So, are you committed to medicine — or your baby? [PODCAST]

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“As I approach this last stretch of residency, still entrenched in the rigors of training and the intensity of raising three young children under five years old, I am in a unique position of being able to reflect on the years and look ahead at what I want to build at the same time. It has been a lonely, emotional, seemingly endless journey at times.

We mothers and doctors are barraged with messages that we do not belong here, straddling both roles. The work of dismantling these messages will be impossible for any single person, but cumulatively we can. And for future young women who are budding doctors and hopeful mothers, I hope their search for answers and advice results in them finding a large community of support and belongingness.

And I will continue my part to advocate, to mentor, to fight this cycle of self-blame that our training system perpetuates, to continually question these messages of what priorities ‘belong’ in medicine, until finally, we expand this radius of belonging. Despite all that I have encountered, my spirit is not broken. I have work to do.”

Eunice Stallman is a psychiatry resident.

She shares her story and discusses her KevinMD article, “So, are you committed to medicine — or your baby?”

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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 Eunice Stallman. She is a psychiatry resident, and she wrote the KevinMD article “So, are you committed to medicine, or your baby?” Eunice, welcome to the show.

Eunice Stallman: Thank you for having me.

Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?

Eunice Stallman: Definitely. I’m a psychiatry resident in my fourth year. I’m graduating off cycle because I’m making up a few maternity leaves, which we’ll talk about later, but I graduate in about three months. I’m here in Boise, Idaho.

My journey to medicine, kind of: I was entertaining a few different things, but ultimately decided that I wanted to do psychiatry. As a doctor, I’m the first in our family. I went to med school at Ohio State University. That was my first time being in the Midwest. It was awesome; it was cold. Then we moved back to be closer to family. I write about my experience having children in training. I had my first in third year of med school, my second in intern year, and my third in third year of residency.

Kevin Pho: So let’s get right into that and talk about your KevinMD article. I’m certainly interested in hearing more about your story, as well as the challenges and how you overcame those challenges having a family during residency. That article is titled “So, are you committed to medicine, or your baby?” Now, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Eunice Stallman: This article in some ways has been years in the making. I remember starting medical school and wanting to have children. I didn’t want to, and I know it’s such a personal decision for everyone, and there are so many factors in place, but I did not want to wait until after training. There were a lot of things that I encountered throughout, a lot of people who said, “No, this is crazy. No one does that.” And I decided to go for it, and so there were a lot of obstacles, I will say.

Throughout my training, I kept this little notebook with me, through med school, on the wards, all throughout training, and I wrote down little notes that helped me just to get it off my chest. I wrote down the hardships. I wrote down what my emotions were like. I wrote down about wanting to quit medicine. I didn’t really pull it all together until fourth year. I think it took a long time to process, and only in the position of being on the other side, and having had a few years to look back on the past eight years, was I able to pull it together.

What I realized is that I’m not the only one, even though going through it, I felt like I was the only one. So I hope to get this message out, that for other women who are considering having kids in training, this is what I’ve gone through, this is what you may go through and experience, and you’ll come out of it on the other end, and you will have an opportunity to shape what it’s like for future generations of doctors. But ultimately, it’s to show that you’re not the only one.

Kevin Pho: Now, you said at the beginning there were a lot of factors, of course, that went into that decision. What were some of those factors?

Eunice Stallman: Some of those factors for me were just that I had always wanted to have a large family, and for women waiting to finish training, sometimes that’s 10 years out, 10 to 15 years out from starting med school. I think that’s a factor that sometimes, a lot of times, women think about way more than men going into this career.

I think also part of me wanted to prove that I could do it. Part of me wanted to say to my future daughter, “This is what I did. This is what you can do.” Growing up, I had a wonderful mom who was a stay-at-home mom, and that’s kind of how I always thought that women were to be: That’s what you do when you have kids. And I didn’t want that, even though I look up to her and I love her dearly and all of that. So those are some of the factors. Also, we had gotten married, and we felt ready.

Kevin Pho: All right. And you said that there were a variety of people who said it wasn’t a good idea. Who were some of these people who discouraged you from doing so?

Eunice Stallman: There were, I think, a lot from all camps of people: some of my co-medical students, some of the residents that I was working under as a med student, some of my attendings. I think as a young woman going into medicine, when you’re thinking about this, you’re talking to other women who have kids or don’t have kids, and if you have a close relationship with them, you kind of ask them, “What factors played into your decision?”

In those discussions, people said, “I waited until a few years after training, and that was the only time that I could have seen myself doing it.” There were residents with or without kids saying, “It’s really hard. I would never do it,” or, “I did it, and I don’t spend very much time with my kids.” And then there were my peers, who said, “How are you supposed to learn medicine if you’re also thinking about having kids, or if you’re also pregnant or taking care of children?”

So at all levels of training, the people that I had talked to, the vast majority, I would say, expressed shock and disbelief. There were a few who stood out to me and said, “There’s never a good time. Do what you want to do.” I think I’ve carried their voices and their support with me throughout training, knowing that there were people there.

Kevin Pho: So if you had the vast majority discouraging you from having a family during training, what was going through your mind then? Tell me what you were thinking as these people were advising you in terms of your family and career path.

Eunice Stallman: One thing that went through my mind, for people who didn’t have kids during training and were advising me, was, “Well, I’m sure it’s easy to say that on the other side.” These people haven’t gone through it, so I’m taking their advice with a grain of salt, knowing that yes, they have gone through training and know how difficult and strenuous it is, but they haven’t gone through this specific thing in training, which is having children, and all that.

Then I think there’s just a part of me that was like, “This is not how medicine should be.” For so many years, it’s been a male-dominated field. And then there are other factors, where for the majority of the past years, men might have wives or partners who stay at home with the kids, or who work part time or have flexible jobs, and this is just not how current society is. As we see, over 50 percent of med students now are female, and in a lot of the previously male-dominated specialties, there are more and more women, and it’s time to change that. It’s unrealistic to expect women to wait, I think.

Kevin Pho: I think that journey of having a family is, of course, I’m sure, very challenging. But before I get into that, tell me how rewarding it was. Tell me why you made the right decision of having a family during your medical training.

Eunice Stallman: It’s so rewarding. I acknowledged that it was really hard. I acknowledged that there were parts that were heartbreaking, going through intern year, going through the 80-hour workweeks without seeing your kids during the majority of it. But it was so rewarding to have something that is so important to draw you home, to have this other aspect of your life that is equally, if not more, important than medicine.

For me, it helped put everything that I went through in training in perspective: OK, medicine is awesome, and it’s important, and I’m doing a great service, and I love it, and it’s not the only thing that defines me, which I think sometimes we might get in the trap of falling into. I just remember coming back from a 28-hour shift and seeing my son, and all the death and suffering that I saw earlier in the day was just, OK, put that aside, now I have this joyous fund of life in front of me. So I think it was just so, so rewarding. Looking back, and now my kids are one and a half, three and a half, and five and a half, I just couldn’t imagine going through training without them.

Kevin Pho: Now tell me, who did you lean on for support, guidance, and mentorship during this journey?

Eunice Stallman: Yes, that is huge. My husband has taken on, throughout the vast majority of training, such a huge part of the burden: the burden of child care, the burden of taking sick days when the kids are sick, the burden of housework.

We also moved closer to family for residency, especially intern year. Our family is in Seattle, Washington, and during the two years that we were in Seattle, we had grandparents help take care of my first two, and they alternated. My mom took care of them Tuesday, Wednesday, and Thursday, and then my in-laws took care of them Monday and Friday. That was how we did it. When we were still in Columbus for med school, we had the grandmas alternate, taking turns flying and staying with us in this tiny apartment, watching the baby.

I feel like if we did not have the support that we did, in terms of family, and in terms of our friends who chipped in when grandparents couldn’t help. I think that was the only way that we did it. So our support system was huge.

Kevin Pho: So the title of your article was “So, are you committed to medicine, or your baby?” Did people actually question your commitment to medicine as you were having a family through training?

Eunice Stallman: Yes, definitely, people did. I think there were people who thought that you’re less committed, or you’re less than, or you won’t be as good of a doctor because you’re distracted or you’re thinking about your home life. I’ve had my peers ask me that. I’ve had attendings; I’ve had residents.

There was one attending who pulled me aside. I was pregnant with my second, and I was taking Step 2 and just really stressed out. I was on inpatient psych, I was doing my job, I was doing it well and getting good feedback, and he pulled me aside and said, “I wonder if part of you is distracted. You’re getting everything done, you’re doing a fantastic job, but I just wonder if you’re distracted, or if you’re committed to this.” And he asked me, “Have you ever thought about leaving medicine to stay at home?”

I thought, “Whoa, this is a man who has a stay-at-home partner watching his kids, and he’s pulling me aside asking if I’m committed or not.” I don’t think that he would do that to a guy who is expecting a baby. So I think that was really hard, and those words, those little words, “Are you committed to medicine or your baby?” were ones that I had heard from not just him, but a few other people.

Kevin Pho: What are some of the things that you did to address that criticism, or try to resolve that within yourself?

Eunice Stallman: I think it’s hard when you’re a trainee. You are under this hierarchy; you take your attending’s or your superior’s word. I think part of me said, “Yeah, if this attending is doubting me, maybe I am not cut for this. Maybe I am not meant to be trying to go through training and still taking care of my kids.” The guilt is real, the mom guilt, saying, “Well, am I not doing well in training, and am I not doing well at being a mom? So how can I cut my losses? Maybe I should just be at home.”

So I think there’s this part of it, and then this other part of really digging deep and saying, “I know what I’m capable of, and I know that I’m strong, and I have all these people behind me saying, ‘We’re going to help you. You can do this.'” And it was really keeping those voices and that encouragement near and dear.

I’ve also had fantastic female mentors who did have children in training, whom I reached out to in those moments, and speaking with them was really helpful and reaffirming, like, “OK, you can do this. This is not forever, and it’ll be worth it at the end.” I think pulling yourself out from that moment of despair or questioning yourself was necessary. So I hope to be one of those mentors, or one of those attendings, for the next generation of med students and residents.

Kevin Pho: We’re talking to Eunice Stallman. She is a psychiatry resident, and she wrote the KevinMD article “So, are you committed to medicine, or your baby?” Eunice, if you were to do this journey all over again, is there anything that you would do differently?

Eunice Stallman: I don’t think so. I think the timing that I had my kids, people have told me, “That’s the worst time that you could possibly have kids.” I mean, third year, during wards; first year, during intern year. I agreed that it was really, really hard, and I would not have changed it. I think it helped me get through those hard years.

There was a point where I took some time, a leave of absence, when I was rethinking my decision to go into medicine. I was home with my two older kids for about four months, and during that time I was thinking about other jobs that I could do with an intern year under my belt. Ultimately, I came back, and I thought to myself, “Do I regret that time?” And I don’t regret it. I think it was important for my growth. It was important for me to think about and really recommit to this decision that I was going to go finish training.

Now, on the other side of things, I’m making up four months of residency, and that was a worry of mine. I was worried about jobs. I was worried about graduating off cycle, and if people would question, “Why are you graduating late?” And it doesn’t matter. There was no difficulty finding a job. I had those four months with the babies at the time, and that was much more important to me than this arbitrary goal of graduating in July. So I don’t regret that either. No one cared that I’m graduating in November. And I think it defined a lot of this journey, to define who I am and how I work with patients and what I’m committed to, which is both.

Kevin Pho: And my final question: Give advice to other prospective parents who are also going through medical training, and perhaps you can end with a take-home message to the KevinMD audience.

Eunice Stallman: Yes. My take-home message is that you are not alone, and that you belong in medicine whether or not you have kids. You’ve worked hard to be there. The fact that you’re going through that journey shows that you’re committed to medicine. And so whether or not you choose to have kids, that is your choice, and if you do choose to have kids, then you are not alone, despite maybe at times feeling like you are.

After this article came out, I’ve had quite a few people reach out to me, through Doximity, through social media, saying, “I also had kids in training, and your article was something I could have written. Those things, I experienced exactly.” And so I think that was really validating for me. So my message, too, is for people who haven’t read this article, or haven’t met any other people who have gone through training having kids, and they’re hearing all these people tell them that they don’t belong or that they’re not committed: That’s not true. You’re not alone.

Kevin Pho: Eunice, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

Eunice Stallman: Thank you, Kevin.

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