June 30, I walked out of the OR around 8:30 p.m., finished my floor work, and turned off my pager, placing it into a pre-addressed manila envelope. I changed clothes and walked out of the hospital for the last time as a General Surgery Resident at the Mayo Clinic in Rochester, Minnesota. It is surreal to have this challenge behind me; 6 all-consuming years of my life including my Surgical Critical Care Fellowship, not to mention medical school and the preceding marathon of hard work and stress. I started this website near the end of my residency and had planned to do a post on our crazy dual-residency routine (my husband Josh is a neurosurgery resident), but with board prep and trying to wrap up a million tasks on the to-do list, I never got around to it. Still, I think sharing what life was like these past few years might help someone else navigate their own rocky trail, so I thought I would share some of the more pragmatic aspects of how Josh and I managed our day-to-day routine. In the spirit of Indie Docs, I would like to emphasize that no two lives or routines look the same, and this is all about cultivating our best life and thriving where we have intentionally and stubbornly planted ourselves.
First, we needed quite a bit of help and intentionality to make having a family work. I researched possible childcare options before deciding to start a family; I could not even mentally commit to becoming a mother without having a workable plan. I honestly didn’t think it could work until I researched the au pair programs. I was surprised to realize that the program was affordable, particularly in comparison with the larger full-time daycares (with extended hours) in my city. Having someone live with us was essential since we were often both on-call. I planned to return to work after 6 weeks, and the au pair couldn’t start until the baby was 3 months, so I reached out to family members to help me and was so blessed that my aunts were able to move in with us for 6 weeks to fill in the gap. Looking back, I wish I had considered just slowing down and staying home; I didn’t even seriously look at the finances and just assumed I needed to get back to residency. This was a very hard time physically and emotionally and not something I ever advocate for families and babies, but I digress.
The au pair program limits work hours to 45 per week, so we needed daycare in addition to the au pair. My husband had a stroke of genius in finding our daycare. He searched for all the childcare licenses closest to us, and just started cold-calling them based on proximity. Less than a mile away, in our neighborhood, was a wonderful lady with decades of experience and an opening! Once we hit that 3 month mark, we had our au pair and day care established. For the next couple of years, the routine was essentially the same; I left home around 5:30 or 6, our au pair would keep the baby until 8:30, drop off at daycare until 3:30, then keep baby until we got home around 6:30 or 7. My husband and I did our best to stagger our call nights, but there were plenty of nights when the au pair knew she was also “on call” and we would wake her if we both got summoned to the hospital.
Next for my working-nursing-mom spinning-plate trick: I was hoping to breastfeed as much as possible, but I honestly expected to need to do a combination of formula and breastmilk. I even had a package of formula on hand when we got home from the hospital, just in case. I was lucky enough to have a great supply, and I managed to keep a schedule that allowed me to pump enough milk to create a surplus before going back from maternity leave and then more than enough to keep up with day to day demands for the next year. I’ll be candid here, I was freakin’ proud of myself for making all that milk and for having the discipline and determination to keep going through the year. I’m happy to share my specific schedule with anyone interested, but in general terms it took a lot of time, energy, and so so many calories. I ate more at this time of life than I could even have imagined before. I pumped while getting numbers, while dictating, answering pages, patient phone calls, reading…I may have also nodded off a time or two at 3 a.m. in the ED pump room. I also dealt with a few unsupportive colleagues and staff. One OR assistant told me not to tell him when I was going to pump because it was gross, to which I replied, “Well, considering you are alive, I’m assuming YOU were also breastfed around 50 years ago, so that’s a tad hypocritical.” He laughed and was very protective of my pump-time afterward. On the other hand, one of my attendings never ever wanted to hear about it and wouldn’t even give me 5 minutes between cases (she wanted me there for turnover) to hand-pump in the restroom (I attempted this out of pure desperation because I was in engorgement agony), and I got two bouts of mastitis on her service. Despite the challenges, it was worth it to have the bonding time with my baby and feel like I was providing for her even while we were separated so much by my work schedule.
As a money-saver, (and probably also as me wanting to go the extra-mommy-mile as over-compensation for working so much, ahem) we use cloth diapers. I had help with the laundry from my au pair, but honestly the effort expended on this routine was minimal. I would much rather do a load of laundry than rush out to the store to grab a pack of diapers. We used disposables for travel and at night. After getting used to the routine and realizing how much money you can save even using cloth diapers some of the time, it’s hard to believe that cloth diapers aren’t a more common part of life for most families.
Whenever we had a weekend off together, we were intentional about trying to spend time outdoors. We got into camping during the beautiful Minnesota summers, and we hiked as much as possible.
I used either a woven wrap or a Beco baby-carrier for hikes. We also have a big Osprey baby carrier gifted to us by a neighbor for serious backpacking, which we’ve only used a couple of times, including for a music festival (Eaux Claires).It was pretty awesome for keeping the baby strapped in and comfy while we carted her around from stage to stage.
Admittedly, we didn’t get much time to ourselves for the first 18 months or so, as we were constantly trying to maximize our family time during golden weekends. Having an itty-bitty is stressful for many healthy relationships, and we are no exception. For 10 years together before our first child, Josh and I thrived on spending lots of time with just the two of us, and suddenly we had almost none. One revolutionary change we’ve made in the last 6 months is having date-nights, which has been wonderful for our relationship.
The days and nights over the last couple of years have gone by in a blur. I could not possibly be prouder of my little girl or of my husband. She is thriving with her routine, and she is incredibly loving and affectionate with us, our animals, and her many baby-dolls. Josh is in the thick of his Chief service time now, but I have opted for a research fellowship with a flexible schedule this year in anticipation of baby #2 arriving in September. I know that I will always cherish having this short, precious time to spend with my girls while they are tiny, and it will help me feel eager and ready to take on my first position as a trauma surgeon after Josh graduates next year.
Moving forward as physicians with humanitarian-focused careers, we will need to remember how to focus our time and energy on what truly matters to us. I’ve discovered some amazing resources to help focus our priorities by Jillian at Montana Money Adventures. Mrs. Montana has created some wonderful mentoring worksheets for focusing time and resources that I will be utilizing and sharing here at Indie Docs. Many thanks to Jillian for sharing her wisdom and for being open to allowing us to document how we are utilizing her worksheets.
Until then, I hope that catching a glimpse into our world can help someone realize that having a happy family is possible even with our career demands. In fact, you can be an extended-breastfeeding, cloth-diapering, baby-wearing, semi-crunchy-granola mom AND a surgeon! The key for me has been accepting our reality and feeling satisfied in my efforts (no guilt) and cherishing the precious time I was able to spend with my baby. Also, asking for plenty of help, especially in the realm of childcare, was key. In turn, my hope looking ahead is for a happy future of global surgery work, travel, and a happy family. For me, that’s what Indie Docs is all about.
Enjoy this hilarious, heartbreaking, and candid tribute to nursing moms…