I forget where it was, but I recently heard a woman remark “Well, you see, my husband’s a doctor.” The implication was that she needed to be fully responsible for everything on the home front, and she couldn’t pursue any sort of demanding career because, well, her husband was a doctor. Wasn’t it obvious that this is the way things should work?
As you can imagine, I have always found such remarks grating. I tend to think lines like this say more about the person uttering them than about any truth applicable to the broader world. There is nothing inherent in medicine that means you can’t also be an active and present parent, or that your spouse can’t also have professional aspirations.
I was thinking of this as Sarah and I welcomed Swati Singh to the program this week. Singh practices emergency medicine at a handful of hospitals in the greater Washington DC area. She also has two children. Her husband has long had demanding jobs in international relations, including in the state department, and USAID. These jobs have required a lot of travel. He clearly didn’t think that because his wife was a doctor, he simply couldn’t pursue his professional passions, and couldn’t try to do work that advanced the cause of international understanding.
Instead, the two of them have made it work together.
Indeed, as women have gone into medicine in droves, comprising a reasonable chunk of medical school classes, we’ve seen that many of the old assumptions about how family work must be split if one party is a physician have changed. Some women physicians might feel they’ve gotten a raw deal on this. (And I did ask Singh if she resented her husband’s 10-day business trip to Delhi when it meant she had to cover stressful late night shifts AND kid care!)
But it has some upsides too. I recently looked at time diaries of a number of female dermatologists. Several chose to work four day weeks. They were still the primary breadwinners in their families (it’s a well-paying specialty). But since their husbands also worked, they didn’t face quite the same pressures to maximize earnings. They could choose a balance that worked for them.
Anyway, as you can imagine, managing life with two careers, including one with international travel and one with shift work that could encompass any of the 168 hours of a week, is a challenge. Here are a few strategies that Singh uses.
Hours aren’t set in stone. Yes, an ER always needs to be staffed, but different arrangements might make the hours more workable. In Singh’s particular hospital group, several of the ER physicians decided to split some of the overnight shifts. So someone might work from 2 a.m. to 7 a.m. instead of the entire night, and do more mini-shifts instead of fewer longer shifts. This makes it possible to be functional during family commitments during a normal day. Comparable shifts have happened in other female dominated specialties; OB-GYNs now generally work in group practices where it’s expected that any of the physicians might deliver your baby. That makes call schedules more reasonable (rather than around the clock).
Even physicians can sometimes work from home or work flexibly. Singh has some administrative responsibilities and some teaching responsibilities as part of her job. Some of this can be done remotely, and some can be done during school hours.
The right childcare is key. Singh and her husband originally had a nanny, but with Singh’s varied schedule (working during the day one day, and then middle-of-the-night to morning on the next) it was hard to get the right coverage. Most nannies would like to work regular day-time hours. So they’ve used au pairs for the past several years, and have found it more doable to have someone who lives with them. Plus they’ve enjoyed getting to know these young women as members of the family, and since they’ve all been from Mexico (a request) the children now speak Spanish. Singh recommends talking to other parents who’ve hired au pairs about their process because it’s not necessarily intuitive, and you have to know what will work with your family.
It takes a village. Corny cliche, but true. Singh’s brother lives nearby, and will sometimes pitch in. Her mother has come to stay with them sometimes too. She has had friends watch her kids when she has a weekend shift and her husband is in, say, Delhi. On snow days, Singh’s neighbors will take turns watching the kids, with them moving from house to house for a 2-hour shift, so all the parents get some time to work (remotely).
Modify cultural expectations. Singh and her husband come from traditions where there is a big emphasis on homemade food, and of women spending a lot of time making these meals. Even women who have jobs outside the home. Singh admits that she does find cooking and meal planning stressful (more stressful than intubating a patient!) However, she has reached a balance where she cooks a big Indian meal once a week. Then other days they do other things (like tacos).
You have to believe in what you do. Singh loves her work, and she also believes what her husband is doing is important. So that helps them take the daily complications of life in stride.
Anyway, it’s a good episode. In keeping with our guest’s profession, we start off with a discussion of our family ER visits (all my kids have been at least once. And my husband in recent years for a chain saw accident…) And then the Q&A deals with the office social implications of asking for a modified schedule. If your boss is OK with you coming in a little later, does it matter if your colleagues are snarky about it? Feel free to post thoughts on any of these topics in the comments!