Sometimes I say that I am a doctor and a mother. Sometimes I say I am a mother and a doctor. It depends on the situation and who I am talking to and what is on the forefront of my mind at the time. And both are an essential part of my identity. I don’t always realize how much one affects the other.
I read an excellent article this week in JAMA written by a doctor at UCSF about her experiences sleep training her first daughter. It brought tears to my eyes as the slightly blurry transition from physician to physician-mother came into focus. Not until I read this did I realize how profoundly my experiences as a physician shaped me as a mother.
I did residency just before duty hours restrictions were enacted. As a result, every fourth night, I spent 36 hours working in the hospital. Then I went home for 10 hours and went back to work by 6 am the next day. I learned so much, but also confronted unimaginable heartbreak and difficulty. I saw addicts who spent a month in the ICU locked into their bodies. When they woke up, they were detoxed, and no longer could imagine using. I saw them come back, high, defeated, broken. I delivered babies too early and too small who did not survive. I cared for gunshot wound victims who were resuscitated heroically but who did not survive. And then I told their parents and cried with them when they wailed in grief. This was before the time where support to process these things was part of training. My fellow residents and I shared war stories and our grief but these things become a part of you. We all dealt with it in different ways.
When I finished residency, I started my first job and was very happy to be pregnant with my first baby. All was smooth until I woke up one night at 7 months pregnant, itching my hands uncontrollably. My itching got worse, soon involving my soles of my feet as well. I found out that I had a liver condition associated with pregnancy called cholestasis. However, mine was a severe form. The risk was not to me, but to the baby. My doctors told me that they would monitor closely, but that we should be aware that the baby could die at any moment.
I cried everyday. I couldn’t sleep because of the itching. I was in the hospital constantly with terrible contractions. One day, my doctor called and told me that my bile acids were very high (“I’ve never seen them so high before! It’s remarkable!”) and that the risk to the baby was unacceptable. That day, I had an amniocentesis to confirm that the baby’s lungs were mature. When we got the results that night at 9 pm, we were scheduled to come to the hospital the next morning for induction.
After a crazy day, with my husband and my mom by my side, our beautiful Diya was born. She was 5 weeks early, 4.5 lbs and perfect. The days afterwards were an exhilarating process of discovering an incredible love with this tiny baby. However, they were also filled with more stress of another hospital admission for her high bilirubin, too many blood draws to count and no sleep.
I went into debt: sleep debt and self care debt. Already sleep deprived before I became pregnant, I did not sleep more than an hour straight for the first year of her life.
And yet, when the question about sleep training came up, I could not do it. After so many years of helplessly watching so much suffering, I could not watch her suffer. I would not. And thus, we started co-sleeping. The type of parent I became was directly a result of the trauma of residency and then the pregnancy. So I put her first, always, for a very long time.
I would like to say that over time, and after having more children, and getting older and wiser, that I am more balanced now. I do take better care of myself. But, I will still hold Nisa longer if she needs it even if my arms ache and I need to put her down. And I will suffer too much along with Esha when she has a belly ache.
I don’t think that I can be any other way. I am a doctor and a mother. And a mother and a doctor.
Thank you Carly for helping my see my mothering with more clarity.