it takes us all much longer to get there.

And you can start by taking care of yourself, but if that’s not working, get yourself some real, reach out. You know, reaching out to a coach is beautiful because, in many people’s minds, there’s no shame in it, right? Athletes have trainers. Physicians, our job is really difficult, and in a pandemic, it’s even more difficult. And if you have children, and I have three teen and young adults myself, that’s even more difficult. And so we’re really superhuman. And so getting help, if you think about it, is like a performance tool. It’s a happiness tool. And I think as physicians, we have a lot of difficulty investing in ourselves, and yet investing in yourself before you desperately need help is a really good time to do it.

Kevin Pho: We’re talking to Jessie Mahoney. She’s a pediatrician and a physician coach, and she wrote the KevinMD article “How parenting in a pandemic is an unexpected opportunity.” Jessie, what’s your take-home message for the KevinMD audience?

Jessie Mahoney: My take-home message would just be, my biggest one right now, to take a deep breath. I think, you know, so many of us as physicians and as parents don’t stop and take a deep breath and pause and be really thoughtful about how you want to be showing up in the world, for the world as it is today, whether it’s as a parent or whether it’s as a physician. And put on your own oxygen mask first. So whether you’re a parent, physician, or spouse, you can’t show up and heal and take care of others if you don’t take care of yourself. And if everyone in the world did that, what a different world we would have, right?

Kevin Pho: And how can people find you?

Jessie Mahoney: You can find me on my web page, which is www.jessiemahoneymd.com, and it’s J-E-S-S-I-E. So you can find me there. And Pause & Presence Coaching is the name of my coaching practice, if anyone would like to reach out. I would love to answer questions.

Kevin Pho: Well, thank you so much for sharing your insight, and thank you so much for being on the show.

Jessie Mahoney: Thank you.

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