Why GPs Are Like Stay-At-Home Mums

CDC/ Amanda Mills acquired from Public Health Image Library (Website)

CDC/ Amanda Mills acquired from Public Health Image Library (Website)

Our very own Royal Australian College of General Practitioners (RACGP) has rolled out a community awareness program they have dubbed “The Good GP” aimed at highlighting the invaluable role that GPs play in healthcare. Which got me to thinking about the similarities between GPs and Stay-At-Home Mums (SAHMs). Don’t get me wrong, there are no “doctor wars” like there can be with the “mummy wars”, and I have the deepest admiration for my specialist colleagues and their amazing knowledge. I went to medical school with them after all, and count specialist physicians, surgeons, and anaesthetists among my closest friends. No, the problem doesn’t lie with doctors vs doctors, it is in the eyes of the general public and the government. Let me explain why GPs are a bit like SAHMs.

1. The work we do is underrated.  

Like SAHMs, it’s assumed that all we do is write scripts and medical certificates if you have a cold and we’re always late because we’re having a cuppa in the tearoom. “Oh, are you just going to be a GP?” I’ve been asked so many times over the years. “You’re not going to be a specialist?” Just a GP? I think. I can suture a wound, counsel a grieving widow, perform an eight-week baby check, screen for cervical cancer, diagnose a rash, reassure a worried mum that her child will recover from their virus, know straight away when I have to send a sick child to hospital, diagnose surgical emergencies, remove foreign bodies, manage an acute asthma attack and stabilise a patient who’s having a heart attack, drain abscesses, and treat all kinds of ailments from acne to depression to osteoporosis. The list is endless. Oh, and I can help my patients prevent chronic disease too. And most people aren’t aware that general practice is considered a specialty in Australia with extra training and high standards expected of our GPs. I should know as I’ve been a proud RACGP examiner for 8 years.  Just a GP? It’s like saying “Oh, do you just stay home with your kids?” (cue eye roll)

2. We are undervalued and underpaid.  

Unlike SAHMs we do get paid, but our worth has been significantly under-valued for years and things are getting worse. A four-year freeze on Medicare rebates has been announced, which means that by July 2018 Medicare rebates will have been frozen for a total of six years. This comes on the back of years of undervaluation of our services, and GPs had to fight hard to have a proposed further $5 cut to Medicare rebates overturned. Given that we are a highly cost-effective form of healthcare, this is an insult to the service that we provide, and it is expected that we either absorb this cost, which will prove unsustainable for most practices, or pass it on in some way to our patients.

3. We do our work because we love it.  

Most GPs I know speak of how much they love being a GP – the continuity of care, the relationships they build, and the variety of their clinical work which always challenges them. GPs feel passionate about caring for their patients – as can be  seen by the recent successful campaigns by the RACGP and AMA against the proposed co-payment, which doctors felt strongly about because it would compromise the care of our most vulnerable patients. This video created by the RACGP sums up the life of a GP and the rewarding journey we are on, which takes us through generations of patients. Yet, it can feel like a thankless job much of the time. Like being a SAHM.

4. It’s hard work and it feels neverending.  

Like SAHMs, we work hard. We see patients back to back, usually sacrificing on our lunch times (morning tea break? hah!) and there is a lot of unpaid work that goes unseen. Not only do we see an average of four patients an hour, GPs face an hour or two of “paperwork” after the end of the day – finishing consultation notes, writing scripts, making phone calls, arranging urgent specialist appointments for a patient with a serious illness, checking test results. Being a GP is exhausting which is part of the reason I had to take a sabbatical to finish my PhD – I simply cannot keep up the pace, plus finish a full-time PhD, and look after my children and myself.

There’s hope for the future though. The new Minister for Health Sussan Ley has announced a review of the Medicare Benefits system, which will be “clinician-led” which means she wants to talk to doctors. I applaud this and hope that with appropriate consultation, a new and better model of Medicare will emerge, one that rewards quality rather than quantity of service. I also hope that the community awareness campaign by the RACGP will lead to increased community engagement, and that together we can create a better way of providing services to our valued patients. At the moment both GPs and patients are frustrated at the challenges we face – I am well aware that patients are unhappy with lack of affordability and access to GPs for one. I constantly hear of how difficult it can be to get a timely appointment. I hope that new and innovative ways to revamp general practice will come from consultation with the community and other stakeholders, and policy-makers.

What do you love about your GP? What do you think we could be doing better? I’d love to hear from you, and also would love you to contact your local MP if you also feel strongly about the rebate freeze.

I’m Not The Mother In Those “Letters” Any More; or, The One Thing I Want Mothers To Stop Saying

www.pixabay.com By TawnyNinja

www.pixabay.com
By TawnyNinja

About a year or so ago I wrote a little post on working and stay-at-home mothers. I had few followers on my blog at the time; blogging was something I did for “fun” and to practise my writing skills. I sat down one evening to pen some thoughts in response to blog posts I had read that attacked both stay-at-home and working mothers. What bs! I thought. There’s two sides to every story. So I wrote a letter, from one mum to another, addressing it to dear friends of mine on both sides of the fence, but also addressing it to myself. I remember getting a tingly feeling after I posted it. Perhaps I had a premonition of what was to come. But never did I expect that it would be viewed by almost 2 million people, that our server would crash because at one stage it was getting 2,000 views an hour, and that my inbox would be flooded with emails from emotional mums and eager magazine editors.

Social media can be brutal as well as enormously supportive and rewarding, and I bore the brunt of some very negative commentary, which only seemed to validate the importance of my message. Some said I was out of touch with real working mothers, such as those without a profession, and those who did NOT want to work. Point taken. Another major criticism of what I wrote was that I was perpetuating the myth of the “good mother”, of the need to put the family needs first (for example, getting up early to exercise).  And that was a very very bad thing.

Since then, I have been thinking about this A LOT, and I have also blogged about the damaging “cult of motherhood” which exhorts self-sacrifice with the promise that it is “all worth it”. And I have to say that I am no longer that mother in those “Letters”. Here’s a post I wrote a while ago that I entitled “The One Thing I Want Mothers To Stop Saying” which explains it.

I’ve heard this too many times. I hear it from patients, from friends, and colleagues. I have said it myself. But even though there is truth in it, I really want mothers to stop repeating this phrase.  Enough is enough.

“It makes me a better mother”.

“It” is usually something the said mother thinks she shouldn’t be doing, or feels guilty about doing. “It” refers to time away from her family, often enjoyable, usually self-care, and is somehow regarded by many people as selfish, unnecessary, or indulgent in some way. “It” is often –

  • time at the gym
  • going to work
  • going for a walk
  • going out for a meal without the children
  • yoga
  • any activity that implies the mother has some protected time away from her children.

Yes, in most cases, mums do come home refreshed and a better mother, better able to engage with her children, happier, and less stressed. And this is a wonderful thing, a positively reinforcing cycle. Health care workers often use this phrase to somehow entice mothers away from their profound responsibilities of caring for their families. The oxygen mask analogy is trotted out – put your oxygen mask on first so you can then attend to your children and family. You can’t care for them if you’re not well. Etc etc. I’m guilty of using this to encourage my patients to take better care of themselves.

But it has to stop.

Why? Because we are human beings first and mothers second, or third, or however we choose to see it. Why is it that once a woman becomes a mother she is expected to put her needs at the very last? We know that working mothers feel so guilty about not being with their children 24/7 that they will sacrifice their own sleep and leisure time to see to their “responsibilities” when at home. Stay-at-home mothers have to justify every minute that their children might spend outside of their care, for example in childcare. But why is it that we must always reference our roles as mothers when justifying time “off”? At the risk of grossly over-generalising, how often do we hear fathers saying “Oh man that was a good night out with the boys. It really makes me a better father”. While I am not suggesting that this phenomenon affects all women, nor that fathers do not ever put their families’ needs above their own, I base this post on what I have heard over and over again in the past few years as a mother, a doctor, and a friend. Why, just in the last week, I have heard it four times from different mothers.

When we lose the ability to consider that we have needs too, that we are human beings, when we start believing that our needs for sleep, relaxation, social interaction (with adults!) and physical activity are only important in the context of our ability to perform the role of mothering, we fall into very dangerous territory. We martyr ourselves. We put conditions on ourselves – when you do this, will you come back a better mother? Will your children benefit? We send a message to ourselves that we have no intrinsic worth as human beings beyond the work we do as mothers.  

I want all mothers to look after themselves, and to proudly say that their self care makes them a better person. It makes them a healthier, happier, more relaxed person. It enhances their quality of life. It gives them energy, brings a smile to their face. I want mothers to say that they go to the gym because they freaking like to go to the gym, not because they come back a better mother. They are going to see their girlfriends because they miss them and want to have a laugh with them. I want mothers to assert their needs for self-care irrespective of the fact that they have children.

And that, my dear followers, is why I am no longer the Mother in those “Letters” any more. I am slowly putting myself back in the picture. I am systematically exterminating guilt while continuing to think about the combined needs of my family – which includes me.

Amen.  

One Day At A Time; or I Don’t Know How I Did It

I hate to jinx it, but very recently my children have become easier, for want of a better word. They are five and two now, and are the best of friends. They play adorable games together which allows me to have cups of tea in peace. My five-year-old can wipe her own bottom (yay!), shower herself, and get her own snacks. My two-year-old is talking well now, and can tell us what he wants; while we still have tantrums, and the sight of him in restaurants still conjures up a mix of pity and terror from fellow diners, he can sit still for longer, have conversations, and is generally happy. At times, I am even that mother sitting and reading while her children colour or play quietly. (For about five minutes).

Proof that life has become a little bit more bearable is this.

Making a prawn and fennel bisque. Like, from Gourmet Traveller! From scratch! Who would have thought?

Making a prawn and fennel bisque. Like, from Gourmet Traveller! From scratch! Who would have thought?

I’m cooking again. Real cooking. Not throwing things hastily into the oven, churning out boring casseroles, or relying on good old spag bol. On weekends anyway, I feel remnants of the old me returning – the one who loved to cook elaborate meals, involving many ingredients, much simmering and sautéing and chopping, and the type that is celebrated with the clink of glasses at the dinner table and “Compliments to the chef!” I am able to do this mostly because my two-year-old has now been surgically extracted from my leg, and no longer needs to be in bed by 6:30pm.

This state of affairs sounds quite delicious, I know, to other parents who are still in struggle-town. I was there not long ago. I do not remember now what exactly made it so hard – the pain is all a blur. I do remember that it was freaking hard, and that I was miserable at times, and that I cried occasionally. I remember everything being a struggle with my toddler – each simple task of living like getting dressed and eating was an enormous and often physical and loud battle. I remember the 12 months or more of 5am wake-ups – of sitting on the couch in the dark with a wide-awake baby, the whole household asleep, wondering how on earth I was going to stay awake until 8:30pm. I remember being so tired at night my eyeballs felt like they were going to fall out of my head. I remember a lot of food on the floor.

And yet I worked and studied full-time, nine days a fortnight. Truth be told, going to work was an escape in many ways. Whenever I was tired, I reminded myself that being at home would have exhausted me just as much. Still, looking back, I don’t know I did it. I do remember making a pledge to connect and engage with my children to the fullest, despite the challenges, and to live these precious and exhausting years with more joy and less guilt. I do feel that I have done that. I have kicked mother guilt in the ass. And while I have trouble remembering the exact details of the pain, I remember the exquisite joys as though they were yesterday. I can taste and smell them; I can feel the little hands in mine still. These are etched in my memory.

I am not much different to any other parent. I do not have extraordinary challenges – just the everyday, mundane challenges of parenting small children while working. I do have flexibility, a reasonable salary (as a GP anyway, not as a student…) and find meaning in my work. But mostly, I coped because I took things one day at a time. (I had no choice really). And I know that new, different challenges are to come. But I want to pen some encouragement to every parent who is still in that dark, hazy time of raising small children. (Studies show that parents are generally as happy as compared to people without kids, except for those with preschool-aged children. These people are pretty unhappy and stressed). Perhaps you have the dreaded combination of two under two. Perhaps you have a ten-week-old, and have just been through the most difficult ten weeks of your life. Whatever the case may be, I want to say this to you, with all my heart.

Take things one day at a time.  

But make a promise to do your best every day. 

Some days, your best will disappoint you. That’s ok. Be kind to yourself. You’re just doing the best you can, and you’ve never done this before. Every phase makes you an absolute novice at parenting again. But tomorrow is another day.  

Some days will be very dark. This just means you are right in the middle of the tunnel and the light cannot be seen yet. But if you keep moving forward, there is a light. It’s bright and very beautiful. It will make you cry tears of joy.  

Every day, connect at least once with your children, and once with yourself, even if only for a moment before you shut your eyes at night. Be grateful at the end of the day, breathe, and start again tomorrow.  

It’s ok to “lean out” during these years. It’s ok to say you’ve got too much on your plate right now. You have. It’s crazy. But it won’t last forever.  

If the days are too dark, talk to someone straight away.  

One day at a time, the days will roll excruciatingly slowly into weeks, and months, and then a year or two. You will look back and that cliché will escape your lips-  “They are growing up too fast!” Stupid cliché. But it’s true. 

But I know that seems far away now. I know how hard it can be. But don’t blink. Take it all in. 

One day at a time. That’s all you need to do. The best is yet to come, but in some ways the best is with you right now. That’s the exquisite conundrum of parenting.

When you come out of that tunnel, I hope you come out with more joy, less guilt, and no regrets. And eventually you too will be stirring prawn bisque in the kitchen, glass of wine in hand, like me. (If that kind of thing floats your boat). 

x

 

By Kyle Flood from Victoria, British Columbia, Canada (Waaah!) [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

At the very least, photographs of tantrums make for hilarious 21st birthday party slideshows. By Kyle Flood from Victoria, British Columbia, Canada (Waaah!) [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

To My Patients: Thank You for Letting Me Take Care Of You

By Flickr user vistamommy [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

By Flickr user vistamommy [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

This is a difficult post for me to write, and I have put off writing it for far too long. Today is World Family Doctor day and it is time to put pen to paper. I have made the sad decision to leave the clinic I have been working at for the past eight years. Next week is my last clinic session at the Whole Health Medical Clinic. My family and I are moving to Sydney for a lifestyle change, to be in warmer climes and closer to the beach and surf, which we love. I am also taking a six month sabbatical from clinical work to concentrate on finishing my PhD. Juggling the clinic, a full-time PhD and a young family has taken its toll on me recently and I have to take my own advice and attend to self-care and self-preservation; my health and my relationship with my family has to take priority. I cannot replace myself at home but I can easily be replaced, I am sure, in the clinic. But in doing so, I am incredibly sad to say goodbye to my patients, and yet grateful for the lessons they have taught me.

So I just want to say, to my patients, even if you are not reading this: Thank you for the privilege of being your family doctor for the past eight years. Thank you for trusting a fresh young GP (not so fresh and young now!) with the care of your health. Thank you for the times you were patient and understanding when I ran very very late. Thank you for letting me into your lives, sharing your deepest secrets, so that I could better help you. Thank you also for taking care of me – for the kind inquiries as to how I was, the warm wishes and presents and cards when I left you for two maternity leave periods, the welcome when I came back. Thank you for the laughs together, and the times we cried together as well. A huge thank you for putting up with my frequent absences, and for the gradual reduction in clinical hours due to kids and then PhD. Thank you for “gas bagging” with me about kids, babies, parenthood and life. You have all taught me so much about life and medicine. Clinical life has been so rewarding and has given as much to me as I have to it.

I wish you all the best of health and many healthy and happy years ahead. I hope you will continue to try your best to eat well, stay active, and look after your mental health. I hope you will treat all family doctors as generously and warmly as you treated me. And thank you again, for everything.

Much love

Dr Carolyn Ee x

 

The Joy of Juggling

Happy birthday to my princess. And hello to fondant cakes!

Happy birthday to my princess. And hello to fondant cakes!

At the start of this week I wasn’t feeling very good about myself. I was facing a week of extraordinary juggling of roles and responsibilities, and to put it plainly, I was grumpy. Grumpy that I had so much on, grumpy, even, that I had said yes to some of the things I had. Let’s take a look at the week that was and how it went, because it’s clear from the title of my post that I found unexpected (or perhaps expected) joy in much of what I did.

Monday morning: Go to baking store with four year old. Spend $120 on cake making equipment for her birthday cake. Perhaps I should have outsourced? Never mind. Browsing aisles of coloured fondant and plunger cutters gave me so much glee it almost felt illegal. 

Monday lunchtime: Meeting with Kindergarten teachers about the nut allergy incident from last week. Get handed a bunch of forms to fill out. Brain explodes slightly, but am grateful for the opportunity to discuss this very serious issue, which has now been resolved. 

Monday afternoon: Submit journal article to none less than the Lancet (which has a 99% rejection policy). Get quite excited when I don’t get rejected within the first 3 hours. 

Monday evening: Frost first birthday cake, followed by work on conference presentation until 11pm. Exhausted. 

Tuesday: Clinic. Am grumpy because of impending teleconference at 7:30pm. Think of pulling out. 

Tuesday afternoon: Teleconference cancelled. Mood lifts! Text husband, who immediately suggests we go and watch the Avengers. 

Tuesday night: Go out for dinner and watch Avengers Age of Ultron, which was tolerable because of my favourite character Ironman was in it. Kids are with Mum who is visiting us from interstate. Eat a choc top. Bed at 12:30am. Yawn!

Wednesday morning: Parent helper morning at kindergarten. Bring birthday cake along. Four year old is very excited, says it is a “really special day”. Listen to some awful knock knock jokes. Learn some Italian songs. Four year old cries when I leave, makes quite a scene. Wonder if I have done the right thing.

Wednesday afternoon: Supervision meeting with my Honours student, followed by practice presentation for upcoming conference talk. Get lots of “feedback”. Realise I have to change half my presentation. Brain starts to throb slightly. 

Wednesday evening: intend to go for a run but am too tired. In bed when the kids go to sleep. Paper is still not rejected by the Lancet! Get a glimmer of hope. 

Thursday morning: Work on presentation. 

Thursday afternoon: Hairdresser appointment. Finish reading Brene Brown’s book. 

Thursday evening: Run followed by dinner and then frost second birthday cake which, to my relief, was a success. Fondant is easier than I thought to work with! Why have I not done this before? Consider offering to make birthday cakes for our our friends and family. Slap myself a little bit. 

Friday morning: Paper is rejected by the Lancet. Resubmit to another journal. 

Friday lunchtime: Give a tutorial. Thoroughly enjoy being around “young people”. Their jokes are funny! Feel a little bit young again. Also feel thankful that I had my grey highlights covered the day before. 

Friday afternoon: Home early to make decorations from fondant with my four year old, to put on the cake. The cake is finally done and all ready for the big party on the weekend! 

Well that was my week. Looking back, it was such a wonderful and full week, and I came out of it feeling really really good. Why? Because I had made the decision to make every single scrap of my day count, to spend it only doing things that were meaningful, rejuvenating, important, or that would make someone else important to me happy (or me happy). And the teleconference, for a voluntary position on a committee, was one of the things I had reluctantly said yes to but felt that I shouldn’t. Once that was taken out of the equation for the week, the rest of my week was authentic, honest and very satisfying, inasmuch as it involved jumping (leaping?) from one role to another.

I feel like I am giving an Oscar speech now, because I cannot do this juggling without flexibility. The nature of what I do is not time-based but outcome-based. This makes my week very flexible, apart from my clinic day, and allowed me to take two hours off to volunteer to sharpen pencils at kindergarten. Of course it’s not about sharpening pencils but about doing something that meant a lot to my daughter. But yes, thank you flexibility, and may you grace the work weeks of everyone else.

I also cannot do this juggle without a healthy disdain for meals that require hours of preparation. Meals this week consisted of baked salmon (in the oven and off to the gym!) and tacos with grilled pork and guacamole. In the big picture, time doing things I love is more important than spending hours in the kitchen, but I still do pump out home-cooked meals for every single weeknight.

Thirdly, sleep. I skimped on it for the first two nights and started to feel pretty grizzly. Then amazing after catching up on sleep. Sleep is the working mama’s secret ingredient.

Fourthly, fun and self care. Respect for the “date night”. Making the time in a busy week to get my hair done. I’ve given lip service to self care before and this week I had to force myself to pay attention to it (or rather the state of my hair forced me).

And lastly. The realisation that I am juggling very very good things and even things that bring me joy. Sitting in on an kindergarten Italian lesson and laughing at four-year-old jokes? Joy. Making birthday cakes? Joy. Even the tutorial, tacked on to the end of the week and seen as yet another time stealer, was joyful because I was teaching, and because it was fun. So I am filled with joy and gratitude, on this Saturday morning, for the week that was. An amazing week of work and love. And choc-tops. Now if you’ll excuse me I have a birthday party to organise :)

PS. Sunday evening. Party was a success. I cannot believe she is almost five. They do grow up fast… after the toddler years :)

Why I’m Grateful For Crises

https://www.flickr.com/photos/special-fx/5889811436/

https://www.flickr.com/photos/special-fx/5889811436/

Two days ago, during a meeting, I got the dreaded phone call from kindergarten.

“She’s had an anaphylactic reaction”, they said. “The ambulance is on its way. How soon can you get here?”

It turns out they meant an allergic reaction, thankfully, but still that call was enough to send my heart pounding, and see me racing to collect my things in a slightly delirious haste, and run out the door.

But even though this unfortunate mistake of both kindergarten parent who sent birthday party food in with nuts accidentally, and teacher who didn’t check, meant that my child’s face swelled up and she threw up three times, I am grateful, once crises are over, that they come along at all.

I am grateful because nothing puts your true priorities into focus more blindingly than the experience of running down the street desperately trying to hail a taxi so you can get to your sick child’s side.

At that moment, it’s crystal clear what’s really important. And I’m ashamed to say that of late, it is mostly these crises that remind me. I tend to forget and become focussed on what doesn’t really matter. Just that morning I had a thought, as I scurried around Uni doing this and that, being “busy”, that I was so absorbed in work that I wasn’t really living the moment.

But during an emergency, I suddenly remember.

My laptop and what’s on it isn’t the most important thing. I couldn’t care less at that point.

Money isn’t the most important thing.

Having clean floors is definitely not important.

The most important, the dearest and most precious things to me, are the people that I love, and making them happy and safe. Being with them. 

Health is important. So valuable and so underappreciated, until it’s gone.

Time is important. Time to spend with the cherished ones in your life. Living each moment to its fullest.

I’m not saying that it’s good to live with crisis after crisis, unresolved; this is extremely stressful and damaging and sadly, is the reality for many people. Neither am I suggesting that we should neglect planning for the future, and managing our finances. These things clearly are necessary, though they tend to pale in comparison when the safety of a loved one is at stake. Who would rather have lots of money in the bank than be able to hold a frightened but healthy and alive child in their arms, or speak to Mum on the phone to hear that her biopsy results were all normal?

Our little crisis settled quickly, with the help of antihistamines, the reassurance of the nice paramedics, and lots of TLC. The appropriate steps have been initiated to strengthen the policy around not bringing nuts in. The poor parent rang me to apologise from the bottom of her heart, which I appreciated.

Crises like these are what I call my “reset” button. All the rubbish that was building up in my head is now cleared. I’m back on track again. But I don’t want to rely on crises to help me rethink my priorities, so I’m (re) starting a daily gratitude practice, to ensure that I’m fully appreciating and living every single day instead of missing out. Because you never know what tomorrow will bring.

What about you? What helps you to “reset” your priorities?

Dear Working Father: Here’s How You Can “Pay” Your Stay-At-Home Wife

www.pixabay.com

www.pixabay.com

This is Part I of my thoughts to that lovely post by a father who calculated what his stay-at-home wife and mother to his toddler would cost him if he had to pay for all the services she provides. But really it’s an open letter to all primary income earners in families, who are lucky enough to have a stay-at-home spouse, whether they be dads or mums in heterosexual or same-sex partnerships.

This post was important because it highlights a couple of key facts about partnerships. One, it is the woman who still shoulders the lion’s share of domestic duties, even if she is employed outside the home. Two, this work is unpaid. Three, this work is often goes unrecognised, which is what this lucky dad wrote about. He hadn’t realised, up until recently, how much his wife meant to him – in very practical terms as well as emotional. Him having a stay-at-home spouse allows him to go about his work without worrying about childcare dropoffs and pickups, what to cook for dinner, whether he has a clean shirt, whether the gas bill is due, or whether there is milk in the fridge. It is this kind of happy arrangement that has benefitted men for decades and that Annabel Crabb writes about in her brilliant book The Wife Drought. And I applaud Steven, and I know he probably feels like hiding in a corner at the moment with what sounds like an enormous response to his heartfelt post. I’ve been there. But as a woman and a mother, who has been both a SAHM and working mum, here’s a few suggestions as to how you, Steven, and all the other fortunate people who have a stay-at-home spouse, can really repay your beautiful wife (or husband). I apologise in advance if you are already doing all of this. You sound like a great guy, so it’s quite likely that you are. If you’re not, here’s what you could do.

1. When you come home, she needs to have a break. Even if you worked flat out without a break today, you at least had some quiet time on your commute home. So when you walk in that door, remember that she has had a full day giving your toddler all her attention – she’s been working, too.  She might not even have had a proper lunch. So you take the toddler, reconnect with him, and tell your wife to go and do whatever it is she has been longing to do all day – go for a walk, read a book, hide in her bed.

2. Let’s talk about groceries. Have you ever done groceries with a two-year-old? When you call her during the day, ask if there’s anything you can pick up from the shops. Chances are she’s run out of wipes or milk or forgot to buy garlic. Pick it up on the way home. On the weekend, offer to do the weekly grocery shop or better, ask if she wants to go to the store. Alone.

3. Laundry. Ask if you can help with a load of laundry. Every day. If there is a pile unfolded on the couch, do NOT, I repeat, do NOT ask why the house is messy. Simply pick up the clothes, fold them and put them away. If you see your wife coming out of the laundry with a basket, tell her you will put it up.

4. Spend a day with your toddler. Alone. Send your wife out for the day to do whatever she wants. At the end of the day cook dinner for your wife. This way you will really know what she goes through every day. Your appreciation for her will skyrocket. Extra points if you use minimal TV.

5. Never ever ask why the house is messy. If you start doing this, repeat Number 4. (I don’t mean to offend, your wife might keep an incredibly tidy house; if so, pay her double).

6. Let’s talk about finances, paying bills and all that admin. There are of course advantages to being able to do things during business hours like go to the bank. But lots of admin tasks can be done online. Yes, online, in the evenings, after work. Take over some of these. It’s a huge burden for your wife to look after EVERYTHING.

7. On the weekends, you are equals. You share childcare and domestic duties. You both deserve a weekend off. Her job of being exclusive carer to your child is not to spill over onto the weekend. Does your boss expect you to work on weekends and after hours? No? Remember, he is your child too. Do the diapers. Cook a meal. Give him a bath.

8. When your toddler wakes in the middle of the night, take turns to go to him. Yes I know you have to wake up and go to work but so does she. Take. Turns.

9. Holidays. Your wife needs a holiday every now and then from her job. See Number 4.

10. Just remember these four magic words that you should repeat as often as you remember. “How can I help?”

I promise you, if you do these things, you will repay her far more than any dollars will. She will feel equal, something she has probably struggled with since giving up her paid employment. Nothing is more polarising than having a family revert from a double to a single income. What she does is priceless, yes. But she doesn’t have to do it all. Once we start moving towards a more equal distribution of domestic labour, this parenting stuff will get easier. And if you’re already doing all of the above, well done. You really do get it. :)

Part 2 to come soon 😉

How Being Overwhelmed Affects Your Health (And What To Do About It)

I-try-to-take-one-day-atBeing a GP isn’t easy, but there are some aspects of my job that are quite simple. Like asking a few well-placed questions about lifestyle with every patient that walks in the door. I am constantly surprised at how commonly lifestyle factors contribute to illness – and feeling overwhelmed is a major culprit when it comes to poor lifestyle habits. The way I see it, becoming overwhelmed is the result of expectations exceeding capacity -either the expectations have increased, or capacity to cope has decreased, or both.

I am not immune to becoming overwhelmed. When my son was a baby and my daughter a toddler, I would get the same comment whenever we were out and about (him in the baby carrier, her in the stroller) – “You’ve got your hands full!” You bet I still have my hands full even though they are older now. I juggle two careers (GP and academia) and a family and in between I must run (as in jogging, not running away!) or I will go bonkers. And yes, at times I do become terribly, desperately, crying-in-my-GP’s-office overwhelmed. It’s tough being an adult, no?I know only too well how this leads to a vicious cycle of poor habits that exacerbates the situation. Let’s have a close look at how being overwhelmed affects our health:

My really high-tech and fancy diagram of how being overwhelmed affects your health

My really high-tech and fancy diagram of how being overwhelmed affects your health

Is it sounding depressing? Don’t be discouraged! Life is dynamic, not static. It’s how we roll with the punches that defines  the outcome. When you’ve come off course, don’t beat yourself up about it. Realign yourself with your destination and get out of that vicious cycle. I’m not a counsellor, but I’ve counselled many patients about this, and I’ve learned a lot from them. Here are some of the lessons.

1. Ask yourself: Is this temporary?

Many situations are – a colleague is sick and you must pick up their shifts; a family member falls ill; you’re moving house. There are many “overwhelmed” periods in my life that were absolutely worth it, like passing final exams, having babies, or finishing a thesis. If it’s temporary, go into survival mode, and plan a recovery later. Try as much as you can to limit alcohol, take short breaks, and do some kind of exercise.

2. If it’s not temporary, is it worth it?

Diet and lifestyle are now considered the biggest threat to our health. Consider this: over time, and with genetic susceptibility, a poor diet and lack of exercise leads to high cholesterol, high blood pressure, diabetes and obesity – all risk factors for chronic illness and major causes of death such as heart disease, stroke, and cancer. This might be a wakeup call, a time to re-prioritise. And leads me to number 3:

3. Talk to someone about it.

The most powerful thing you can do is to say, out loud to someone else, what YOU need to do to improve things. This is when my job as a GP becomes dead easy. I sit back and ask a question like “Have you been exercising?” and a long monologue ensues which ends with my patient saying “I think what I need to do is…” And all I need to do is listen, and be witness to that. Amazing!

4. If it’s not temporary, can you change something?

Can you increase your capacity (learn a new skill, ask for more help? Can you resign from the PTO?) What isn’t necessary in your life, and what are you doing only to please others, or what can you reasonably say No to even if it’s a one-off or for a short time?

5. Connect with your body first. 

Yoga can be a quick, powerful way to reconnect with your body and listen to what it needs. I have a few favourite yoga poses (that don’t require athleticism…) when I need to remind myself of this. Breathe. Exist in your body for just one or two moments and not just in your mind. Aerobic exercise, of course, is a brilliant way of kickstarting wellbeing and motivation.

6. Practise mindfulness.

I find this really difficult when I feel overwhelmed, but I try very hard to stick to it as much as I can. However, it’s even more challenging when I haven’t attended to Number 5 above – connecting with the body first.

7. Practise positive psychology.

The negative spiral often includes a good dose of negative self-talk which is of course counter-productive. Be vigilant and consciously practise positivity. Start a gratitude journal. Start the day with positive affirmations. Challenge your negativity. But also be kind to yourself.

8. Take a mini-break. 

This might only be a couple of hours, or even half an hour if things are really dire. But take a break from what’s on your plate and get a different perspective. My children force me to do this every day and it does help, most of the time, to keep me balanced.

So here I am putting my money where my mouth is. Over the past few months, I’ve been the definition of overwhelmed. I’ve exercised less, eaten more junk, stayed up late, drunk way too much coffee. My skinny jeans have gotten a lot skinnier. I went through the steps above. Yes, it was temporary. It was worth it. I talked to someone about it. I changed things (I am about to take a sabbatical from clinical work for 6 months to finish my PhD). And I’m now exercising religiously at least every second day again. Diet, hmm let’s say Easter got in the way, but I’m getting there.

In fact, this makes me feel positively encouraged. It reminds me how much health and wellbeing is determined by what we do, and is in many ways within our control. Just as the negative spiral of poor lifestyle habits leads to the consequences of low concentration and mood etc that promote the feelings of being overwhelmed, so can a positive spiral lead us back to optimal health. I’m also grateful, in many ways, because these experiences of feeling overwhelmed allow me to completely emphathise with my patients. It makes me a better doctor. I’m on my way back to better habits – just as soon as I finish the kids’ Easter eggs. Now if you’ll excuse me, I have to get to bed early.

If you’re feeling overwhelmed, it’s imperative that you talk to a health professional and be screened for depression and anxiety, which require more management than what I have described above. Don’t be afraid to tell your GP. It’s very therapeutic. 

photobucket.com

photobucket.com

To My Children: Thank You For My “Career Disruption”

https://www.flickr.com/photos/gilesrcook/5346737067/

https://www.flickr.com/photos/gilesrcook/5346737067/

It’s official. I’ve had 2.61 years of career disruption due to kids. I have all the dates; I even have a signed letter from my supervisor to confirm my years of maternity leave and part-time candidature. I need this for my fellowship application, because my “research output” will be assessed “relative to opportunity” – a new concept but a welcome one for others like myself who have taken a break, leaned out, along the years.

I have been saying to my colleagues that “This PhD is a doddle; building an academic career is the thing that is difficult”. I have wondered how life might have been without children – working ten hour days, weekends, writing and publishing and presenting and researching, building that “track record”. I’ve even had moments of fleeting envy when I leave at 4:30pm and see my childless colleagues free to stay until all hours of the evening, and on weekends to know they have the freedom to keep working, keep writing, keep up that research output.

And yet I have come to realise the truths that perhaps only parents understand: productivity is about quality, not quantity. Six solid hours is realistically what I can produce in one day; I have grand plans for the evening but after wrestling two small children into bed, lying down with them for half an hour, fending requests for water and a special blanket and more kisses, my brain is mush and I would rather watch cat videos on Youtube than write a paper.

Even more than this, my children give me something more than wide hips, grey hair and a quiet, desperate wish to one day complete my morning ablutions without an audience. They bring me meaning. They connect me to life itself. When I hold a tiny, chubby hand in mine, when I kiss a round cheek at night, when I breathe in that gorgeous warm just-woken-up smell and hold a soft little body in my arms in the morning, I know why I am here and why I am doing what I am doing. This is not to say that people without children do not have meaning in their lives; they do, of course, and in fact they have so much time to contemplate this sense of meaning too. Perhaps this is why, as a parent, connecting with our children is one of the most breathtaking experiences, because it occurs in the midst of utter tedium, repetitiveness, even boredom.

And those years of career disruption? To be sure, my career WAS disrupted. I have no papers published during that time. No conference presentations to put on my CV. It’s a gaping hole, that 2.61 years. And yet, on the other side, it was marvellous. It was filled with muslin wraps, long walks with the pram, sleepless nights, spew on my shoulder, delicious baby gurgles, toothless smiles, babycinos, trips to the library, quiet moments at home, noisy moments at home, dancing, scribbling, and lots of cleaning food off surfaces. It was marked by a feeling like I could never love more than I did that very moment, like my heart was exploding out of my body. It was a sense of awe, that I had been entrusted with the care, feeding and raising of these very special people. (It was also the hardest thing I have ever done. I have written of this previously.)

And so, to my children, I want to say this. Thank you for “disrupting” my career. Thank you for those years, the best years of my life.

Thank you for the way you love me without hesitation, without any judgement; for forgiving me for all the times I am distracted because I am thinking of my work, or my research, for loving me even though I am nowhere near perfect. 

Thank you for the way you remind me to be mindful and grateful of every single moment.

You are my guiding stars. Every evening I pack up my laptop and race home because I cannot wait to hold you in my arms again. (Sometimes I go for a run before holding you. But you know exercise makes mummy less cranky).

And every single morning, you give me a reason to get out of bed, to keep showing up. 

Thank you for making this trip worthwhile. 

 

The Courage To Be Imperfect

I-Am-EnoughI’ve been writing a blog post entitled “Nine Ways to Beat Anxiety”. It’s sat there, unfinished, for weeks. In the meantime, my anxiety levels, which started rising when I decided to apply for a very competitive fellowship, have skyrocketed. Eventually I faced the facts – I was suffering a major relapse of Impostor Syndrome.

Impostor Syndrome is marked by the desperate feeling that some day someone is going to discover your dirty little secret – you’re just an impostor. You don’t belong where you are. You’ve faked your way. And some day, they are going to find out.

Impostor Syndrome took its toll on me. I started to say Yes to everything that might allay my Impostor anxiety. Looking back it was easy to see how it all snowballed. A host of changes looming this year, major milestones and deadlines, it all came to a head recently. I broke out in a rash, went to see my GP and wept (doctors are human too), and wept again when I saw my counsellor.

Deep down I couldn’t shake this feeling like I just wasn’t good enough, and I felt like I was paddling desperately to keep my head above the water. I also felt extremely time-pressured and like there was no escape.

I tried lots of things. I explored self-compassion – showing myself compassion, loving myself despite my imperfections. I started reading Brene Brown. I confessed to my husband, who already knew, really. Eventually, all of the above helped me make an enormous decision that lifted the burden significantly. But more on that in another post.

I’m now feeling a lot better. But not before I had done some soul-searching. I tried to search for the origin of these “not good enough” messages. I always assumed that someone, somewhere had said things that made me feel this way. But when I looked back, I realised that nobody had ever said to me that I was hopeless, or not a worthy person. I have had negative feedback, awkward moments, humiliation, embarrassment, times of extreme discomfort or stress, but mostly, the messages were internal. I interpreted negative feedback, no matter how minor, to mean that I was intrinsically “no good” as a person, and I was intensely uncomfortable with this feeling. So I always strived to be perfect, to avoid the burning shame of feeling inadequate. But the messages were all mine. The tape, the voice was mine. I couldn’t blame anyone else – I had, effectively, imprisoned myself.

The way forward, then, is to see myself as who I am. Not black and white, good or bad, but a human being intrinsically worthy of love and belonging. And to have the courage to stand up, feeling vulnerable, but accept my imperfections, even accept that I might fail. To have the courage to challenge my beliefs. To finally be kind to myself. This is the ultimate courage – to stand up to my own criticisms. It’s the only way to free myself from this prison of self-doubt. I have been my own worst enemy, for decades. But through these next few difficult weeks, I am going to be brave, by saying “I Am Enough”. That whatever outcomes arise from the day, the week, the month, or from this fellowship application, I am and always will be worthy of love and belonging.

I Am Enough.

Have you ever suffered from Impostor Syndrome? How did you cope with it?