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Join Eleanor Menzin, a pediatrician, to explore the intricate dance of motherhood and medicine. In this heartfelt discussion, we delve into her personal journey, navigating the dual roles of a working parent and health care professional. From code-switching between worlds to the challenges of pandemic parenting, we’ll uncover the emotional landscape of this unique experience.

Eleanor Menzin is a pediatrician.

She discusses the KevinMD article, “Juggling medicine and motherhood: a doctor’s journey.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome Eleanor Menzin. She is a pediatrician. Her KevinMD article is titled “Juggling medicine and motherhood: a doctor’s journey.” Eleanor, welcome to the show.

Eleanor Menzin: Thanks for having me.

Kevin Pho: We’ll get into your article in a little bit. First off, briefly share your story and journey.

Eleanor Menzin: I am a primary care pediatrician, and I’m the mother of three now theoretically grown children, who are 18, 20 and 22. In the last year or two, I’ve started to do a lot of thinking about my career path, moving through medicine while raising three kids, and the challenges that entailed. My own residency baby is starting the medical school application process, and I’ve been thinking about what her career trajectory is going to be like. One of the things I’ve realized is that there were a lot of challenges I experienced that I didn’t talk about much at the time I was going through them, because it just wasn’t done. As I think about my residents and my own daughters, I’m now at a position, seniority-wise and power-wise, where I can afford to speak up a little and talk about some of those hard things. So that’s what I’m doing.

Kevin Pho: All right, so before you get into your story, I’m interested in hearing a little more about what you said: Back when you were in training, or earlier in your career, there was some tentativeness about sharing your experiences of raising children. Talk about some of the pressures against sharing your story. Was there any implicit pressure not to share?

Eleanor Menzin: I think so, and it’s weird, too, because I’m a pediatrician. You would think that if there were ever a world in which the duality of being a parent and a physician was encouraged, it would be pediatrics. But that wasn’t the case. I had my first child in my last year of residency, and there was a lot of negative feedback, let’s just say, around the idea that it inconvenienced the program or inconvenienced my co-residents. I have to say, there was no negative feedback from my co-residents, who could not have been more wonderful. But the idea of asking for an accommodation, even if you needed it medically, was completely not done. My maternity leave, which was considered really generous at 12 weeks, was 12 weeks because they, quote unquote, allowed me to use my entire vacation for the year and all of my elective time as maternity leave.

Then, as I got older, we would sit in meetings sometimes, and people would volunteer to cover other times when the office was short, and there were times when I didn’t have child care. I couldn’t volunteer to work on what had been my day off, because I had nobody to leave my kids with. At the time, a really lovely female practice manager pulled me aside and said, “Listen, just don’t raise your hand. But whatever you do, don’t say, ‘I can’t do this because I don’t have child care.’ Just be quiet, or say you have a meeting, but don’t tell them where you’re going. It’s not their business, and it’s not making people think highly of you.” So I really knew from the beginning that I was meant to keep these two spheres separate, which, again, is pretty weird when you’re a pediatrician.

Kevin Pho: All right, so with that context, let’s talk about your KevinMD article, titled “Juggling medicine and motherhood: a doctor’s journey.” Tell us how this article came together.

Eleanor Menzin: The article came together because, when my kids were young, I worked part-time, and I really felt that I was moving back and forth between two worlds. There was this mom world, and there was this doctor world. I was really comfortable in the doctor world, except for the little piece of me that was worried about the snow day and who was going to take the kids. And I could kind of pass in the mom world, but I was never totally comfortable there. As my kids grew up and I worked more, I became less of a full-time citizen of this mom world, and there’s a tension in that, for your kids, in not being quite like all the other moms, and even for me, in not totally fitting in.

I think I wrote the article in part because, although we’ve gotten a little better as a system about talking about some of the things intrinsic to the system that make it hard to be a parent and a physician, I think we don’t want to talk at all about the things outside the medical system that make it hard. But those are a really significant contributor to burnout, loneliness and bad feelings. So I wanted to put this article out there as a way of saying to people, “This is what it’s really like.” It’s not just the pressures people feel within medicine; it’s also the external pressures they feel.

Kevin Pho: So during this time, when you were training and early in your career, juggling those two worlds, where did you turn for support, if you didn’t feel you received the necessary support professionally?

Eleanor Menzin: That’s a great question. I’ll be clear: I had a lot of family support. My mom is a mathematician, and she always worked full-time, so I had a great role model in terms of somebody who had done it before. And I stayed very close to my medical school roommate and to people who were not totally in this mom world of mine, where a lot of the women in my community were not working, but who knew what my life was like.

Kevin Pho: How about the other residents or early-career physicians, as you were just starting out? Were there many, or any, in a similar life situation to you?

Eleanor Menzin: It’s a great question. I think I had my kids a little on the younger side. A lot of people waited until fellowship or just after fellowship, so I did gradually pick those people up along the way. And I have been unbelievably lucky to essentially job-share with a partner whose kids are the same age as my second one. That was 100 percent the single biggest support I had: There was this other person living almost exactly my life, same job, same office, similar-aged kids, who really felt the pull in both directions with me.

Kevin Pho: One of the things you mentioned earlier was the tension between the, quote unquote, mom world and the working mom world. There was that little tension there, so I want to talk a little more about that. What would be an example of where that tension would be felt?

Eleanor Menzin: Schools, for example, have all of these events, and they come out of nowhere. Suddenly everybody should be at school at 10 o’clock on Friday morning. What? I’ve got six patients at 10 o’clock on Friday morning. It’s hard to reschedule your patients, and all of those people making those school events don’t want their doctor to reschedule their appointments. So there’s a lot of robbing Peter to pay Paul, where you’re running back and forth trying to figure it out. It became this thing: “OK, do I need to go to back-to-school night for the same third-grade teacher for my third child? No, I don’t. Do I need to move patients around to be at conferences that are one-on-one about my kid? Yes, I do.” So there’s this constant balancing, trying to figure out what you’re going to prioritize and what you’re not.

And then there’s a lot of casual stuff. It’s a nice day, and people are going to go hang out at the park after school on this half day. Well, I planned my schedule in time to pick the kid up, but I didn’t plan it in time to spend an hour at the park, and I’m stuck.

Kevin Pho: So how did you cope with this? You mentioned that you had great family support, but you’re talking about situations that sometimes may extend beyond that. When you had this tension, how did you resolve it? How did you cope with it?

Eleanor Menzin: I think it’s a different strategy for a different thing. Sometimes I cut corners; I didn’t go to back-to-school night, or whatever. Sometimes I sent my dad and said, “You’ve got to do the swimming lessons,” or whatever, and he had the flexibility to say, “Well, if we want to go to the park after swimming lessons, we can go. We’ve got nowhere else to be.” And sometimes I depended, not on the kindness of strangers, but on the kindness of neighbors, saying to my neighbor, “Hey, Marcy, I’m leaving my kids. Can you just bring them home when you’re done?” “Sure.”

But it’s a hard situation for many people. I think most physicians are pretty independent, so we don’t like depending on people without returning the favor. It felt hard at the time to ask those favors, specifically of mothers who didn’t work outside the home, because I felt like I was always in their debt. They were always the ones schlepping my kids around, and I didn’t have that much to offer, except that if you wanted to show me your rash at 8 o’clock, you could swing by.

Kevin Pho: So you mentioned that your kids are now college age, and that one of your kids is applying to medical school. What’s the landscape now when it comes to juggling those two worlds? Contrast that to what it was.

Eleanor Menzin: I think it’s better, but not perfect. When I look at the paternity leave for my residents, for example, it’s certainly more generous. I think there’s more flexibility and understanding about the idea that somebody might work part-time or do something different, and I think that’s great. But I think it’s still very hard, both externally and internally. The system demands a lot from physicians, and the kind of people who become physicians, and certainly who survive training, are not the kind of people who want to do anything halfway, whether that’s parenting or medicine. So I think there is still a lot of tension that’s intrinsic to this, and I’m not sure that we as a system have done an awesome job of trying to resolve it.

Kevin Pho: So you’ve been an attending for a while now, and you mentioned that as an attending you are now in positions where you can affect the lives of younger physicians or residents who may be in a situation similar to the one you described. Talk more about those shifting dynamics, and maybe the new perspective that has given you.

Eleanor Menzin: It’s interesting. For one thing, I can make accommodations. When a young partner comes to me and says, “My kid is sick. Can I work through lunch in order to leave early and relieve my spouse from child care, so they can go back to work?”, I say, “Absolutely,” because that’s the kind of accommodation I would have been afraid to ask for. So I can do that.

The other thing I can do is try to be more overt in modeling the tensions I had to deal with, and the fact that I’m still pulled, that I’m still a parent, and that that’s the job I would never give up. I’m off this week because I’m taking my youngest kid to college, and I’m just doing it. It’s not a great time for a pediatrician to be off, in early September, but the kids win every time. And it’s OK for me to say that to trainees, residents and mentees, and to say, “Hey, this is hard, and this is how I did it. This is how I made it through. It might not be the same for you.”

A big part of what I wrote this article about was that sense of isolation, of not fitting in perfectly in either sphere. I think the solution for physicians who are the primary parent is to find their own people, to know that there is a community of other people who really get it. Some of them came up through a system that so discouraged talking about it that they keep it inside. So I feel that the more that conversation happens, the more supported people feel, just by normalizing the stress and loneliness that are intrinsic to this.

Kevin Pho: I completely agree with that, in terms of finding other physicians who may be in a similar life circumstance to where you are now. For those who may have some trouble finding those people, what are some tips you can give for finding others who are going through the same things?

Eleanor Menzin: One thing is to look back at your college friends, your medical school friends and your residency friends. Those are people with whom you have a pretty big shared experience. You may not be geographically in the same place, but they may be in a life place that’s similar to yours. For many years, I had kind of a commuting schedule on the phone. It was before there were podcasts to listen to. I’d drop my kids off at school and then call my friend who’s a neuropsychologist in Cleveland, and I’d spend my whole commute talking to her. So you can think about ways to carve out time for those supports, and commutes are a great one. Or sometimes I would drop somebody off at soccer practice, go for a walk and talk to my medical school roommate. So I think that’s a good one, because those people don’t have to be geographically where you are.

And the other thing is just stopping to see people and talk to people, reaching out and making that connection, even if it’s only five or 10 minutes. A couple of days ago, I talked to a cardiologist about a mutual patient. I know her youngest kid just graduated, so we talked about the patient, and then we talked for five or 10 minutes about what it’s like when you’re an empty nester and your kids are grown, and what you’re going to do. That’s important, taking that time. Sometimes you don’t have it; I didn’t have half an hour, and neither did she. But you can take five or 10 minutes and build a bridge.

Kevin Pho: We’re talking to Eleanor Menzin. She’s a pediatrician, and her KevinMD article is titled “Juggling medicine and motherhood: a doctor’s journey.” Eleanor, tell us some of the take-home messages that you want to leave with the KevinMD audience.

Eleanor Menzin: My take-home messages, I think, are that it’s hard but doable. A career in medicine while being the primary parent is challenging but doable, and totally worth it. It may require structural changes in what kind of parent you think you’re going to be, which is always an eye-opening experience, and in what your job looks like, which might be slightly different from what you thought it would be in training. But it is doable, and I think the challenges are tremendously ameliorated by reaching out and finding other people who have walked this walk, both people at your level and people who are more senior to you. So if you’re young and struggling, which I think a lot of people are, go find some woman 10 or 20 years older than you who looks like she’s done it, and say, “Hey, can we have a cup of coffee? I’m struggling, and I could use your advice.” If you do a really good job of keeping your struggles hidden, we don’t really know what you need.

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

Eleanor Menzin: Thanks for having me.