Podcast: Making life work, with emergency medicine physician Swati Singh

Best of Both Worlds PodcastI 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!

19 thoughts on “Podcast: Making life work, with emergency medicine physician Swati Singh

  1. I hope “Runner” was listening because I think she needed to hear your and Sarah’s advice! There may be some workplace culture issues that affect her fears that her co-workers will look askance at her arrival time. I work in a library where 1/3 of the employees have faculty status, which is very flexible in some ways, while the other employees are hourly staff. This contributes to some unfortunate dynamics about hours at work, arrival/departure, who’s working how much, etc. And the autonomy of faculty status is juxtaposed with the competitive nature of “doing enough” to get renewed, get tenure, and be promoted. I got tenure about a month after I had my second child and I try to be transparent about how I spend my time and I don’t question how my colleagues allocate their time. My other colleagues who are parents take the same approach and we have discussed that this attitude has helped in situations in which employees have needed flexibility for other professional or personal reasons. Anyway, thanks for the good lunchtime listen 🙂

  2. +1 to the nanny! My mother was a physician and my father worked in a field that required long international trips. (This was in the 70s and 80s.) There were also 3 of us kids! My parents had a live-in nanny for many years, who then became a daytime nanny when their work schedules changed. Seemed to work just fine and “us kids” are now all functioning adults in our 40s!

  3. Laura,
    I am always wondering what brought you to this topic of interest. Have you written a prior post about it, or is it in one of your books? Was it a pattern you saw that successful women could also be successful parents and you wanted to shout that from the mountains?
    I am always wondering about your ‘origin story’, because I love your work and your passion on this topic.

    1. @Angela – I’m not sure there’s a good origin story (I wish there were!) I think I simply believe that women, no less than men, are capable of doing amazing things in the larger world. So I’m always on the look out for stories that I think serve to limit people’s aspirations.

  4. I’m not through this episode yet since my driving time has been vastly reduced since I went back to work (from home) a couple of weeks ago and we now have a more equitable schedule of kid-shuffling between spouses 😀

    But I love that she comes from a similar ethnic background as me, and talked a bit about the pressures around being a mom/wife that come with that.

    It kind of reminded me of the anecdote from Indra Nooyi (Pepsi CEO) that horrified me, about her mom berating her for not buying milk one night when she came home from work late: https://www.theatlantic.com/business/archive/2014/07/why-pepsico-ceo-indra-k-nooyi-cant-have-it-all/373750/

    Anyway, I really like these interviews with different women and their nitty gritty logistics. 🙂

    1. @ARC – yes, the southeast Asian/food pressure issue is fascinating to me, not being from that background myself. I did a talk a few years ago for a group of mostly Indian American professional women and many of them were comparing notes on cooking from 6-8 p.m. after working a 9-5 job. From my perspective, it seemed like a simple way to find more time was to not do that most nights, but deep cultural expectations mean of course it’s not that simple. If even Indra Nooyi feels them!

      1. Yeah, I remember my own mom doing pretty elaborate cooking each night when she worked full time. And my dad would “only eat” a typical South Indian dinner so she would often cook something “American” for us, but always had rice, vegetable, etc for him. I shudder thinking about that now 😀

        I also noticed at work that some of my coworkers from South Asia often had a thing about wanting “fresh” food each night – ie they weren’t even cool with batch cooking on the weekend, or cooking every couple of days and eating leftovers. Some would creatively outsource this – there were Indian “aunties” who would make fresh roti and curries, etc and drop them off at your house daily. But some were stressing hard about this.

        1. I am so glad I seem to have escaped this pressure. Having ridiculously picky kids who refuse to eat indian food may help…? Indian food is a PITA to cook and clean up after. there is no “easy” way around a full indian dinner. and all the oil spatters & roti flour everyday. nope. not for me.

          1. I am so glad this is being addressed! Despite my mom working 8-5, she is still doing the second shift at home, mostly because she loves to cook and come up with new dishes, but partly because, that’s what South Indian women do. She’s exhausted by 8 PM every night because even putting together a meal of leftovers still requires rice/roti/heating up and cleanup after.

            She does batch cook and uses store bought tortillas whenever she can, but, some habits are just impossible to break. I’m home for the week and taking over the chores while she works and I’m astounded by how long they take. I think we only just realized this in the last year, after my grandmother passed away-while she was well, she insisted on doing all the cooking at home so Mom could focus on her job.

            (And Dad insists now on eating at their favorite restaurants 2 nights of the week, which has helped a lot more. There’s something to be said for modifying standards for what, exactly, a meal has to be comprised of)

          2. @DVStudent – the requirement to eat out twice per week sounds like a good way to get rid of some of the compulsion. Now if your dad takes a night, and they institute leftover night, that takes it down to 3x per week – much more reasonable!

  5. One of my favorite episodes to date! Swarti was articulate, composed, upbeat, intelligent, and I want her to be my friend! She has such a reasonable approach to work-life balance- as a physician mom with a hard working, busy spouse I’m impressed!

      1. Agreed — I really loved this one. Definitely one of the best guests you’ve had so far.

        On a related note — how are you finding/selecting your guests? (Especially the ones that don’t seem to have a blog presence?) Are they friends of yours, writing in to ask to be featured, etc.? Thinking particularly of Swati and also Hannah from last week.

        1. @Jenny – all of the above. People write in saying they’d like to be on the show (that’s probably the main pool we choose from), then there are people we seek out (blogs/experts/authors), and people who come recommended from other people. Swati was a friend of a friend and was recommended to us.

  6. I loved Swati too! As said above, I want her to be my friend! Really really great interview.

    Not sure if she’ll pop on here but thought I would share a story about cooking. Like Swati, my mom and mil are amazing cooks. Seriously. I’m not. I carried such a chip on my shoulder because of that (and really it took years to realize it was only me being critical). I’ve found my “dishes” (as it sounds like you have — honestly it was finding a site and cookbook that worked for me) which is helpful but also I’m creating home cooked favorites for my son. He is 13 and already saying “mom, when I come home from college will you make meatloaf and garlic pasta?”. All that to say – don’t be so hard on yourself — you’re trying and that’s what counts.

    1. In case it wasn’t clear…the meatloaf and garlic pasta are hardly gourmet and take about 15 min hands on time. 🙂

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