Friday miscellany: Travel, plans for sick days, costumes, etc.

October and June tend to be my peak speaking months. So I was on the road again this week, going to Seattle and Tampa.

Seattle was rainy, but in full fall glory. I went for a walk on Tuesday morning around the campus of the University of Washington and wow. The bright yellows and reds against the more traditional northwest pine trees were just stunning. Unfortunately I didn’t sleep well in Seattle, or at home, or in Florida. I did get a lot of work done on planes and in those long mornings that a jet-lagged traveler from the east coast encounters in the Pacific time zone. A work out, a leisurely breakfast, clearing much of the to-do list, an autumnal walk…

I normally sleep quite well, so I blame the baby, who is active and making his presence known. I do not enjoy pregnancy. I find myself very aware of the days. While on some level I appreciate that this makes time seem to move slower, it’s not necessarily slower in a good way. One thing that’s been oddly motivational this last month is reminding myself how “productive” these weeks of gestation are. I have always gone full-term (or more…) with my babies so I haven’t worried about prematurity, but I did look up the stats the other day. At 23 weeks, very few babies can survive. At 29 weeks, the vast majority (more than 80 percent) do with modern medical care. That means over a period of 42 days, the baby’s odds of survival in the outside world are going up by about two percentage points per day. That’s quite a bit in thinking about any given 24 hours. Certainly more than I accomplish most days!

Now for a less happy medical story: I read a write up at the American Council of Science and Health website of a study in JAMA looking at board certification pass rates for surgeons. In the data set, while 90 percent of single female surgeon candidates passed the face to face examination part on the first try, only 75 percent of married women did, and only 55 percent of women who were married with children. The pass rates for men were unaffected by parenthood. I can’t find any evidence that mothers make worse surgeons. So, what’s going on? Perhaps some folks on the examining panels of surgeons harbor biases about who can be a good surgeon, and it’s reflected in their judgements. Theoretically no one’s asking about marital status or children, which is why the write-up downplays this factor, but I’m pretty sure it could be deduced. It’s also possible that mothers have less time and mental space to prepare for the exams because they take on more domestic responsibilities than male prospective surgeons do (though why pass rates should be lower for married women who don’t have kids I’m not sure). The former problem, medical organizations could — and should — do something about. The latter is tricky to deal with in terms of broader cultural narratives, but both potential explanations are pretty depressing.

Speaking of who covers what…Winter is coming, at least for the northern hemisphere. Consider this the annual public service announcement: What’s your plan for covering sick days for young kids who can’t go to school or daycare? In this week’s Tranquility By Tuesday post, I mention the family’s sick day plan of each parent covering half the day. While there are some inefficiencies on this (both parties need to commute, and both parties spend time getting ready) there are upsides too. Neither party is out for a whole day. If you have some flexibility, and if you know ahead of time that the sick day is coming (the kid has a fever the night before) the party that works in the morning could start early enough to log most of a day. One person working 6:00 a.m. to 11:30 a.m., and the other switching off for 12:30 p.m. to the evening means that nobody falls too far behind. Other families might choose to do individual days. If one party always covers Monday and Tuesday, and the other always covers Wednesday and Thursday, then each party can triage the schedule not to put anything absolutely unmissable on their coverage days.

Of course, this requires that both parties believe that childcare — and figuring out back-up plans — is a joint responsibility. I think this is a conversation that a lot of expectant parents don’t know to have, partly because people who’ve barely ever taken a sick day have no concept of how often young kids can get sick, especially when they are cared for in group settings. We certainly didn’t know this when we put our eldest child on the list for a local daycare five months before he was born. To me at the time, that meant the problem was solved. The daycare was great! We love the friends we made there! However, he was out for about five weeks that first winter, which is one reason we wound up hiring a nanny by the time kid #2 was born.

This weekend will feature a Halloween party and more travel. My 12-year-old plans to be Pennywise, and has a terrifying costume. The 8-year-old will be recycling her Elsa costume from the Disney cruise. It wasn’t cheap to buy the first time but at least we’re getting a second wear out of it! The 4-year-old wants to wear his glow-in-the-dark skeleton pajamas, which I think is great. It will ease the transition into bed after trick-or-treating next Thursday night.

Are you planning to dress up this year? I usually don’t — I just escort the kids.

In other news: My TED talk crossed 9 million views. I gave it three years ago this next week. Very exciting!

10 thoughts on “Friday miscellany: Travel, plans for sick days, costumes, etc.

  1. We are going as a “royal family” this year (King, queen, knight/prince, and 2 princesses). I’m actually kind of excited! And I am usually a total Halloween curmudgeon.

    1. @SHU – that’s a great idea! I just haven’t been able to motivate myself for adult costumes. Plus, Pennywise was expensive!!

  2. I’m sorry you’re not sleeping well. Many of my friends who have been pregnant in their late 30s have told me that their pregnancy at “advanced” age were more difficult than their pregnancies when they were younger for precisely this reason. TWO MORE MONTHS! You got this. 🙂

    I wanted to address your comment on female surgeons with children failing their boards at higher rates. Surgery residents work on average 90-100 hours per week. REAL hours physically spent in the hospital. Yes, post-work hours reform. They do not report their hours truthfully, and indeed, they are encouraged not to by their programs. And most of the work they do while they are at the hospital is a) operating, b) administrative, c) physically seeing patients. Oral board exams cover a massive volume of material much of which simply cannot be learned on the job. A few years ago, surgical board exams were pushed back a month after the end of residency to allow people to study (and move for fellowship) because the failure rate had become unacceptably high. It’s not surprising to me that women with children fail. It is impossible for them to study enough. Many woman surgeons have partners in similarly demanding professions, whereas many male surgery residents have stay at home spouses. Many also want to see their children from time to time, further cutting the amount of time they have to study. As an anesthesiology resident, I often felt that I had no time to study, and I only worked 70 hours a week during residency on average, and when I was studying for an exam I would study at night until I physically could no longer keep my eyes open, on post-call days, and on days off. I passed, but I wonder whether that would have been the case had I been in a more demanding specialty.

    Sexism probably factors in other ways. For instance, other studies have shown that woman surgeons feel more pressure to put in extra hours in the OR post-call than men do. Additionally, acting “female” probably carries its own penalty, as much of surgery is still very… old school. I remember once hearing one of the attendings openly mocking one of the female surgery residents for crying in front of the entire OR staff and some of her colleagues (she was not present). So.

    1. @OMDG This! I can also see how this would affect married women without kids. Because there is so little time to study, I could see a married female resident with a husband in a demanding job taking on more household tasks and having less time to study than a male married resident even without kids. I would also second the continued “old school” attitude in surgery. I am not a surgeon, but during medical school I was pregnant during my surgery clerkship (there was a strategy here which I can get into another time) and all my evaluations made mention of my performance in the context of being pregnant, event those evaluations by FEMALE residents and faculty. Even in 2019 being a female surgeon is a tough gig.

    2. I agree with most of this. I was also not a surgical resident but the hours are brutal. Too many professional women still expect themselves to be homemakers too. I know I told my husband I was not responsible for anything the weeks I was studying for boards. He got a housekeeper. Worked fine for us, we have continued with a housekeeper ever since.

      I wonder if women’s stats for passing oral boards would be better if they went to a blind system, like examinee in a different room with a voice synthesizer to eliminate bias. It would be interesting to see how the pass rates change.

  3. “It’s also possible that mothers have less time and mental space to prepare for the exams because they take on more domestic responsibilities than male prospective surgeons do (though why pass rates should be lower for married women who don’t have kids I’m not sure)”

    This! My sister is married with a toddler and studying for actuarial exams and she is performing feats of time and family management that are baffling to even Upholder/Planner/Overachieving me.

    I can totally see how being married would influence pass rates. Even without kids There is most likely increased housework, more extended family obligations, and quality time spent with your spouse: from what I’ve gathered, even truly understanding and supportive spouses don’t really comprehend the amount of time and focus studying at this level requires. They understand that “study time” will be a part of their life, but also expect their spouses to fit their studying in between normal life things like eat meals together, go to church, run errands, give input on household projects, not live in squalor, have normal married-couple arguments (and there might be more arguments because everyone in the household can get stressed about exams!) etc. Single people can retreat into study caves. They can keep strange hours. They can use PTO that married people might need for family obligations or trips. It’s not unusual in the industry for actuaries to send their families on vacations without them, book hotels to study, or move back in with parents temporarily while they are preparing for exams!

    I’d love to hear an actuary on BoBW! It’s a unique profession, from a time management perspective.

    1. Yeah … count me among those not surprised, re: married non-moms. In fairness, it’s not looking at that group (non-moms), but the recent reports on mothers’ marital status/household situation and housework didn’t surprise me a bit — see e.g. . I am entirely convinced that I personally do WAY more housework than I would were I not married (and in my case that’s with a husband who’s out of the workforce by choice).

  4. Back in the 90s and early 2000s (so maybe it’s a bit better now), my dad was a physician going through residency (he did two, finishing one in the 90s and starting another in the 2000s). He’s male, but he always talked about how much his colleagues looked down on him for trying to be an active dad and have a family. He wanted balance and family life and I know it created some trade-offs career-wise. And my mom stayed at home! So I really can’t imagine what it’d be like for a woman who’s the primary parent. Not surprising, unfortunately.

    Isn’t this part of why a lot of professionals get married/have kids later in life? I believe strongly in having both a career and family, but it really is performing magic. I feel lucky being a marketing writer. Building a business with a young child is tough, but probably 10x easier than having a kid + being a doc, lawyer, actuary, etc.

  5. For snow days and sick days, I take the sick days because I have a lot of paid sick time. Because of this, and because he can work from home and has more flexibility, my husband takes snow days (unless my workplace is closed, which is semi-rare but does happen and seems to be happening more frequently). Of course, this agreement was made last year when our daughter was an infant who slept a lot and could be bounced in chair with one foot while he was working, and now she is a busy toddler who is not fond of being contained. And for whatever hours he doesn’t get work in he has to take PTO, which is somewhat limited (I have more than he does as well).

    I think the crunch with the sick days is not just taking time for the kid, it’s taking time for the kid then taking time for yourself because you caught their illness. I did anticipate some sick days with my daughter being in daycare but I actually ended up taking more for my own illnesses. But there’s really no way around it–a nanny isn’t a feasible option for us and I love our daycare. Besides, if they don’t get it at daycare, they’ll get it when they go to school, and then you’re in the same boat.

  6. Interesting re: the surgeons. I coach some of our medical students as part of my faculty responsibilities. Half of my students are women – so I am going to take this to them and see what they think. And ask my female surgeon colleagues.

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