The Art of Balancing Medical Career, Teenagers, and

Relationships without Prozac

A Memoir
Anna Sylwestrowicz MD FRCP(C) Copyright © 2015 by Anna
Sylwestrowicz MD FRCP(C)

All rights reserved. No part of this book may be reproduced in any form by
any electronic or mechanical means including photocopying, recording, or
information storage and retrieval without permission in writing from the
author.

ISBN-13: 978 ISBN-10: 151 Printed in U.S.A.

Dedication
To my family and the women of medicine.
Foreward
Table of Contents
Introduction ..................................................................................................11
Part 1 ........................................................................................................... 15
My Own Life ............................................................................................... 15
Chapter 1 ..................................................................................................... 17
The Only Child Syndrome .......................................................................... 17
Chapter 2 ..................................................................................................... 27
Striving to Be ............................................................................................. 27
Perfect ......................................................................................................... 27
Chapter 3 ..................................................................................................... 47
Seeking a Husband ...................................................................................... 47
Chapter 4 ..................................................................................................... 51
White Wedding ........................................................................................... 51
Chapter 5 ..................................................................................................... 53
Pregnant! ..................................................................................................... 53
Chapter 6 ..................................................................................................... 57
Graduation, Career & Pregant Again! ......................................................... 57
Chapter 7 ..................................................................................................... 59
Dissolution of Marriage & Hanging On ..................................................... 59
Chapter 8 ..................................................................................................... 67
The Accident .............................................................................................. 67
(Third Pregnancy) ....................................................................................... 67
Chapter 9 ..................................................................................................... 71
Single Parenting .......................................................................................... 71
Chapter 10 ................................................................................................... 77
Co-Parenting with a Crazy Ex .................................................................... 77
Chapter 11 ................................................................................................... 89
The Blind Date ............................................................................................ 89
Chapter 12 ................................................................................................... 93
Blending Families ....................................................................................... 93
Chapter 13 ................................................................................................... 99
Back to Career ............................................................................................. 99
Part 2 ......................................................................................................... 109
The Lives of Others .................................................................................. 109
Chapter 1 ....................................................................................................115
My Son .......................................................................................................115
Chapter 2 ....................................................................................................119
......................................................................................119 Chapter 3
................................................................................................... 123 The Social
Worker .................................................................................... 123 Chapter 4
................................................................................................... 129 The
Teacher ............................................................................................... 129
Chapter 5 ................................................................................................... 133
The Family Physician ............................................................................... 133
Chapter ................................................................................................... 137
The General Practitioner ........................................................................... 137
Chapter ................................................................................................... 141
The Dentist ................................................................................................ 141
Conclusion ................................................................................................ 143
Appendix ...................................................................................................153
About the Author ....................................................................................... 157
Introduction
E

veryone has a story. Of course, they do. After all, we have all been on our
own journeys and down our own paths. For me, my story is one of balance,
or lack thereof. I learned the hard way that actually having it all is really a
myth, and I learned it when I entered the traditionally male-dominated world

I have been an anesthesiologist for 20 years, and through three children as

well as a spectacularly failed marriage, I realized my own inner con

vs. family. There are so many women who choose one over the other and
then have regrets over the choice they made. Some of you will judge me and
think “what a bitch” while others will see that I was simply an ambitious girl
who wanted to “have it all.” I thought I would live a life of no regrets and
scored a big F in that department. Balance is simply impossible to achieve in
some medical subspecialties, especially those in the surgical realm, because
they require practicing the trade over and over again to remain competent.1

Following Advice

I chose anesthesiology on the advice of my obstetrician father. And, despite

what others may say, I do think that many careers are simply not suited to
having a family. This would include general surgery and other medical sub-
specialties. I think the young women who select these residencies simply do
not have the capacity to understand the actual trade they will be making.
They don’t know that the career is all-consuming, making it impossible to
have a happy home life, healthy relationships, and a rewarding career all at
the same time. There just aren’t enough minutes in the day. Intuitively we
know choos-ing to work on the oil rigs in Northern Alberta may not be the
best environment for work-life balance, and yet we pick demanding
specialties in medicine and other traditionally male dominated
1
Malcom Gladwell’s theory in his book Outliers: The Story of Success (2008).
|11{
other “part-time female anesthesiologist” (direct quote from a retired
collegue)
skills have to be practiced over and over again. I knew that and I know it still.
Words of Advice

The obstetrician who delivered my stepson as well as my biological son once

told me that in England, where he trained, his professor told him

offensive to a whole lot of people. But, now that I am 48-years old and have
completed my anesthesiology residency and worked for over 20 years, had
three children, am a mother to two stepchildren, been through one failed and
one successful relationship, and am facing aging parents, I am starting to see
the guy’s point!

I look around and realize that my girlfriends who have remained relevant in
their medical specialties have chosen careers over families because

were not nearly as satisfying as what they were capable of achieving

following tertiary care medical training. For example a plastic surgeon who
just excises “lumps and bumps” in a daycare setting, a cardiothoracic surgeon
who only does operating room assists, an ophthalmologist who doesn’t have
an opera-tive practice, or an obstetrician and general surgeon who teach or
get involved with hospital administration. That’s just the truth of the
situation. There is always a choice to be made. There is always something
you have to give up. This is especially hard for women who try to raise
children and stay relevant

So, I want to tell my story because I think it is unique. Yes, I have remained
relevant as an anesthesiologist. Yes, my life has had many different twists
and turns. Maybe, it is a story that could help someone else. Maybe it

certainly was never dull! I have been doing this job for more than 20 years,
and I have seen ups and downs, marriages and divorces, children and nannies,
etc.

I see what the world expects of women these days and I am completely
confused at how they are supposed to accomplish it all. In a way, women
who
- other – their marriage, their children, or their job. Not making the choices as
to

So, I have not written this book as a way to complain about my own story and
certainly not to brag. I am aware that I have such an abundant life and I am
very grateful! I haven’t even written it so much for myself as I have for
others. Maybe it will serve as a word of advice – or warning – to those ide-
alistic, ambitious girls or young women who approach the medical or any
demanding career expecting to have it all.

At the same time, perhaps it will serve as a way of explaining there are ways
to get through it – to have the rewarding job and the family.
By the way, as I write these words, my twelve year old son told me I

is my book. Here are my stories. Hopefully, here is something that will give
you inspiration.
So, let’s get started and I will tell you about my life.
Part 1
My Own Life
There are two parts to this book, and that is for a very good reason. In the
to pursuing a career in medicine as well as everything in between. This is the
part that I will share the most because it is my story. It is the perspective I
have
husbands, a busy home life, and three children (and now, as well as two
stepchildren).

Through this perspective, I have learned a great deal, and I want to share that
insight with you because I believe that the world has the wrong perspective
on women. After all, women are expected to:

• Go out, achieve their dreams, and “be all that they can be”
• Still take care of the home and raise a family

Essentially, they are supposed to be super women and there simply is no

balance to this. Even in real life, Wonder Woman (Lynda Carter) struggled
with alcohol addiction. “Now I’m focused on health, not perfection. I don’t
want to be a weak, sick 90 year old,” she said.

In the second part of this book, I will focus on the stories of other women so
that you can see things from a wide variety of different perspectives. Because
it is such an important issue to me, I took the time to interview women whom
I know in a wide variety of different professional careers. That way, I can
offer you information beyond just anything I know myself.

No, none of this will provide the exact answer in your life. But what it will do
is help you see how things actually are. It’s not as simple as going out there,
getting a job and raising a family. It is not perfect or easy. And that is what I
hope to show. Partially, I want to do this to open the eyes of those individuals
who assume women “play at working careers” or those who simply see
things as idealistic with no idea of what things are really like. Finally, I am
writing this for the young women who are working toward a medical career.
Nothing here is meant to suggest you should give up. In fact, I hope
it is a pathway that I have greatly enjoyed. However, it is also very
demanding, and not nearly as glamorous as portrayed on television.
As you read this book, hopefully you will gain perspective too. And,
remember that each part of this book looks at things from a different perspec

Chapter 1
The Only Child
L

et’s start where any good book should – the beginning. After all, for you to
truly understand me, why I made the choices I did, and where I am now, you
will need to know where I came from too.

Although the title of this chapter is the only child syndrome, I wouldn’t
necessarily say I suffered from that condition. No, I didn’t have everything I
ever wanted and no, I didn’t grow up spoiled and used to someone else taking
care of me.
Syndrome

What I did develop as an only child was:

• A strong working sense. I knew what I wanted and I was not afraid to go
after it.
• The belief that I could truly have it all. After all, my parents continued to
encourage me, so I followed this encouragement.
As an only child, I was the sole focus of my mother, who did everything to
push me further in education. And yes, it did pay off.

I began my life in Poland in a coastal city called Gdansk. While you may not
have heard of this city, it is actually the fourth largest in the country and
serves as Poland’s principal seaport. During the early years of my life, we
remained in Poland, living in a resort city called Sopot. This is where my
father worked as an obstetrician and my mother as a chemical engineer.
Watching my parents as I grew up, it’s no wonder that I became so career
driven over the years. I had two very focused parents, and since I was an only
child, that focus rubbed off on me.

It wasn’t like that in the beginning, though. As a child, I wasn’t quite so

ambitious. Instead, I was an average, active only child living my life as one
big adventure. While my parents did have their careers, they still looked out
for me as their only child, my mother especially. I will share some of those
stories later.

Leaving Poland
In 1971, we were to leave Poland. My parents had received a contract to
begin work in Nigeria. So, while I was still a child, we moved to Zaria. Here,
my father continued his work as an obstetrician. My mother, on the other
hand,

- madu Bello University, a cause that was and still remains extremely
important for many parts of Africa.

At a young age, as I mentioned, I was very active. I loved to swim and

- ting still. These days, a physician would likely recognize that I had ADHD,
but at the time, I was just a hyperactive child, always testing the limits.
Moving to Canada
After spending four years in Nigeria, my parents made the decision to
immigrate to Canada. Starting out in St. John’s, Newfoundland, my father
had to begin his career again, in a sense, by repeating two years of his
residency. However, we were not slated to stay long in St. John’s. When my
father travelled to Montreal for his oral fellowship exams, the chief examiner
was from Manitoba and he was offered a position in Winnipeg. We moved to
Winnipeg, Manitoba where he worked at the Health Sciences Centre.

- ed my years in school here, all the way through high school. Through
middle school and junior years, I attended a public institution. However, my
senior years were spent at the University of Winnipeg Collegiate, a private
school that served as a preparatory educational opportunity for university.

Beginning My College Career

After high school, I began my university journey with two years in the
sciences. My grades were very high and I actually enjoyed the challenge of
exams – the challenge of attempting to ace them. This is when ambition
began to kick in and I started considering medical school. Many of my
colleagues were already applying for medicine, and I thought, “What the
heck? I will do the same and see what happens.”

Although it came as somewhat of a surprise, I was accepted to the University

of Manitoba Medical School. I began my medical school path in 1987 and
graduated in 1991. I was 23 years old.

Beyond that, I managed to get a scholarship to attend university. This was

something I could do – and do well for that matter. It was an exciting and
stressful time in my life. Not only would I be spending endless hours
studying, but also I still believed I could achieve the perfect balance of work
and family life. I didn’t end up married until I was in residency, but there was
always that voice in the back of my mind that said, even though others have
failed at this, you will be the one who manages to do it. Looking back, I was
never much of a follower or a good listener.

However, you know how some part of your brain always listens to your
parents, even if you pretend you are not listening or don’t want to hear what
they have to say? Well, my father, the Obstetrician always stressed the
importance of having children before thirty. I heard him say over and over
again how the incidence of endometriosis and infertility, Down’s syndrome,
genetic and birth defects goes up disproportionately after the age of 30. I got
that! It was imprinted somewhere in my brain. You must have children before
your reach 30.

Excitement and Fear

school. I was both happy and extremely anxious – happy because I knew this
meant I was on the path to a rewarding career and anxious because I was al

to give up so much. I would be studying for hours every night. While I was
used to that to some extent, there was nothing that could prepare me for what
it would actually be like.

In fact, I remember that during my third year of medical school, I had

working a 24-hour shift and all the new knowledge, stress, and excitement
that came along with labor and delivery. It was an overwhelming thought,
and I just didn’t see how I could do it.

all-encompassing. And, because I was quite driven to develop my career, I

pursued everything in an obsessive way. I wanted to be perfect, and I
believed I could be. After all, I had been told all my life that I could do
anything I wanted

without realizing that I was actually setting myself up for a gigantic fall.

Coping with the Stress

We all had different ways of coping with the two years of intense lectures
and memorizing that was required to get through school. Some of my
classmates were runners, using exercise to get away from the stress. Some
would hole up in a cubicle with potato chips and soda, studying all through
the night. Others simply coped by getting together in the library and studying
through the wee hours together. That worked for them too. The one who ate
chips and drank pop ended up as a successful invasive radiologist. The one
who holed up in a cubicle is now an ophthalmologist.

with stress. Keeping it all inside guarantees an eruption at some point. There
That lets you deal with the stress without exploding. Nothing in the medical
likely not make it very far.

Cases in Medical School

In the third year of medical school, we began the clerkship year, which meant
being exposed to patients, and actually working in the hospital wards. It was
very exciting. Some of the cases I was exposed to during this time will
always be stuck in my mind. They made that kind of impact on me.

For example, one of these was Sadie, a patient in her 50’s with advanced
cervical cancer. It had metastasized everywhere and was inoperable. The
oncology ward had a characteristic smell of death that I remember all too
well. I remember that smell as vividly as I do the smell of the gross anatomy
lab where we worked on cadavers.

was on-call with my father. He wouldn’t let me deliver the baby because he
was too worried that I would drop it. This was also the night that I burst into
tears, wondering how I would ever make it through on-call work.
Choosing Anesthesia
I was matched to do my rotating internship in Victoria, British Columbia.
During that time is when I decided that I would pursue anesthesiology as my
specialty. This was on the advice of my father, something which I will
discuss later. Although I had already been through medical school and I knew
the commitment and time it took, I was still completely unprepared for the

At this time, I had spent the vast majority of my life pursuing a career,
because even through medical school, it had become a career, not a job. I was
young, idealistic, very keen and extremely enthusiastic (probably the
ADHD).

The issue, as I see it, is that we want girls to be educated just as much as men.
My mother had great insight into things. She once told me that the more years
I spent at school, the higher my earning potential would be and the easier my
life would become. This is a very common immigrant perception and that is
why the daughters of immigrant parents are the most highly educated group
of women in Canada.1 At the same time, hearing my father’s voice in the
back of my head “have children before 30.”

But, I learned from experience that before I knew it, years had passed. I was
educated and my life had become my career. No one could prepare me for
what would happen when I had children, and no one could explain to me
what it would be like to try and balance my job and family. No one could
have told me the feelings I would get when hormones kicked in over that
crying little baby.

At that time, I was still seeking the same things I wanted balance. I wanted
perfection. But, did it even exist?
The Medical Field
Getting into medicine is one thing. It is typically actually a matter of
persistence. However, if you have tried a few times and have been rejected,

reassessing their career paths because they are not sure what to do. I believe
the European system where you start on a career path out of high school is
much better than our North American system where we use marks as
currency and expect up to two degrees before accepting students into medical
school. Five years of basic science in no way helps you in becoming a better
physician.

had the opportunity to reassess. I had an interview with Dr. Jack Bowman

people on that committee, but I honestly don’t remember anyone else except
vaguely the face of a pathologist. They spent some time asking me a few
questions. It was a very easygoing interview actually.

Dr. Bowman, led a world renowned research lab, which in the 1950’s,
developed a method to treat Rh hemolytic disease of the newborn. Today,
this laboratory is Manitoba’s largest corporate research and development
corpora

group incompatabilities between a mother and her fetus, and he was the
provincial medical director of the Rh lab in the University of Manitoba’s
Faculty of Medicine as well as the provincial director of blood transfusion
services for the Canadian Red Cross.

Incidentally, this Rh incompatability is why my parents only had one child. It

wasn’t until 1969 that Dr. Bowman co-founded the Winnipeg Rh institute
and was involved in development and licencing in Canada in 1980 of Rho(D)
immune globulin, which is now used worldwide. The trade name is
WinRhoSD “Win” for Winnipeg.

That makes me think of all the ways my mother was devoted to making sure I
had every chance at a successful life.

My Mother’s Influence
My mother was completely devoted to me. She worked full time and still
managed to run the household and be a mother to me. I remember my father
never really coming home too often due to his job. I remember one time
when I was in grade eight, he showed up around lunchtime (I usually walked

- cause my father caught me with pretty heavy makeup and I was told to
remove it before going back to school.

Another time, when I was in grade nine, home economics was not my forte. I
decided that I always wanted to do something extraordinary. So, I decided to
make a jumpsuit from a pattern I found in Vogue magazine. My stitching was
all wrong and it was falling apart. Yet, it was due the next day when we were
going to have a fashion show. I was in tears, but my dad bailed

be good at everything. Then, he spent a few hours using his surgical skills to
help me take the jumpsuit apart and stitch it back together properly, just in
time to walk down the runway once for the grade 9 fashion show never to be
worn again.

That was a true bonding moment for me and my dad and I adore him. But,
honestly, it was my mom who kept our house together and looked after me.
She was careful to make sure I wasn’t getting in trouble in any way. She paid
attention to the clothes I wore and the books I read. It helped me become very
aware of rights and wrongs.

My mother always told me that education was paramount – that I would get
farther and be happier in life with more education. She always put books in
front of me. I even started reading about Marie Curie when I was in grade six.
Beyond that, she always made me aware of books that she felt I should read
like Tess of the d’Urbervilles and Madame Bovary. Essentially, she
encouraged me to read books that were all about women who were
subservient to men and were also completely unhappy. She encouraged me to
be my

woman I am today. She always encouraged me. Always believed in me.

Always pushed me to believe in myself. As a result, as I grew up, I fully
believed I could do anything I wanted.

Flexibility and the Working Woman By the time I reached high school, I
was always very good in science. The natural progression was to enroll in
science courses in university. I always found these classes easy and I excelled
in the area. I remember being quite surprised when one of my friends decided
to give up seeking medicine. She had fallen in love. So, she got married and
now works out of her house as an accountant.

Flexibility for working women is incredibly important and she showed that. It
is the number one factor in job satisfaction.2
Once I was in medical school, I was always trying to be the best I could be.
Even when I chose residency positions, I struggled. I wanted to prove that I
could do just as well as the boys, so I picked male-dominated specialties. I
was interested in neurosurgery and urology at different points. The preceptors
encouraged that I explore many different things. Of course every specialty I
tried, I loved and my enthusiasm was contagious.
Like so many women at this stage in life pursuing all-encompassing careers, I
was unbelievably naïve. I didn’t realize then that something always gives.
Something just has to give. I learned that the hard way, by not seeing the
forest for the trees, but it is something that every young woman should
understand. When pursuing a time-consuming and all-encompassing career,
there is

reason, we know mining, drilling for oil and construction are not the ideal
jobs for women raising a family and yet we pick very demanding specialties
in medicine. Why? Often because we don’t know what we are getting into
and how our life will look fast forward 10-20 years. No one really explains
what it’s like in the trenches of an operating room and the grueling hours
involved. Our eyes are wide shut!

- lenges, which can lead to personal distress for individual surgeons and their
family.3

Moving Past Naivety

Residency was easy for me until the third year. It was involved. I had to be at
work at seven in the morning and didn’t get through until 4:30 and then I had
to study in the evening. This is when things began to change for me,
-
3 Balch, CM, Shanafelt T. Combating stress and burnout in surgical practice: a review. Adv Sugery. 2010; 44:29-47

though. That’s because, in the third year, I got pregnant.

When considering the long hours I worked, how hard I worked, and the sheer
amount of overnight shifts, I went into early labor at 35 weeks. Once my
child was born, it became so much more challenging to do everything. My

residency. So, I hired a live in nanny who stayed with the baby for long
hours. Now, 20 years later, I wonder if I should have taken it slower – taken
longer to
have a chance to actually work. I believe the motivation was a mix of
ambition

My parents helped us buy a house in Vancouver, but we were still facing high
expenses trying to manage a mortgage payment and all the other costs that
come along with home ownership. I wanted to get those things paid off.

and it went well, but I was under a lot of stress.

I was stressed about work as I was handling anesthesia on my own for
my husband in Vancouver while he was completing his residency. It was a
massive struggle and I don’t know what the motivating factor
than one nanny, I wonder how I got through it.

But despite it all, I was striving to be perfect. I wanted to balance everything.

This is something I would venture that many women face, and it is something
that we absolutely must discuss. That’s because, in reality, there is no such
thing as balance for a woman who is trying to be a working professional and
raise a family.

Sometimes, I wonder why I would continue to do this, but I know in

that applies to all parts of my life, from work to home. I want to be the ideal
mother, the best anesthesiologist, and give 100% effort at any endeavor.

The difference between what I used to do and now is that I understand the
balance simply doesn’t exist. Perfection is just a pipe dream. Now, I am more
mature and more realistic in what I can expect. I know that:

• I will never be perfect, but that doesn’t mean I have to stop striving for
excellence.
• I will never achieve perfect balance in life, but I can still persevere.

• I will have to make a few choices, perhaps address it in stages, and never
sweat the small stuff.

By understanding this, I have been able to handle what comes my way, much
more easily. And, in many ways, I do achieve the balance to as much of an
extent as possible.

There are scales though. Essentially, every working woman sits atop those
scales with their work and their home lives on each side.
“If you look for perfection, you’ll never be content.”
- Leo Tolstoy, Anna Karenina.

The scales will always swing in favor one way or another. And every woman
– every single one of them – will need to decide for themselves which way
they want the scales to swing. It will be either work or home life or their own
well being. What do I actually mean by that?

Remember I am writing from my own experiences, but I have talked to others

too. I have talked to enough women to know that there are always
perfect balance with career and family, I have learned this too well.

I want to talk more about striving to be perfect too because it is such a big
issue so many driven women with type A personalities such as mine. I have
changed my opinions and views on many things over the years and my
priorities certainly have changed, but that need to do everything and do
everything right still exists. The operating room is full of these Type A
personalities.
Chapter 2
Striving to Be Perfect
P
erfection – it’s what we all want, isn’t it? Or maybe not?
Perfectionism: Described under anxiety in psychology. It involves a tendency
to set standards that are so high that they either cannot be met of are
and interpersonal problems.

Wouldn’t it be wonderful if every single one of us was exceptional at our

jobs and our home life? There would be no more mistakes. There would be
no more divorces or failed relationships or troubled children. And, for so
many years, I worked so hard toward these goals. Even though I saw so many
other women recognize that a perfect harmony could not be achieved, I
simply

out. I would get it just right. And, the world was teaching me this too in the
form of feminism.

Feminism is an interesting concept. As women, we strive to be successful at

our careers, while at the same time, handling the majority of responsibilities
at home. This is often unintentional, and a generalization, but it

careers thrown in just for the hell of it! One attending told a young female
surgeon “a woman can be a good mom, a good wife, or a good surgeon-pick
one”. So, honestly, in many ways, I am not a feminist. The very idea of it is
impossible. While I have managed to juggle my career, my family, and my

no ideal solution and harmony that feminism seems to purport over and over
again.

It started with pleasing my parents. I wanted to make them proud. This led to
anxiety, studying harder, neuroses, studying harder, not eating, studying
harder, insomnia, studying even harder…

The Career
One may be extremely good at one’s career – a valuable member to any
department in any subspecialty. Once the children are born, though, it
becomes all but impossible to balance family life and that job.

In my case, I think it is best summed up by the words of a good friend and a

workaholic surgeon. He said that for all the years he has known me, and I
have been an anesthetist for 20 years, I have always struggled with whether I
wanted to be a super mother or a super exceptional anesthesiologist on tenure
track at university. Even the people around me noticed how much I strived
for a balance that just didn’t exist. I was pulled both ways trying for some
happy middle ground.

It took me years, decades even, to realize this. This type of balance is not
possible. The feminist concept that it is possible to be both a career- and
family-driven woman was one that I tried to follow only to realize it was
simply a pipe dream and an incredibly exhausting one.

A really great family doctor, a male, who is involved with operating room
assists very genuinely said to me “the OR is no place for a nice woman”.
Where does that place me? Unemployed or becoming an OR bitch?

Other Professional Women

And, keep in mind that this is a problem that many women face, not just me
and not even just those in the medical profession. I have spent time
interviewing my female colleagues and I have come to a conclusion:
something was always compromised. I was not the exception. I was a part of
the rule.

The compromises:
• May have been the marriage culminating in a bitter divorce.
absence as physicians are often physically and emotionally drained from
work.

• Or, mistakes at work and work related problems. The focus was on the
family and not on the job. Possibly leading to lawsuits, disciplinary action
and futher stress.

No matter what, in almost any profession, something gave. While I am

writing this from a personal perspective, I have asked many women in
different careers these same questions – teachers, engineers, dentists, doctors
and

So, no matter what women have been told as they grow up, they actually
cannot have it all perfectly. It just doesn’t work that way. They will need who
has not pursued a career – who depends solely on her husband – and you will
see a woman who won’t know how to survive should her husband leave.

are worth it because they mean she has independence. I’ll never forget when
was cosigning on the mortgage and I replied “no, just me”. It was a very
empowering feeling.

The Choice
I remember having a discussion with my mom. I was talking about women
who are in their late 40’s and end up divorced. Single women in their 40’s
and 50’s are on the rise and, since so many of them gave up potential careers
so that they could focus on their husbands and children, too often, they were
left economically dependent when their marriages ended. They had no
identity other than Mrs. Famous Husband. hd-ds@statcan.gc.ca

Often, they have no skills or work experience outside of their home,

especially if they never even started with a career before they were married
and had children. I felt empathy for them because they had limited employ
-

coming a victim and never recovering emotionally.

My mother surprised me with her response. She said:

“That was a CHOICE they made.”
She went on to say that it was their fault because they chose the easier road
without any consideration of a backup plan for independence.
My gentle mother, a feminist. Wow! It shocked me that she could be so
callous. My mother has obviously always felt this way and subconsciously

We all have to make a choice. It is a hard one to make, but it is a decision that
is required. What will we each do? Give up a job for a family? Give up a
family for a career? No matter the case, there should always be a backup plan
in place. You or your partner could be unemployed or disabled. You could
lose family savings. You could lose the family. You always have to have a
backup plan because you never know what the future holds. You have to
have belief in yourself and you need to have an identity outside of being a
spouse and a mother.

The Problem of Feminism

In my mind, feminism isn’t exactly what it may seem. We strive to be equal
to men. We obtain the same amount or more education. We spend as many
years learning so that we can compete for careers. And then, when it comes
to home life, we often choose to bear the brunt of the responsibility because
that is how we are biologically and psychologically wired.

We want to be equals to our spouses, and yet we spend a great deal of time
feeling inadequate if we don’t work outside of the home. If we work, we feel
inadequate as mothers when we can’t make home cooked dinners or pack
lunches in the mornings. We feel like we are not doing enough if we can’t
take our children to school, or attend parent-teacher meetings, or catch every
recital and sports game. Then, we feel inadequate at our jobs if we aren’t able
to give them the focus that they deserve because we are dealing with things
on the home front. We strive so hard for a fairy tale reality that simply
doesn’t exist.

- ticles like “Working Moms have more successful daughters and more caring
sons,” Harvard Business School study says. Or, “Male Executives Don’t Feel
Guilt, See Work- Life Balance as a Women’s Problem” (Grose, J) and
“Mounting Evidence of Advantages for Children of Working Mothers”
(Miller, C). Why? To make myself feel better about the choices I made!

However, ultimately, your 18 year old self needs to ask herself, “Do I want to
be more like Tina Turner or Mrs. Donald Trump?”

Adding Perspective
I didn’t want this book to just be about my own perspective. In fact, I wanted
to make sure I looked at it from the perspectives of many women. To do this,
I interviewed a number of my friends, all women, who work in a

• A social worker
• A university professor
• A lawyer
• A dentist
online

I decided to interview these people because it offers a real look at what

women deal with on a daily basis. Beyond that, it puts a new perspective on
the feminist rights we fought so hard for so long and it brings a new look at
the

achieved and what it actually means for our lives.

tell the stories of these women, offer insight that I may not have thought of
myself, and they share another perspective. Also during those interviews, I
took the time to analyze my own life. I realized that I love the independence
and respect that comes from working outside of the home. I believe I have
more respect from my partner, and I think I am a good role model for my
daughter, my four sons. I want to be the kind of role model who shows it is
possible to do more than one thing in life – that it is possible to go after the
things you want

great satisfaction.

My current husband has supported me in all of my roles. He doesn’t care

what I do, whether that is gardening, baking, going to the spa, or working. He
knows I am driven and competitive, so he doesn’t stand in my way. In fact,
he goes beyond just staying out of the way to actually support my trying to
manage all of these different roles, especially in the last few years.

Since I have been given all of these choices and opportunities, it is

to do. I am not restricted to just playing one or two roles. I have learned one
simple thing from all of this too: In all the chaos of trying to achieve balance,

I really believe that anesthesiologists have such a unique perspective on

relationships and life in general. It is almost a bird’s eye view of the
operating room. Currently, in my own group, there are more than 45 of us,
and we cover two different hospitals with all specialties except transplant
surgery (although we do procure organs for transplant). All of these surgeons,
nurses, orderlies, cleaners, anesthesia assistants and surgical assistants talk
about their lives and relationships and we sit in our chairs and observe these
human interactions for hours at a time. As anesthesiologists, we see frazzled
disruptive surgeons. Bitter divorced surgeons. Surgeons having affairs.
Anesthetists having affairs. These are almost all work affairs too, because
there is hardly any

socialize outside of the operating room, or, as we refer to it, our bubble. Our
OR family.
All the groups have issues with children. One time we were compar
Hawaii to bail their kid out of jail?” There was deafening silence. “I win,” he
says.

What if Balance Is Possible?

One of my friends says she manages to balance the work and home life fairly
well. She does her job and stays dedicated and she spends time with her
husband and children. Of course, remember, something always gives. In her
case, she spends no time on herself. She never exercises, and likely, she
indulges in too much wine and food as a way of coping with the stress.

I knew the wine drinking was becoming a bit of a habit for me as well when
my thirteen-year-old said to me, “Mommy, you look like you have had a long
day. Can I get you a glass of wine?” My observant kid was observing a poor
coping mechanism!

Balance is a myth. There will have to be something that gives. There will
have to be an outlet for the stress and frustrations of the day. It just cannot

Looking at My Life
Have I achieved the balance? No, and I really do not believe it exists, but let
me walk you through a typical day in my life as of right now. Later, I will go
back and tell you my whole story, but I want to show you the reality of career
and children:

• At 6:30 every morning, I get up and pack lunches for the kids. Then, I pack
a lunch for myself, sometimes I’ll skip this step! Reminds me of a book
called Burnt Toast: And Other Philosophies of Life by Teri Hatcher where
she describes how she always puts herself last (ie: eats the burnt toast).
• I head off to work. I often ride a bike to the hospital which is 40 minutes
away in an effort to squeeze in some exercise.
• Other times, I drive to the hospital closer to home as I often need the car for
pickup after school.
• Some days, work is straightforward. I just deal with daycare anesthetics. I
will work from 7:50 to 3:30 and the shifts are predictable.

• Some days, work is much more involved. There could be a radical neck
dissection for malignancy, a cardiac arrest, or an emergency cesarean section
or an obstructed airway from car trauma. I still scramble home at four
o’clock.

• Either way, I am scrambling home to pick up my kids, get dinner on the

table, and make sure the kids get to all of their music and sport activities. On
regular days, everything happens punctually. However, on days that are more
involved, I am often late for pick up and late for everything else which sets
the tone for the rest of the evening.

from trying to get everything accomplished and not letting anyone down.

I remember one distinct time when my middle son had an asthma attack at
home during the day. The nanny called the operating room and asked to
speak with me urgently. I asked her to bring him to the hospital. I was in the
middle of a laparotomy and bowel resection and I couldn’t leave the
operating room. The nanny had to take care of my child because I was not
available. I will talk more about that later too.

It’s events like this story that stick in my head, creating tremendous guilt.
True enough, it is self-imposed guilt, but these are the kinds of thoughts that
went through my head that day. I should have been there for my child. I could
do a better job for my own child than the nanny could. (Probably not, but
guilt happens regardless). I need to be present for my children.

It doesn’t matter whether it is true or not, the guilt is ever present. I can never
drop my children off for school and rarely get to pick them up. I never have
lunch with them. Because of this, my children have had to learn to be
independent or dependent on hired help. Someone else would either pick
them up or drop them off, which means I have relied on nannies for most of
my working life. I do have regrets about that.

I remember reading an article that hurt me very badly. I was interviewed by

our local newspaper, and I spoke how I had given up raising my kids and
essentially turned them over to a nanny. That certainly brought up the sense
of guilt.

Another time, I came home at 9 or 10 at night and my oldest son and the
nanny were gone. They had been at the McDonalds on Main Street in
Vancouver where she routinely met her friends. I wasn’t exactly thrilled with

supposed to wear cloth diapers, drink breastmilk for at least 6 months, and eat
pureed organic homemade mush.

Not Getting the Job

When I lived in Vancouver, I sought out a job while I was pregnant with my
second son. I remember that interview clearly. It was at a large trauma
tertiary hospital. My pregnancy was showing a bit and I knew if I didn’t say I
wanted full-time work, I wouldn’t get the job. I would end up later getting
hired in Victoria, which in retrospect, turned out to be the best decision.

One of the staff asked me how many kids I was planning to have and I
indicated that I wanted to work part-time, which was incredibly naive on my
part. I was offered a temporary position, but not the full-time job with the as
-

dency, we really couldn’t afford the luxury of a nanny. I was alone,

chronically sleep deprived and overwhelmed with a baby and a 2 year old.
My parents were in another province and I was very lonely.

I cannot stress this enough. I really thought I had found my dream job. I
wanted it so badly. I also thought that I belonged in that department and it
seemed obvious to me that I was the right candidate for the job. I had one
child at home and I was six months pregnant, and showing. The interview
commit

felt I was being judged for A. being a woman, and B. being pregnant. It was
so depressing and after the baby was born, as I will talk about shortly, I
developed postpartum depression. My saving grace was returning to work
and my present job on Vancouver Island.

At the same time, I felt incompetent because I was falling behind in the skill I
wanted to practice. Between putting the pressure on myself about
and chronic sleep deprivation, postpartum depression quietly snuck up on me.
An anesthesiologist at BC Women’s Hospital helped me recover. She offered
I had the income to hire help at home, get relief from some of the household
It was then that I realized that something truly did have to give. Either

at the same time was next to impossible. I could have stayed at BC Women’s,
but it was a very specialized area in anesthesia and I longed for more variety
in my career.

At that time, my ex-husband lost his hospital privileges for unruly

misconduct. We were essentially forced to move cities, which in retrospect,
was exactly what needed to happen. Within three months, I was offered a job.
My son was six months old and my older son was two. It meant life could be
good, and it was good for us again.

Fairytales
But fairytales don’t usually happen in life. When things go wrong, though,
one can choose to learn from those experiences. I believed in the fairytale
when I met my husband at 23. By the time I was 30, I knew I had married the
wrong partner. But, I felt I needed to make the marriage work because we had
two kids.

I think that if we had parted ways when the children were young, I would
have spent my life believing I had not given it my best shot. Once again, the
need for everything to be perfect appeared. I thought that if I worked very
hard at it then things could get right again. So, I carried on.

The live-in nanny was taking care of meals and other things with children.
Essentially, I was giving up raising the children to work. Mothers who

the decision much easier. After all, it just wouldn’t make sense to work
instead of staying with the children. At the same time, I was the one with the
guaranteed position and income for 2 years, while my husband was a
temporary locum.

Daycare is expensive and usually not available until the child is a toddler.
Then, if the child has a viral illness, there is a predicament. Considering it is
common for children to have between eight to ten viral illnesses a year in

time.”1 The parents must take time off work to pick up from daycare and stay
home for the rest of the day. For so many mothers, it only makes sense to
stay

the Live in Caregiver Program which will leave many working parents in a
-
lenge of getting organized and dropping off at daycare in the morning.

Fulfillment
Yes, it made me feel guilty at times to know my children were being

work. However, as a physician, I cannot just call in sick. I can’t be

unavailable all the time when something comes up. This is why a nanny was
a must. In fact, in my whole career, I have never called in sick. I always
dragged myself to work no matter how I felt.

A senior anesthesiologist who was very accomplished in her career and had
four children is now retired. She once told me that you certainly can’t have it
all at once. Something will always give. Whether it is the marriage, the

For ambitious women like me, this is not something one wants to hear.
the one who has it all.” When, ultimately, this means you end up exhausted
and inadequate.

Of course, there are all those male chauvinists out there smirking right now,
saying that yes, women should not pursue a career and should stay at home
and take care of the family. What they forget is that children of working
mothers are acutally far more successful with education and income
themselves.2

The Paradox
- cially independent, and strive and do something meaningful with her life.
But at the same time, if she has a decade of solid post secondary education
and a meaningful career ahead, should she give that up just because she is
“supposed” to be happy staying at home, looking after her husband, and
raising kids? This does not seem like an adequate proposition for someone
like me.

I remember 17 years ago when I had my middle son. I was turned

1 Johns Hopkins School of Medicine
|35{
2 Harvard Business

down for a job because I was very open and told the department I wanted
parttime work. That was not considered acceptable. The job went to a person
with

had my last boy, who is now 13, I had to job share with another mother so
that I could stay home for two months. She had to work full time, but could
manage that as her boys were in their late teens. Of course, things have
changed and we have a lot more support during childbearing years.

The Globe and Mail 2015 discusses how medicine is feminizing in a hurry.
According to this article, the share of women who practice is rising very
quickly and women even outnumber men in medical schools. The article
stated the following:

• 45% of Canada’s family doctors and one third of the specialists are women.
• These numbers include anesthesiologists, which have gone from 500 per
3,000 to 1,000 per 3,000 who are women.

• Between the years of 2009 and 2013, the percentage of female physicians
jumped as much as 22.5% and male physician numbers have only increased
by 9.2%.

Women in medicine are becoming more prominent and they juggle their
careers and their family. In the early stages of career, the price they pay is
long hours away from their family, as they are challenged to achieve
competence in

exposed to a variety of cases.3

For the women seeking balance, surgical subspecialties simply are not
conducive to this. Ask any female physician privately about changing from
the fee for service model to salary and pension and you will be surprised at

That is the thing about being a woman in the world of surgery and
- ist. That’s because there are too many people who are seeking your
attention. Think about it like this: if a doctor just doesn’t show up for work
one day, what happens? Patients needing medical attention may not get it.
They have to go another day without medical treatment. And, when the
doctor returns the next day, they have double the workload of people needing
to be seen. It just doesn’t work. And what about the family? The husband?
The children? The and leaves little energy (mental and physical) for the
second shift at home.4 Surgical competence and its assessment is one of the
most hotly de
|36{
3 (The Feminization of Medicine and Population Health, Susan P. Phillips, MD, MSc, CCFP; Emily B. Austin, MSc JAMA. 2009;301(8):863-864. doi:10.1001/jama.2009.155.)

bated topics engaging the profession. In the current climate of diminishing

working hours and shorter training, the surgical profession is having to
address the complex issue as to how surgery as a craft specialty should be
taught, and how to assess when an individual is competent within their
chosen sphere as well as how that competence should be maintained.

In my personal opinion, competence in surgery can be achieved in 5 to 10

years of full time work with the associated full time call. After a decade it
becomes less important (you never forget how to drive a car or ride a bike).

Working Mothers
For working mothers, it isn’t that things don’t get done. They actually

well being. You don’t take care of your physical and mental health and you
make excuses for letting your hobbies and interests slide. You ignore proper
nutrition, hydration, you skip exercise, and you are always sleep deprived.
When stress accumulates relationships suffer. Resentment builds and things
begin to gradually unravel at home.

One time, in the OR, inspiration came to me. I had been looking at a friend’s
blog (doctorswivesliving.com) and I thought about how much wives who are
mothers AND doctors have in common as well. I posted a simple question:
“What advice do you have for women who are doctors, wives, and mothers?”
Their response was “work part-time if you can,” but for many this is not an
option, especially when competing for getting hired at a tertiary hospital. She
also recommended outsourcing some of the home responsibilities, like
cooking, cleaning, and childcare. Honestly, the answer just depressed me.

nurture it?

For decades, women have fought hard for freedom to work outside the home.
We have engaged ourselves in other activities besides looking for a husband,
kids, PTA meetings, bake sales, and as my kids say “being professional
grocery shoppers.” And yet, the choice to have professional careers have also
come with so many compromises.

my third year of anesthesia residency. My program director was a progressive

fellow whose wife was a vascular surgeon on maternity leave. He nominated
me for Chief Resident in my fourth year of residency (picking me out of nine
men in my year of training!). I was honored and I accepted the challenge with
my original due date, I wrote my fellowship exams sleep-deprived, with
breast milk soaking my blouse through the pads and sore from an episiotomy.
4 (Teaching and Assessing Surgical Competence Ann R Coll Surg Engl. 2006 Sep; 88(5): 429–432. WEG Thomas)

I elected to start back with a pediatric anesthesia rotation as I thought this

group of subspecialists would understand the need to pump every three hours.
Every time a baby cried, though, my greens would be soaked with breast
milk. Somehow I missed the chapter on letdown! No milk if you can’t relax
enough to nurse and sometimes fountains when you least expect it.
Endocrinology, the study of the medical aspects of hormones, is a fascinating
subspecialty!

I did crack a little after my second pregnancy when I didn’t get hired because
I was pregnant and honest in saying I wanted part-time work. There I was—a
mother – with no job prospects, very little income, and a colicky and
asthmatic baby along with a husband busy studying for his fellowship exams.
It all culminated with postpartum depression and it’s not so simple as just
“snapping out of it.”

This is when things really deteriorated. Many people don’t understand what it
is actually like to go through postpartum depression. It is not as simple as
feeling a little blue. Instead, there is much, much more to it and it can
completely wreak havoc on a person’s life. Often it is insidious and one may
not even realize that it’s an issue except that there is insomnia, lack of
appetite, irritability and lack of joy.

I will get back to all of this later because it was such an important part of
everything I went through and it is something that working mothers face all
of the time.

Doctor’s Wives
When I look at the wives of my male counterparts, I simply do not envy
them. Their husbands work from seven in the morning to seven in the
evening all week. They spend all weekend working on call. Essentially, they
are not home to provide help and support with the family. Many surgeons
provide call for the entire week. That translates into being ready and available
to work for 120 hours in a row!

Most of those men whose wives are at home have very challenging
relationships as well. The wives have to handle the brunt of home
responsibility. Beyond that, they are alone most of the day. I would imagine
they are lonely. They feel like they have no support.

Being a surgeon’s or anesthesiologist’s wife simply cannot be fun. I think

that’s probably why doctorswivesliving.com was created. This is a blog that a
friend is a part of, designed to be a support group. It provided advice, support
and social interaction for many physicians wives.

“Being a doctor’s wife is not a job that lasts long as you are often replaced
even before the children are grown,” quotes a surgeon’s wife.

“Surgeons are never home,” says Dr. Nada Stotland, Chairman of Psychiatry
at Illinois Masonic Medical Centre in Chicago. “They’re abused in their
training, it’s extremely hierarchial, they’re used to giving orders and having
them unquestionably obeyed. Not all spouses are into being surgical nurses”.
Interestingly, surgeons and psychiatrists have the highest divorce rates in
5
The Modern World
Because this is the kind of world we live in, I advise all young women to go
into the interview stating that they want a full-time job. However, when they
begin their 80-hour a week career, they should take the time to reassess.
Then, they can possibly analyze the situation, whether they get married or get

1. They should accomplish as much as possible with education and career

because they are equally as competent as men.
2. Pursue their passions.
3. They should be available for their family and children.
How can they possibly do all? I know now that it is impossible to get that bal

didn’t know. So, I was honest. I told the interviewers what I wanted, and for
being honest, I set myself up for failure. While it may seem strange to
suggest not being fully open and honest when being interviewed, it is often
the only

- erwise, the interviewers will see you as just another female candidate who
will
opportunities to work in smaller community hospitals, but at the time this was
not satisfying enough. This is the price of ambition.

So, the best thing to do is seek the best job and then prove to the department
that you are dedicated. Or, reevaluate and determine which is most important
to you: family or career. Perfection and balance do not happen. There is no
fairytale to life. There is the only reality that something cracks. Some of the
best female cardiac, plastic and general surgeons have chosen to be
completely dedicated to their career and have made a choice not to have
children.

Either way, the key, as I have learned it, is to understand that the balance
doesn’t exist. You have to let some things go sometimes. You have to more
attention to one part of your life at the expense of the other…in chapters.
Yes, it does leave you feeling guilty, and yes it means you are not perfect.
However, at the same time, it is the only way to accomplish having both
career
5 Dr. Bruce L. Rollman. Medical Specialty and the Incidence of Divorce. New England Journal of Medicine 1997; 336: 800-803
the one you started prior to that, as opposed to having both books on the go
simultaneously.
Not Much Has Changed
child in my last year of residency, I have seen a great deal. I am actually quite
involved in medical teaching and I see all of the young women in the medi

was young. They struggle trying to determine how they will make it all work.
Yes, a few things have changed, but honestly, so much still hasn’t. The brunt
of child bearing responsibility is still on the mother.6 Women are expected to
balance career and family. Women are expected to do more but still stay on
top of everything they did before. In many ways, things have changed for the
better. For example, women now have support for leave and other needs after
they have had a baby. At the same time, women are still expected to be
superheroes, managing two full-time lives often with very little support and
physical help.

The Old Fashioned Way

However, I also think that the idea of living on one income, expecting to be
supported by a man and needing them for everything to survive is simply
ludicrous in this day and age. In 1976, 1.5 million single-earner couple
families, or 53 per cent of couple families in the country, had a stay-at-home
parent. In 2014, 500,000 couple families, or 18 per cent, did.7

“In other words, couple families with one stay-at-home parent repre
more than half in 1976,” the report said.

In single-earner families without a stay-at-home parent, the non-earner is

temporarily unemployed, going to school, or permanently unable to work, the
report said.

The report also looked at single parents and employment. It found that single
mothers and fathers were less likely to be employed than their coupled
counterparts.

According to the report, 69 per cent of single mothers were employed in

2014, while 75 percent of mothers in couple families were employed.
Meanwhile, 82 percent of single fathers were employed, compared to 90
percent of fathers in couple families
I have many friends in their mid-forties. Their husbands chose to leave
6 Working Mothers Research Institute
|40{
7 Statistics Canada

the marriage without any consideration of the fallout on them. These women,
who have devoted themselves to looking after the household, their husband
and their children have no safety net.

When asked what they have done for the past 20 years, all they can write
down is “homemaker.” Unless they go back to school, which requires a clear
head, will power, as well as expensive, their job opportunities are very
limited. The most they can earn is minimum wage, which is less than the
lifestyle they were used to and may not even cover the mortgage. I see many
of these women struggling to even get the spousal support they are owed.
They simply can no longer maintain their lifestyle, they become victims, and
it’s a very vicious cycle to break.

Many didn’t pursue careers or simply gave them up when they mar
they were required to help their partners succeed in lucrative business, law,
medical, and entrepreneurial careers. Sometimes business failed! Sometimes
because there is no money left?

Independence is a must. Knowing that, if I had to, I could look out for myself
and my children, is extremely important to my well being. If my husband
were to leave today, I would be very sad, unhappy but I would survive. There
is a sense of peace many dependent women simply do not have. They

- cially and emotionally.

My Memories and Coping
After three children and a failed marriage, here I am on my second
There are a few days in my life in the operating room that stand out more
than others.

I had a two year old and a three month old at home. My ex-husband was busy
with surgery. Our nanny was from Vancouver and as I mentioned, she came
to us from Victoria. We had even made sure we had a vehicle for her. I
basically handed over parenting duties to the nanny.

Every day, the nanny would start her shift at seven in the morning and I
would leave for work. Workdays were long. I had very little time to even eat
or drink. It was simply moving from one thing to the next.

There would be twelve different children needing surgeries. I would deal with
the anesthesia for twelve children, and that also meant 24 parents who needed
to know what was going on too.

On other days, I may work in daycare, which was physically very demanding.
Then, there were longer cases, like craniotomies, clippings of intracranial
aneurysms or thoracotomy and lung resection. These take longer and are
more challenging from the anesthetic point of view. The days are stressful.

airway, uncontrolled hemorrhage or cardiac arrest.

Then, second shift would begin when I arrived home. My kids wouldn’t have
seen me all day. There would be a baby crying, the older child wanting to
show me what they had done in the day. The nanny would leave and I would
have to move into the shift of full-time mother. Of course, there were times
when I had to be on-call. I would feed everyone dinner and then go back to
the hospital at seven pm.

The shifts were grueling, long, and fatiguing. I have always used exercise as
a way to cope, but everyone handles it differently, and you can certainly see
why divorce rates, suicide rates, self-medicating and alcoholism are so

- thesiologists.8

In another memory, I was rushing around after a day of work. I had fed the
kids. The four year old was busy sewing (even though I did not know about
it) while I was chasing after the 6 year old who didn’t want to stay in the
bath. In fact, he was sewing salami, his favorite snack. Inadvertently, he
thought he had swallowed a needle while eating the salami he was sewing.

So, here I was trying to get ready to go to work at seven at night and my four
year old thought he had swallowed a needle while practicing his Montessori
preschool sewing skills. My husband was busy and nowhere to be

I remember another when I was working for daycare, handling a variety of

different procedures as well as laparoscopic gynecological procedures when I
got a call from the nanny. It was one in the afternoon and she was taking the
two year old to the emergency room. He was dealing with asthma. He was
turning blue. He couldn’t breathe. While he has since grown out of the
asthma, this was a real problem in his childhood. At the time, I could not
leave the operating room to be there for my son. I was tied up with my
patient. The nanny was the one with my baby at the emergency room.

I was a novice, proving myself in the workplace and I couldn’t simply cancel
my slate. These days, I would be much more assertive and insist that
someone relieve me from my duties. However, early in my career when I was
trying to prove I was a full time team player and leaving simply wasn’t an
option.

Then, there was working shift work. There were times when I would work 48
hours straight on a weekend. It would be one case after another, with all of
the planned surgeries as well as any obstetric emergencies. On call work

STAT or emergent, and is like the adrenalin rush of base jumping. Following
one of these marathon shifts, I totaled a vehicle into a telephone post falling
asleep at the wheel.
|42{
8(J.P Zacny,J.L.Galinkin, Psychotropic drugs used in anesthesia practice: abuse liability and epidemiology of abuse. Anesthesiology: 1999, 90 (1); 269-88.)

A Word of Warning
This type of stress, even though you learn how to cope with it, is cumulative.
It builds up and does damage, and this is something I feel the need to warn
women about. In their young years, they may be superstars. They may have
accomplished so much up until they have a baby. Then, they don’t
understand at all how one can do both of these jobs.

It is disheartening. Women don’t expect this. They have been told for so long
that they can do anything and accomplish anything, when in reality, that isn’t
necessarily true. Perhaps with extended family support, an understanding
spouse and hired help it can be achieved.9

Being Forced to Choose

In medical school, we are forced to choose a subspecialty very early on, in
the third year of medicine. The choices are between family practice, which is
a two year program, and anything else, which will range anywhere

Imagine being very young and fairly naïve to the world. Suddenly, you have
to make a decision that will affect the rest of your life. And, a decision that
will decide how long it will be before you can actually start working. On top
of that, employability isn’t even guaranteed at the end of that period.

communities and the teaching hospitals or tertiary care centers are full. Why
are they full? We are paid fees for services and medical professionals want to
maintain a certain lifestyle. The only way to do this is to work and be on-call.

are no positions available.10

when they are still so young. Some enter medicine after two degrees or
another
years are they willing to spend getting educated? And, I believe this is harder
9
Diána Dweik2 and Edmond Girasek3

1 Institute of Behavioural Sciences, Semmelweis University, Nagyvárad square 4, H-1089 Budapest, Hungary
2 Department of Obstetrics and Gynecology, University of Szeged, Semmelweis st. 1Szeged, H-6725 Szeged, Hungary
3 Health Services Management Training Centre, Semmelweis University, Kútvölgyi st 2, 1125 Budapest, Hungary BMC Women’s Health 2014, 14:121 doi:10.1186/1472-6874-14-121
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6874/14/121

Received: Accepted: Published: 2 June 2014

23 September 2014 2 October 2014)

10

on women in many ways. Here are these young women just starting their
career path, likely trying to determine how they will juggle both their career
and their relationships, knowing they will likely want children, and having to
make

they pursue the shorter term and get working sooner so that they can start a
family? Alternatively, should they pursue a harder subspecialty, become
established themselves, and likely have to delay starting a family for even
longer?

Picking Anesthesia
I picked anesthesia for a few different reasons. Yes, to some extent, it was a
male dominated subspecialty, but it was one that would make things a little
easier for me and it is the route I chose under my father’s guidance. He saw
being an anesthetist as having an advantage because:

• I would be able to bike to work and get exercise (plus save on wardrobe).
overhead.
• I would be essentially self-employed with very few responsibilities for
patient care once I left the hospital.

- ally a family. In the back of my head somewhere, my father’s words, “You

should have children before 30 because of endometriosis, infertility, yada
yada yada…” But, what no one warned me about is that it is a high stress
specialty with a high burnout rate. When I was hired in 1997 in Victoria,
there were very few job openings in BC. Then, one summer, I received a
phone call from the chief of anesthesia that there were two openings. That’s
because one of the

asleep at the wheel after a long shift and died in a car accident.
-
jority of them in their forties were divorced, had trouble with their children,
or
had issues with their career. It seemed like no one had been able to do it right.
So, I thought to myself, “I can do this.” I can be the one who does it right –
that
became my plan. But, in trying to do it right, things still didn’t work for me.

Women Should Have Control

Incidentally, this is why I am very much pro-choice. No matter how modern
the world has become, and no matter how many people believe we have
moved past the old-fashioned ways, it is still the woman who is makmorning
sickness. She is the one whose body goes through intense trauma to have the
baby. She is the one who is pressured to nurse the baby for the next six
months (which is a full-time job all on its own). So, right there, a woman is
giving up so much for at least 15 months. And then, ultimately, childcare and
the household are her responsibility.

July 2015 Harvard Business Review shows that no matter how much power
female executives have, or how much lip service male executives may
publicly pay, family issues are still perceived as a female problem. Women
pay for practical help, while male executives tend to receive practical help
from a stay at home spouse.

Yes, I am quite aware that there are a few modern situations where the roles
have been reversed and the father has taken on the responsibility of the
children and home, but this is not the norm. And, in my experience, those
situations are, more often than not, unsuccessful. I have many friends who
have:

other partner (actually a very common occurance).

mother still has to clean and care for the children. Many friends whose
husbands look after the family still hire “mother’s helpers”.

Resentment does build. The moms feel like they are going out there, working
hard and never seeing their children, and the fathers are raising the children.
There has to be a balance in that too, and if there is not, then it simply will
not work. Again, though, the role reversal is not common.

Instead, even in our modern society, the woman is responsible. The

and career path. I think the optimal thing is if one can have part-time working
situations and if both spouses can, then that means they can spend equal
amounts of time with their children. However, the medical environment does
not facilitate this. It is not an option in many areas like surgery and obstetrics.
They have recognized the need for this in high-burnout areas like oncology.

However, patients prefer to see the same physicians for continuity of care,
and the physicians feel like it is their duty to be with the patients throughout
that care as well. Honestly, women in medicine are torn in all directions.
They are obligated to their patients. They are obligated to their spouses. They
are obligated to their children. Not necessarily in that order, but no matter the
actual priority list, a woman in medicine will truly feel as if she is being torn
into numerous different directions.

I continued to feel as if I was being torn that way for many years.
2002; I realized I was deeply unhappy and knew that something had to
change.
Medical Training
The thing about medical training is that it sucks you in. It just does.
Not matter who you are, once you get involved with medical training, you
will good
time to start a family. Everyone always looks for the right time, but in this
profession, it just doesn’t exist.
Once you have been hired by a hospital or have started a private practice,
there is a certain amount of commitment required by other people. That’s
the only way to keep things going. If you are gone, then the machine doesn’t
work. People don’t get the treatment they need, the call schedule is
incomplete, and why should a department made up of self-regulated, self-
employed
individuals accommodate you?
If a pregnancy happens during residency or after you have started your
own practice or have been hired by a hospital, then things can become very

think about how to keep that machine going and how to take care of a
newborn baby. You have to restructure your career. You have to
accommodate an infant into your life. You have to learn how to continue with
life while being sleep deprived and exhausted. And, no one can tell you just
how sleep deprived and exhausted you will be. You have to continue working
and dealing with stress in your career. You cannot put that job on pause
because people need you. The

have to repeat an entire year of residency which is a very unpalatable option.

You still have to master skills and continue learning in your body of
knowledge. You have to reintegrate back to work, especially if you take a
few years off after having a baby.

One time, I was talking to a family doctor, and they said to me that the
happiest physicians are those with stay at home husbands, but what about the
rest of us? What are we supposed to do? Can we be content as well?

I believe the most content female physicians are those with supportive
husbands, who they respect, who also help with the physical demands
running a household and raising children.

Chapter 3
Seeking a Husband
W

e, as women, are told certain things. Throughout childhood, many of us are

told that when we become adults, we should get married, have kids, and at
the same time, have a successful career. It is ingrained within so many of us
to accomplish all of this from a very early age. So, during my internship,
- nize my psychopathology in that I am so goal oriented I sometimes forget to
enjoy the moment in front of me.

As a child, I had been told I could be anything that I wanted to be. I could
accomplish anything I wanted to. My most memorable birthday present was
ballerina Barbie in Grade 3. I wanted to be a ballerina and I felt that I could
do just that except I grew much too tall. After all, I was reasonably smart. I
was good at science. I excelled in school. In high school, I obtained a full
scholarship to university. Even university came easy for me. Yes, I did
believe I could do anything I wanted.

However, while striving to be a perfectionist at everything, I found myself

sucked into perpetual academia. I never thought about what my personal life
would be. Instead, I wanted to go into an area that allowed me to prove
myself – perhaps one that was male-dominated – so that I could prove I was
just as capable as all those silly boys. This didn’t leave much time for
anything else.

I Wasn’t Necessarily Looking

In reality, I wasn’t necessarily seeking a husband at the time, so to speak. I
was in an internship and getting ready to start deciding on a specialty. This
was a big time in my life and my world was consumed by work and school. I
didn’t have time for a personal life at all!

a stressful, male-dominated specialty, but I also knew that I fully believed I

could have it all – that I could achieve that balance. So, while I wasn’t
necessarily actively seeking a husband, I wasn’t completely closed off to the
idea.
-

this. I knew that my work was all-encompassing, so when would I have time

A Bucket List Life

Throughout my life, achievements have always been a part of one big bucket
list. I had all these things I wanted to check off, and I was getting to them one
at a time:

• Perfecting sports and dance…check.

• Skiing…check.
• Running marathons…check

• Getting married…check
• Having children…check
• Finishing residency…check
• Getting a job…check
• Paying off a mortgage…check

Essentially, then, seeking a husband and starting a family was just another
part

above. Instead, I was methodically checking things off. I wanted to start a

family, so I needed a partner. I thought that meant I needed the institution of
marriage. It was as simple as that.

As you can see, in some ways, I tried to make my life simple, straight
- ed a family. That was all there was to it. Since I already believed I would be
- ing over the consequences. Instead, I made decisions and went with them.
This

Meeting the Guy

It was during the rotating internship in Victoria, in which we would spend a
year rotating into each of the specialties. That way, by the end of the year, we
would be in a better position to decide on a specialty. So, as you can imagine,
it was a crazy time in my life. That’s also when I met the guy I would
eventually marry.
He walked up to me one day and asked if I needed a place to live. That’s
because he and his roommate needed one more roommate to afford their
accommodations. I politely declined with no idea I would eventually end up
married to him!

exciting, spontaneous, energetic, intelligent, and well travelled. He owned a

white Datsun from the 70’s. Since he couldn’t afford a convertible he created
one by chopping the roof off with a chain saw. His convertible didn’t have a
parking brake, and he had to take out the car battery to block the rear wheel
when he parked on a steeper incline. It didn’t occur to anyone that the car
could be structurally dangerous. We were stopped by police several times and
most just laughed at the ridiculousness of it all. Then, a couple of weeks later,
he asked me to join him in Vancouver for a family brunch after church. It
certainly sounded interesting, so I simply couldn’t turn it down. That’s when
I met his family - his very educated, large, crazy Irish Catholic family. And,
honestly, I fell in love with them.

Wanting the Family

At this point in my life, I knew I wanted the family. I wanted it all and I had
been told I could have it, so it only made sense for me to go after everything.
I could seek the career, the family, the husband. I had found my work calling
and I had now found the man. So, I was two thirds of the way there. That’s
how it seemed to be, and since I really did believe I would be the one

wouldn’t be for years in the future that I realized I was going down the wrong
highway when it came to my personal matters. At the time, everything
seemed right with the world.

So, it should come as no surprise that I married the guy. The one with

and convertible. It should also come as no surprise that the marriage didn’t
work out, but not before we had three sons and a great deal happened to and
for me during that time period.
White Wedding
A

fter meeting his family, I knew that I was falling in love with my soon-tobe-
husband. Soon, I found myself caught up, not just in such an important part
of my education, but also in planning a beautiful, big, Catholic white
wedding.

Mostly I was caught up in the Laura Ashley wedding gown, the bridesmaids
gowns, the wedding invitations and planning the reception at Hycroft in
Vancouver.

The thing is, in traditional Catholicism, there is no opportunity to live

together. This is simply not acceptable. So, we didn’t do that, and maybe that
took away some of the “getting to know each other” we needed to determine
if we were really compatible.

Classes
A big part of planning a wedding in Catholicism, though, is going to marriage
preparatory classes at the church. These classes covered all sorts of subjects
and we even had to promise not to use birth control as that is the Catholic
way.

I will never forget sitting there in the church and scribbling notes back and
forth to each other and silently laughing about how ludicrous the whole
concept was. However, we had to complete all 10 classes before we could
have a church wedding. This was required, and somehow we both bought
into the concept for The Family (his very devout Catholic Family).

Looking back on this, things were quite crazy in life at that time. I had just
chosen a residency specialty. I was planning a wedding for 150 people. I was
attending Catholic marriage classes. I was training for a half marathon, all the
while thinking I was living every girl’s dream life.

I told myself “Yes, I can do this! I am already on my way! I have met a good
guy from a great loving family. We are getting married. I am doing well with
my internship and planning residency. I am even pretty certain what I want to
be for the rest of my life.” So, all the while I was planning the wedto have it
all.

I would have the white wedding and it would be both absolutely beautiful and
unforgettable. At the same time, I would live my life as an aspiring doctor
soon to go into anesthesiology. It was like living the dream! At the time,

life and a work life. I mean, on some level, I had the idea, but to me, it just
wouldn’t be a factor, I thought.
Pregnant!
I
cannot really speak for anyone else on what it’s like to be a professional and
be pregnant at the same time. Again, I am only looking at things from my
own perspective. For me, I was working in my third year of residency when I
found out I was pregnant. It wasn’t necessarily ideal, but it was my very
happy reality.

At that time, I was working long hours and handling overnight on-call shifts.
In other words, I was putting a great deal of stress on my body. As a
1

During that time, I was also nominated for Chief Resident (the only girl out
of 10 residents in my year), and that meant I had even more responsibilities.
This is most likely when it really hit me. I would no longer be able to achieve
any sort of perfection. Something had to give. I could not continue in my job
and be a full-time mother. My only choice was to hire a nanny. That way,
someone would look after my newborn while I was at work. What a shitty
trade off. This is exactly how I felt.

As I have mentioned several times previously, this was a decision that caused
me tremendous guilt. However, it was a decision I had to make to continue in
my career. One must remember that this type of job takes constant practice
and hours of mandatory continuing medical education (MOCOMP) to stay
current and competent with the work. If I had taken time to raise my son, I
would likely have never been able to get my foot back in the door again, not
having the work experience on my resume. Many part time nurses have told

to determine how many hours are enough to not have this feeling and loss of
1 (Obstetrics & Gynecology:
May 2009 - Volume 113 - Issue 5 - pp 1008-1017
Original Research
Associations of Unscavenged Anesthetic Gases and Long Working Hours With Preterm Delivery in Female Veterinarians

Shirangi, Adeleh MPH, PhD1; Fritschi, Lin MBBS, PhD2; Holman, C D’Arcy J. MBBS, PhD1)

happen in the OR environment. Many collegues after having a child admitted

to me that they felt this way and felt anxiety at work.

had one more year and then I would be able to pursue a full-time job with the
-
creased earnings. Most residents these days take a full year of maternity leave
adding an extra year to their training programs.
Somewhere during this time, I really began to come face to face with
the fact that having balance is impossible. I had to give up time with my son
to be an anesthesiologist. The only other option was to give up the work, and
by this point in my training, so much time and energy invested, I felt this was
absolutely not an option. So, my perfectionism and Pollyanna outlook on life
had to end. I really began to understand what happened to all those pioneer
women before me.

Pushing Myself Too Much

pregnancy. I was in a precarious position with my job and I did not want to
slow down. After all, women have been getting pregnant for centuries. They
that is what I attempted to do, and it didn’t even stop with work.
to my cervical incompetence. By week 28, I was on bed rest with bathroom
privileges, stuck at home.
I admit, I have a type A personality. That’s no secret. So, being at
read and re-read them so much that I had memorized entire chapters in four
inch textbooks.

At the same time, my husband was in his second year of surgery so he was
very busy and we ended up eating a great deal of fast food for dinner –
obviously not the healthiest thing and that goes double for a pregnant woman.

At 34 weeks, I came off bed rest and delivered a week later. It was pretty
depressing and frustrating for me that I went almost straight from bed rest to
having the baby and all of that bed rest took away holiday time that I should
have been able to share with my newborn.

I only had three weeks to take off postpartum and that required stacking all of
my holiday time off. That is clearly not enough time for a woman to spend
with her newborn, but it was all I could do without repeating an entire year of
residency.
One of my role models in surgery gave birth on a Friday and was back
operating the following Monday. Yes, I know it was ridiculous. Her marriage
didn’t last either.

Going into Labor

I won’t forget the day I went into labor. It was a Sunday dinner at my parents
in laws home and we had ribs. I spent most of my labor pacing at home.
Then, I took a warm bath and put on my makeup. Then, I woke my husband
at 4 am and said it was time to go to the hospital.

When we arrived, the front desk was checking me in when I had to interrupt
and say, “I am sorry. I don’t think I have the time to do this.” The very next
thing I remember, I was on a stretcher and the nurse was examining me. She
said, “Holy shit! We are going to have a baby!” It happened very fast.

My perfect Alec was born at 5 am. With a perfectly large scrotal hernia that
is. He was still perfect though and he went with me everywhere in his bucket
seat. He was there after fellowship exams. I was proud of my academic
accomplishments for sure, but beyond that, I was so proud to be a mom. I felt
I had already accomplished so much in life. July 31, 1995 was one of the best
days of my life and I was on Cloud 9.

Being a Mom
That’s the thing about becoming a mom. Everything changes focus.
Suddenly, work and education are only parts of your life. Instead, that child –
that tiny little baby – becomes the priority.

Yes, I still worked very hard and yes I was very proud of everything I had
done professionally. However, I had this tiny little person who depended on
my fully. It was love in the purest sense. All I wanted to do was hold him and
look at him.
Graduation, Career & Pregant
Again!
I worked so hard for so long to
reach this point in my career. After
all of the
a real job with real earning potential and it took a great deal of perseverance
to get to this point. After all, before I graduated from residency, I worked
long hours and pulled so many nightshifts and on-call work that I couldn’t
even

child was premature because of the physical demands of the residency. As a

very driven individual, the one thing I had been working toward was
graduating from residency and pursuing a real job. By then, I believe I

last year of residency, I was even named chief resident, a minority in a

position held almost completely by men before me. So, graduating from
residency was a very exciting time in my life.

Pursuit of a Career

career…the dream job I had envisioned for so long. I knew I wanted to work
in a teaching hospital with interesting academic cases. I didn’t want to be in a
rural community where I wouldn’t have the same opportunity to practice all
my skills, and would have to be on call much more frequently.

Academic departments in Vancouver are large with more than forty

members. This enables one to share the call schedule equally. There is some
added pressure to be involved in research and teaching, but this was
something that I wanted and I felt would keep me stimulated.
I had many opportunities to pursue fellowship training (extra subspecialty
training) in the US and Australia. In fact, I was even offered a fellowship in
neurosurgical anesthesia in St. Louis, and a job at Lucille Salter Children’s
Hospital in San Francisco. I opted to stay in Vancouver for a Clinical Trauma
Fellowship as I had the baby a husband still completing his surgical
residency. We had also purchased a small house with a loan for a down
payment from my parents and had mortgage obligations.

Pregnant Again!
Getting pregnant again with my second son happened at a very interesting
time in my life. It is something that I already mentioned. In fact, while I was
pregnant, I pursued a new job – the one I considered at the time the dream
job. Yet, I was showing and was interviewed by twelve men, all of whom I

disjointed way women were viewed. Because I was pregnant and because I
was honest and stated that I wanted to work part-time, what I thought would
have been my dream job didn’t come to fruition for me.

The Difficulties

hired for my perceived dream job, I was depressed. I also had a toddler I was
running after all of the time and I had locum work which was unpredictable
and bilateral inguinal hernias. Doing all of that with a pregnant belly was dif

And, my ex-husband’s behavioral issues became even more evident. That

was likely due to the demands of his residency as well as the demands of
having an out of order, pregnant wife and a toddler who wanted his attention.
So, our relationship became very strained too.

a toddler, and a pregnancy. It is not easy. Just imagine having a bowling ball
strapped to your stomach trying to bend down and do things with a one-
yearold child. Doesn’t sound like a great deal of fun, does it?

- cally fatigued, which would evolve to depression after the baby was born. I
was exhausted from being a mother of an active toddler, being pregnant, and
struggling to have a career. I look back now and realize I also had an
absentee partner.
I developed very poor coping mechanisms resulting in my not eating, nail
biting, and cigarette smoking. I was unaware that I was clinically depressed. -
able to postpartum depression, perhaps because they are used to being in
control of their own lives: they have completed a long education and
established a career before they have children,” lead researcher Silje Marie
Haga, from the University of Oslo, in Norway, said in a statement.1
1 Healthy Living “Women Choosing Careers before Motherhood Are More Vulnerable to Postnatal Depression” Mar 21, 2012 02:24 PM By Christine Hsu |58{
Dissolution of Marriage & Hanging On
“A good marriage is where both people feel like they’re getting the better end
of the deal.”
- Anne Lamott, Writer (1954-)

ith the hours I was working and the time my husband spent busy with his own
surgical training, then career and other “personal pursuits and interests,” it
seems as if divorce was inevitable. It was just not an adequate partnership
and not a good match either. The two of us stayed together for a very long
time, coexisting like roommates, and it was not until after the birth of my
third child that I realized something had to change.

“All happy families are alike; each unhappy family is unhappy in its own
way.”
- Leo Tolstoy, Anna Karenina

After all, I was pulling all of the weight. I was raising the children and taking
care of household duties. When things went wrong, my husband was nowhere
around. I have already mentioned a few of those stories, such as when my son
thought he swallowed a needle or when the nanny had to take my baby to the
emergency room. My husband was always busy, and that meant I dealt with
everything at home.

So, when my youngest was born in 2002, I knew something had to change. I
started contemplating divorce. My parents retired from Winnipeg to Victoria
and having their support I was ready for separation.

The Argument
Things had been going downhill for quite some time. At that point in my life,
I didn’t feel like a wife. I didn’t feel like we had that kind of connection.
Instead, I felt that there I was trying to work in the medical profession and I
wasn’t just raising three boys. I had four teenagers in my house. I had to look
after all of them, and this is not the kind of connection a husband and
Then, in April of 2005, my husband and I had a big argument. That’s
house in a central neighborhood where I planned on starting over again
knowing that the marriage could not be repaired.
Going to the Lawyer
I remember going to the lawyer to discuss my divorce and to determine child
support. He essentially laughed at me and said no one who made
not alimony. Honestly, I felt completely ripped off. I felt I was getting penal

Why was it that, even though I was the one who took care of the children and
did the majority of the work at home, my husband would be able to walk
away without having to pay a penny? That’s the reality I faced once again as
a mother and member of the medical profession. I was labeled as “career
obsessed.”

However, after he had moved out of our family house, I really felt it was a lot
easier living on my own. Yes, I had to work harder and more often. I had to
go back to full-time. It meant a lot more stress on me, but none of that
mattered. It was simpler.

After the Divorce

Do you remember when I mentioned those women I know – the ones who put
all of their dependency on their husbands? For them, a divorce is devastating.
They have been left out in the cold with nothing – no work experience, no
partner, and no provider to look after them. For those women, divorce means
the end of the relationship and lifestyle and economic dependence on a

We had been together during some of the most important steps in both of our
careers. Yet, we were not together at the same time. We were incompatible. It
was just not meant to work no matter how long it dragged on. Like I said, I
knew after the birth of my third son that it would no longer work. I simply

same time. Something had to go, and it was my marriage that would.
I did have to work more. That’s when I went back to working full-time. Yes,
dealing with more stress now that I was working harder and constantly. Some

But, to me, it was worth it. For one, it meant I had gained my freedom from a
marriage that simply wasn’t working. And, I had also gained the chance to
start working hard on my career again and I felt empowered. Work became
exhilarating!

However, at the same time, it made the balance even more tenuous.
Suddenly, I was the sole provider for my three boys and I had to balance
being their mother with working. Again, that balance is not easy and, in many
ways, it is impossible especially working in a operating room.
What People Don’t Understand
A lot of people have a misconception about marriage. They think that if the
two members of the marriage try hard enough and love each other enough, it
will all work out no matter what. That’s another fairytale in my opinion.

In a way, a marriage is like a work contract. It isn’t something that will keep
renewing on its own. It needs work and nurturing and reassessing. It needs
equal attention from both spouses. This can be hard enough to manage when
there is nothing else getting in the way. But, then throw in:

• Two physicians with demanding shifts.1

• Two careers with demanding hours.
• Three children.
• A partner who is not pulling their weight at home.

You end up with a recipe for disaster. There is just no way to make it
1 BMJ 2015;350:h706 Female physicians are substantially more likely to divorce than male physicians, which may be partly attributable to a differential effect of hours worked on
divorce. |61{
work. Maybe we were incompatible from the start. Maybe we weren’t.
Maybe at one point, we worked well together (before children).

I honestly don’t remember because during our early years, we were both so
busy with our jobs. All I know is that, throughout the marriage, when my
family needed its husband and father, he was rarely around to offer himself.
Instead, he always seemed preoccupied with his own career.

In a way, I think he expected that would work. He thought, in much the same
way as so many others (especially surgeons) do, that he would work. I would
work. I would take care of the household. I would raise the children. That’s
the way it is supposed to be, right?

I am not saying my husband should have done everything. Remember that I

mentioned so many women who prioritize career end up divorced because
somewhere along the way they lost their husband. My second husband says
he believes most men need a little softness not another man in the house. This
is probably quite true as many high power couples need to take turns and not
pursue their interests full throttle at the expense of their partner.

What I am saying is that there should have been balance. He should have
been there as much as me. He should have helped as much as me. He should
have been a grown-up instead of another kid in the house. Maybe, then, it
could have worked.

But, the bottom line is we were incompatible. The decision to go out on my

own was the best decision I could make in that situation. Having separate
households actually made both of us better parents. Initially, I believe he

I believe he learned to enjoy parenting and became much more involved as

the

“I used to think the worst thing in life was to end up all alone, it’s not. The
worst thing in life is to end up with people that make you feel all alone.”
- Robin Williams.
The Difficulties
Getting a divorce did mean a few things for me though, and I will talk about
them more later. They meant I would:
• Be the primary caregiver for three sons.
children.

• Work even harder to maintain balance between my home life and my

career.
• Find someone who could help with the kids since I would not be there and
my ex-husband may not be of much help either.

The whole thing turned into a very nasty tug of war and a new nanny from
hell. The reliable nanny resigned, as she didn’t want to chose sides or be

The new Australian nanny would “borrow” the vehicle and disappear for the
weekend, take warm baths for menstrual cramps in the master bath
-

Worker’s Compensation. Needless to say, she was dismissed with two weeks
notice.
I was going to have a lot on my plate, and I don’t care what anyone says,
divorce is hard on everyone involved, especially the children. I think

Even though I was the one who chose to leave my husband, it was still hard
on me, very stressful, and very exhausting. Ask anyone who has been through
a divorce, no matter how amicable it may seem on the surface, they will tell
you that it is very hard. With the children involved, I always just wanted to
take their pain away.

So, I had to make a lot of changes in my life, which included adjusting to

being single and independent and juggling my kids and a very demanding

The Fee for Service

As a female specialist, I realize we all have choices. That is, we have choices
to some extent. However, when we work for a health authority and we are on
a fee for service schedule, this is essentially a license to kill oneself from
sheer exhaustion. Family physicians too have way to many patients and to
great a demand on their time. Most specialists have unacceptable waiting
lists. Yet, new specialists (over 150 orthopedic surgeons in Canada) cannot
get work, because they cannot get hospital access.2 Why? Because the
established surgeons don’t want to share the pie. Physicians are competing
for fewer and fewer resources. 3

Think about it. We make money by seeing patients. We don’t get paid
work more hours to make more income. We become like hamsters on an
exercise wheel with no time to look after our own well being.

Since we are independent and have a career, we are not eligible for spousal or
child support. Unless, like my ex husband, you go on disability! So, when a
divorce does occur, you end up having to work much harder as you are told
you are “not working to your full earning potential.”4
2 Dr. Brian Day.

I believe I was very independent when I sought a divorce. I just had

- port for the “disabled” ex. And, I have always felt like an equal at work. I
have never experienced sexism and I feel that I am well respected.

My children are looked after because I do make them my priority. I do

everything I can to make sure I am available for their major life experiences
like the school concerts, sporting events, graduation ceremonies, and doctor
and dentist appointments. But, there is an expense to this. And that expense

resentful, but at some point I am going to have to reassess my priorities. My

children are growing older and leaving to pursue secondary education. My
parents are getting older. I value my marriage very much (no one likes
failure). So, I have to determine what is going to be most important to me in
the coming years.
Physicians in Canada who are on fee for service schedules often feel like
hamsters running forever on one of those exercise wheels. It gives incentives
for physicians to provide more treatments because payment is dependent on
quantity of care rather than quality.

When we need more money to cover private school fees, failed invest
4 Personal Finance | Tue Dec 24, 2013 7:05am EST Related: Money “More men get alimony from their ex-wives” By Geoff Williams

ments, mortgage payments or to go on holidays, we work more. As a result,

we work and we work and we work. We are self regulated and we are very
poor
I see many middle aged colleagues falling sick. Many female col

male colleagues have found out they had colon or prostate cancer, coronary
artery disease, and arrhythmias. I see many of these middle-aged
professionals dealing with stress-related conditions like hypertension and
kidney stones. I see a fair number of middle-aged divorces. I see many
teenaged children going down the wrong road. In fact, I believe that children
need their parents more during their teenage years than when they were little.
Teenage problems

addiction, teenage pregnancy and MVA’s. I see specialists making the

decision to go part time or taking a break from their career during their
middle
- ting work to deal with children’s issues. Then I see really old physicians
(well over 65 years) still doing surgical assists or running walk in clinics
because

I continue to see these things because it is such a demanding job, and it is one
that takes a heavy toll on the body. Then, when these people stretch
all-encompassing profession.
Hanging on to a Career
Research has found that most women will only apply for a promotion
on the other hand, will apply for a promotion just because they are capable of
breathing in and out. But is that men’s fault? No, it is not. In my experience ,
how well this works. Eventually, when you are 50 or 60 or so, it will
probably go away.5 Yes, men have no problem being assertive.
Sometime after my second child, I realized that my partner was not
My career became my lifesaver. In fact, I looked forward going to work on
Monday after a weekend at home with the children and often absentee
husband.

operating room.
This is when my ex labeled me as “career obsessed” and became pas
5 Margaret Wente Globe Focus July 11, 2015 |65{
sive aggressive with helping with children, the household, and saying he
never could “understand my call schedule”.
We gradually started living parallel lives and his mail was redirected

card statements and I was certainly not privy to his personal life as his
presence at home was chaotic and he always seemed to be the busiest surgeon
in the city, or created this image.
Chapter 8
The Accident (Third Pregnancy)
M

y wonderful accident! As one may imagine, my third pregnancy was a bit of

an accident. At that time, my marriage was already falling apart. He had been
saying that he would get a vasectomy. However, he kept putting it off.
Having a child at that time was less than ideal because I didn’t want any more
children with him. I wanted out! But, it happened and the accident resulted
with the birth of Will. He says he may not have been “expected but he is
certainly the most wanted.”

Pushing Myself
This seems to be how I cope with stress. It’s my coping mechanism. During
my third pregnancy, I was still pushing myself too hard. I was working

and second pregnancies. And, this did not sit well with my obstetrician. In
fact, he was furious. He said, “There are people you put on bedrest and they
listen and go on bedrest for months, and then there’s you - a terrible patient.”

When I was around 34 weeks pregnant, one night, he refused to do an

emergency C-section with me at six in the morning. He told me to call my
don’t listen well. I wanted to set aside income for maternity leave and I was
still contemplating separation.

Then, I was induced at 35 weeks for oligohydramnios. I found out none of

my other labors hurt like an induction did! I had heard it before, but I never
considered it could hurt so much more. It certainly did even though I had two
previous vaginal deliveries. The uterus isn’t ready and forcing it with
oxytocin translates into unbelievable pain. An analogy would be like having

tiny…let’s call him tiny…can we return him?”

was not thrilled with the competition a newborn would present. Bribing him
with Lego from his baby brother helped for about 5 hours.

Doing This Alone

During the delivery, he (the ex) was nowhere to be found. Our marriage was
already crumbling, and it would only be three more years before we separated
and sought a divorce.

There is no such thing as an amicable divorce. Let me reiterate, there is no

such thing. It may seem as if it is amicable and collaborative in the
beginning, but it doesn’t stay that way, especially when it comes to the
division of assets, and that includes the children. Even if everything seems to
go smoothly for a couple of years after the papers are signed, it can turn
acrimonious within a week.

And, having children together means you can never fully remove yourself
from the ex-spouse. Instead, co-parenting is mandatory, and it can lead to a
great deal of stress, hurt feelings, and many heated arguments. It’s hard to
phathom how a friendship, love, marriage, children, and all those years
together can culminate in just as much emotion with resentment and dislike

I Don’t Have the Answers

I continue to say that I don’t have the answers for a very good reason. I don’t.
I know what I went through. However, I also know that every single marriage
and divorce is different. Everyone goes through a different experience. You
may not have children or you may have a husband who doesn’t want custody,
or who will go above and beyond to help. There are so many different
variables and factors that I cannot provide all of the answers.

If only it were so simple as saying what you want and signing on the dotted
line. For most couples who were on the same journey, following separa
to opposite ends of the country.

For people who have children, divorce means arguing over who will be the
primary caregiver, having to be in contact with the ex from now on in order
to arrange responsibilities, dealing with changing schedules, and always
feeling like you are juggling and out of control. If your ex is amicable, then it
may be easier, but there will always be changes to available days, times, and

change at the drop of a hat.

Co-parenting is hard on the children and everyone involved, for that
to be willing to work together on caring for the children and making
decisions
don’t see eye to eye.

Falling Apart Without Even Noticing There have been people in my life
who have always been very supportive of me. One senior colleague who I
think a great deal of once told me that as you go through all these motions of
trying to make it work or working, you don’t realize what is actually going on
with you.

That’s because you are silently neglecting your spouse. You don’t realize it.
They may not even realize it. But it is happening.
Instead of having actual conversations, you leave notes for each other. You
leave a note that says:

• Whether or not you fed the dog.

• What needs to be purchased at the grocery store.
• Where the kids need to be taken for extracurricular activities.
These notes take the place of any conversation. Slowly, the relationship
crumbles and there is simply nothing left but hurt feelings and resentment.

Resentment Builds
When things get to this point and there is no real communication left,
resentment builds on both sides. You may begin to resent that you never see
your spouse and have no quality time. Husbands may be resentful that you
are focused on career and neglecting them.

And, that resentment takes time, building slowly and insidiously. It sneaks up
on you. And you end up blindsided by the results. And this resentment and
lack of communication will have tremendous impact on the kids who may not
be surprised by the divorce.

So, my colleague who I do admire, said if your children aren’t getting in

trouble, out there doing drugs, getting drunk or getting tattoos then you better
look elsewhere for the problem. Your marriage is likely in trouble.

Why is that? Because something is in trouble. When you attempt to work full
time, raise a family, and have a solid marriage, something will be neglected
whether you realize it or not, And if you don’t know what that something is,
there is a very good chance it is your marriage. Interestingly enough, a
professor at Children’s Hospital asked me if I was having problems 18 years
ago! It’s amazing how often we chose to see what we want to see and ignore
the reality.

“Respect was invented to cover the empty space where love should be.”
- Leo Tolstoy, Anna Karenina

But what if you lose respect too?

Then Getting a Divorce

And if you aren’t aware of what is happening, it sneaks up on you
insidiously, and before you know it, you are getting a divorce. It may have
been your choice; it may have been your spouse’s. Either way, you are
splitting up

Scheduling becomes a nightmare.

And suddenly, everyone is being neglected and this is the fallout that
comes along with things falling apart.
Honestly, all I can say is you can deal with it. There is no other choice.
You take one day at a time.
There’s no one who will be able to handle it for you. No one is going
to hold your hand and help you make decisions. No one is going to provide
you the money you need. No one is going to support you while you try to
raise
your children.
Divorce is not easy. I know mine wasn’t. And I hated to see what it
was doing to my children. It could not have been easy for them to spend part
of their time with their father and part of their time with me.
It could not have been simple for them to see their parents argue over
who would take them where. I think that a lot of children in these divorce
situations come to feel as if they are a burden. They are confused, they don’t
want to take sides, and often one will side with the other parent for the sake
of
“fairness”. The parents argue over them. They in turn want to please or act
out
for attention.They get forgotten and because both parents are working they
are
silently neglected.Money is suddenly stretched thin and everyone has to learn
to budget (not the worst thing in the world).
Overall, the kids often get neglected whether it is by accident or not.
I like to think I worked very hard to make sure none of this happened to my
children, but the reality is that it always happens to some extent no matter
how
hard we try.

Chapter 9
Single Parenting
A

fter the divorce, I had a new role in life. No longer was I just a mom. I was a
single parent and this meant something completely different. Now, instead of
being a parent while sharing this with someone else who is in the house and
knows what is going on, I had to be a parent all of the time and handle
everything. Yes, we did have a custody agreement and yes, he did have our
sons half time. But, as is often the case, the brunt of the responsibility fell on
my shoulders. The bottom line is this:

Men CANNOT get pregnant or give birth to a baby.

Men CANNOT nurse babies.

Men CAN HAVE the same capacity to raise children and run any household.
But, many are reluctant to do so. Is this society’s stigma on stay at home
dads?

I know so many women who work full-time and are the primary
breadwinners. They end up having to hire mother’s helpers for the husbands
who cannot handle raising the children and running a household all at the
same

out on their children growing up and the fathers, because they are missing out
on interesting careers.

So, yes, even before the marriage fell apart, I was doing it all. And, when I
became a single parent, it wasn’t all that different for me. What it did mean is
that I had to do more. My ex hired a number of nannies (all of them
incredibly attractive) and would send them over to pick up the boys on “his
week of custody.” Over the years, he started to enjoy parenting and became
more involved, which has served everyone well.

I think that this is something that many women face. While they are in an
unequal marriage, they do most of the work and they are not paid. However,
when the unequal marriage ends, they end up having to work more in order to
make enough money, handle all of the house, and raise the children. It is a
great deal of stress that comes from the old concept that women are the
caregivers. Yes, we are, and I will not argue with that. It is in our nature to be
the caregivers. However, that doesn’t mean our spouses cannot do the same
thing. Some do, but many are completely resistant to the idea.

A New Single Life

I had to do even more than usual. Somehow, I had to be super mom while
working full-time to make enough money to care for my kids. I had to:

• Prepare breakfast.
• Make sure the kids got to school.
• Go to work.
• Come home.
• Make sure the kids are home safely.
• Make sure they get to their extracurricular activities.
• Cook dinner.
• Do laundry. Clean the kitchen
• Go to on-call night shift work.
• Get up the next morning and do everything over again.

most people realize, for both parents. Now, even though I am married again, I
don’t just have my children to worry about, but two other children as well. I
will talk about that more later.

Private School
I made the decision to send my sons to private school for one very

would be nearly impossible for me to provide them with the supervision they
needed. I couldn’t get them to all of their activities because I had to work and
also do shift work.

So, I knew that I wanted more supervision for them. By choosing private
school, I knew that my children would receive that. Yes, it was much more
expensive, but the peace of mind knowing they were in a safe environment
was worth the cost.1
Of course, the expenses added up quickly. I had to keep the boys busy when I
wasn’t available. That meant paying for private school tuition (their father
didn’t believe in private school and wanted them in the public school
system). Paying for before and after school care and paying for extra-
curricular activities (again, we could never agree on the types of activities…
soccer
1 Academic Outcomes of Public and Private High School Students: What Lies Behind the Differences? by Marc Frenette and Ping Ching Winnie Chan, Social Analysis and Modelling Division,
Statistics Canada

versus rugby versus basketball versus tennis).

were looked after, but the cost does add up. And, even though I got my sons
involved in many after-school activities, this doesn’t eliminate the need for
childcare, especially as a single parent trying to handle everything on my own
as his argument was that he “didn’t believe in private school”.

Someone still had to get them to the events and school as well as pick them
up. Someone had to make sure they were fed breakfast on those days where I
left early and was not able to. So, that also meant paying the cost for
childcare.

Anyone who thinks single parenting can be easy must have never done it. I
had extra expenses trying to make sure my children were properly cared for.
And, beyond that, I was trying to juggle my own career and home life so that
I could actually be a parent and spend time with my children too.

that if she knew how her husband wanted to parent, she would have thought
twice before marrying him.
My Oldest Son and Guilt Trips

when he is not thriving at school. I think he uses it as a diversionary tactic.

He thinks that by making me feel guilty, I will simply overlook the fact that
he did not get the grades he actually could have.

This is what he says, “Mom, how many months did you breastfeed me
postpartum?”
He’s really smart, and knows the answer, and even though I say “six
months,” he knows that simply isn’t true.
I had to go back to work. And, since he was premature (because I was
working so hard and focusing way too much on my career, running around
like a complete idiot trying to prove something) I couldn’t make enough
breast milk. I pumped. I took medication. I did everything I could to keep
producing breastmilk.

and unable to nurse. I had not enough milk. I was busy all the time. I had to
freeze what milk I could make. I didn’t have the amount of bonding time with
my son as I felt I should have.

The whole thing was unbelievably stressful. So, he brings that up to use
against me that:

1. He was premature.
2. He was not nursed enough.
3. My uterus was a hostile environment. He brings these things up because he
knows the truth of how he was born. And, I know that in reality, so much of
that was my fault.
If I hadn’t been running around with something to prove, maybe I would
have been able to carry that baby to term. Yes, I know that looking back
things should have been different. Now I know I don’t have to keep up with
the guys when I have so much else to offer. But, at the time, it was all I knew
to do. I was very competitive. And, I did not want to be labeled as “just a
woman”. So despite being pregnant, I kept on with the long hours, on-call
work and night shift. And, this directly contributed to going into early labor.
Again, as soon as the baby was born, I was itching to get back to work. That
was partly because I wanted to stay competitive and we needed the income.
And, it was partly because, in reality, I had no other choice. If I had stayed at
home for too long, I would have lost my residency position and any chances
of the position. And, I would have gained the reputation of putting children
above the job.
Well, that one is mostly just him trying to make me feel bad. But, to be fair to
my son, my cervix did dilate prematurely and my “hostile” uterus did go into
labor very early. It is thought that anesthetic gases (OR pollution) often
contribute to early labor and prematurity.
After the baby was born, I took metoclopramide, which is medicine that is
supposed to help increase milk production. However, it didn’t seem to help.
A friend of mine told me that she used to pump breast milk while driving to
work! She was very good at providing fresh milk. So, when she had to go to
Vancouver for a conference and forgot to leave fresh milk, she put her
pumped milk on the Helijet cargo and it was in Victoria in just 30 minutes.

but I also tried to do everything right for my work and things did not go very
well, or as well as I would have liked.

Once I was called in for an emergency craniotomy on an 8 year old. I

underestimated how long I would need to be at the hospital and left Alec with
a small bottle of breast milk at the bachelor brother in law’s home. Alec cried

on his chest and gave him his nipple. Alec fell asleep out of sheer exhaustion.
He says this vision of his uncle nursing him has left him permanently scarred
with PTSD.

And, unfortunately, there are people who make mothers feel very guilty if
they are not able to breastfeed. For example, the La Leche League in Canada
is really doing women a disservice. They make parents feel guilty if they are
not successful at breastfeeding, and they are very forceful on the concept. As
a result, mothers who cannot breastfeed for one reason or another are left
feeling like they are failing at being a parent.

There are so many reasons, though, why women may not be able to nurse:

• Mastitis
• Premature Infants
• Post-Partum Depression
• Other psychological factors such as stress. (This can keep letdown from
happening even when the baby cries.)

It is hard enough for a woman who is having trouble breastfeeding. Then, the
societal pressure that comes from groups such as this one makes things so
much worse. I really wish groups of this nature would take the time to
reassess their stances. It is a sensitive topic and it is one that should be
handled in a different way. After all, a woman could already have post-
partum depression. Adding in the pressure to either breastfeed or be a
“terrible mom” and this could be detrimental.
Looking back on those things, there are so many things I wish I had realized
at a younger age. But, it is the life I have lived. I cannot change it, and I think
I have been the best mom possible to my sons at the time. I do have the
career that I love. I do have a family and children. However, when my son
brings this up, it does make me feel guilty. And, I suppose it likely always
will.

In a study of 50,000 adults in 25 countries, daughters of working mothers

completed more years of education, were more likely to be employed in
supervisory roles and earned higher incomes. Having a working mother

because men were generally expected to work. Sons of working mothers did
spend more time on childcare and housework.2

Older Children
Things are easier now because my children are older. With three kids and two
stepchildren, I still don’t have as much to do because they are ages 21, 20, 18,
18, and 13. I haven’t needed a nanny for two years and even the 13-year-old
is so busy with sports that the most I need to do is make sure I can take him
to events and pick him up.

I do most of the cooking at home, sometimes we order in, but family meals
are very important to us. Dinner time is when everyone regroups at the end of
the day and reconnects. It is very gratifying.

Work is stimulating now, but honestly, there are times when I feel old. I see
these young women who have children and are having the same struggles as I
did when I was 20.

The Idealistic Rainbow

they are looking for in spouses, this is the response I get:

• A stay at home spouse to look after the household chores, cooking,

2 Miller, C.The New York Times May 15, 2015 |75{
and them.
• To be independently wealthy without doing much work. What they don’t
realize is that purpose is important for life satisfaction.
• To essentially have it all without having to do anything to actually
children’s peer group.

All I can think is “good luck with that.” It doesn’t happen. So very few
people ever manage to be independently wealthy. Something like that doesn’t
just fall from the sky. Instead, the vast majority of us have to work very hard
for our money and it is virtually impossible these days for one spouse to stay
at home and make ends meet on one income.

That’s an idealistic rainbow world that just doesn’t exist. My children are
young, but they will have to learn that in reality, they will need to work for
their money. Their spouses likely will need to work to support the household
too. No one will be there to do everything for them. And, if they do manage a
stay at home spouse and they are working, then there could be resentment

And that is something I have not been able to teach my children. They will
have to learn just learn for themselves.
Back when I was in my 20s, I knew some things, but to a large extent, I was
as naïve as my children. I had this idealistic image that I would be able to do
everything – have the family, have the great house, have the husband, and
have the job. It would be amazing. I learned that the reality is I would need

satisfying.

Chapter 10
Co-Parenting with a Crazy Ex
F

irst of all, following divorce, most exes are “crazy” whether it’s true or not.
People don’t actually understand what it is like to co-parent following a
divorce. It isn’t all sunshine and roses. There is no perfect plan set out for
who will do what, who will have the children when, and who will make what
decisions. I wish it were that simple, but it isn’t. There are schedules to attend
to. There are things that get in the way of a perfect plan. There is often a
constant, underlying tension between you and your ex that makes things all
the more

I think, sometimes, that a divorce without children involved has to be easier

in some ways. Without children, you can wash your hands and walk away,
never speaking to that person again if that is how you would like it. Instead,
because there are children involved, I continue to see my ex. I have to talk to
him, text him, deal with him in person. We have children together and that
means we will always be tied together in some sense.

What My Ex Is Actually Like

It would be impossible to explain all this in a way that would make sense
without talking more about what it is like to live with and then co-parent with
a crazy ex. To begin with, he spends so much of his time going and going and
going. He overeats, binge drinks and hardly sleeps and I have always
expected a moment when he would burn out. I suppose it hasn’t happened
yet. After divorce he added sex addiction and overexercising to his regimen.

When he was good and in a good mood, then life was one big thrilling
adventure. It was great! And, that is the guy I fell for. But, he was somewhat
of

going to get on any given day.

Just to give you a little glimpse of how he acted, he decided to perform his
own vasectomy because he didn’t trust anyone else to do it. Yes, you read
that right! On a couch, following several scotches, sometime after midnight,
with the little bits being morselized in the kitchen garburator.

Shortly after the two of us divorced, he married a supermodel who already

had four children. I was surprised. I was jealous. I was furious. Especially
when his answering machine message was “You have reached Doctor

surprise, but they only lasted six months.

Being married to this man for 12 years and raising children with him was
exhausting, and there certainly was never a dull moment, to say the least. He
was on the go all the time! He hardly needed sleep, was working all the

me to even track him down. I never knew where he would be. While we were
During our marriage, he volunteered for coaching hockey (even

played. Yet, he was never available to get things ready on time. As a result, I
would leave work, rush home, get the boys ready and drag their equipment as
well as his to the arena.

ever following up on anything he commits to or completing tasks he started.

An example would be getting yards of topsoil delivered for the garden that
- ute it.

to cope. And, once we were co-parenting, I essentially learned to never

depend on him.

while we were married and it carried over through the divorce when I was
supporting my children. I remember once we went for a run to San Francisco.
When he came back, I said, “I confess. I spent $1,000 on clothes.” I felt bad.
He just laughed and said, “Oh, that is nothing. I spent $10,000 on car hood
ornaments last week.” Seriously? Car hood ornaments? That’s what I could

to school expenses and extracurricular activities for the boys. He was the fun
loving dad who dissected toads, exploded eggs in microwaves, allowed Call
of
So, guess how things went with the kids? He was the spontaneous, unreliable,
childish insomniac. I had to be overly controlling and punctual to make up
for everything he didn’t do. As a result, my kids called me the Nazi mom. I
knew that raising my kids liberally in chaos with no boundaries would be a
set up for big problems in the teenage years. My children are not my buddies.
They are my kids and I have to be a parent. This isn’t something that their
father ever understood. |78{

Now, imagine raising children with this type of background. It was virtually
impossible! While things improved somewhat after the divorce, I still had to
deal with the ex-husband’s erratic behavior and sharing the kids. I will admit
that he became a better parent over the years, and will probably be a great
grandpa.

What Co-Parenting Is Really Like

I want to give you a glimpse at what co-parenting is really like so that you
can understand what I deal with on a daily basis. Ten years later, after a
divorce, I am still sharing my children with my ex-husband.

Here is a text conversation just from today. I have to work with him on-call
tonight. That, of course, makes things more interesting and more dif
children? Our son has basketball, so someone has to take him to the gym.
Here is how the text conversation between me and my ex-husband went:
Me: Are you taking Will, 8-9, to the basketball parent thing tonight?
Ex: Yes, please.
Me: He still has a dry cough and huge lymph nodes. Did you book a doctor
appointment or should I?
Ex: Yes, I tried to call and left message, will try again in AM.

(This is where it gets ridiculous and interesting. The ex was sending the next
line to his date and he was so rushed to do so many things at once that he
copied me in as well. This is how my ex’s mind works. Always on the go and
things get very confused as a result.)

Ex: Such a pretty city. Do you own a little black dress? I can wear a
Me: Sorry. Working night shift.
Ex: Hahahaha woops. Besides, yours would be muuuuuch to hawt.
up stents and get out in 20 minutes if you come right at seven. Then I can
take Your Child to the basketball event. Does this sound ok to you? Many
thanks, your humble plumber. (I should have mentioned that my ex is a
urologist.)
Me: Ok, I will be there at 6:45 so My Son can get to the basketball

This sums up my life pretty well. Today, I ran around, getting things done,
picked up, dropped off, packed lunch, did laundry, cleaned house, put on a
salmon dinner. Now I have to go to work. It’s exhausting, cuckoo and
nothing that I am proud of. But, it was my choice to leave, I was unhappy,
and now I had to face the consequences of that decision.

That’s what co-parenting is really like – trying to work with someone else on
making sure everything is taken care of for the kids. It is a constant battle to
ensure the children are always looked after, taken to where they need to go,
etc. There is, unfortunately, no way to set one schedule and stick to it. It’s
hard enough to schedule busy children under one roof, now add to that two
households, two nannies, and two busy careers!

So, for all of those people who get divorced and never see or communicate
with their ex again, I cannot even begin to imagine how simple that must be.
Honestly, I have to talk or text my ex most days, even though I have moved
on and remarried. And, as you can probably already imagine, he is of

myself missing his humor.

Co-parenting is an art, and it is one that no one actually prepares you
don’t really realize until you get a divorce that co-parenting means being
connected with your ex for the rest of your children’s lives. Always put the
chil

Delegating Everything
Sure, you can delegate everything as a single parent if you have the means,
which is rarely the case. You can put all of the responsibilities of cooking
meals, driving to and from school and to and from practices on someone else.
But, that is obviously not always the solution.

I have a friend who is the mother of three children. She found herself a
single, working parent. In order to deal with her children, she needed to work
full time. It was the only way she could continue supporting her children on a
single income. So, she hired a nanny, and essentially, that nanny took over
the entire household. While it was a godsend for the mother, it changed the
whole dynamics of the situation.

- thing that happened during the day and became so empowered that she
advised the mother exactly how the girls needed to be raised.

There is a compromise and it is one that is not easy to make. As a single

parent, you have no choice but to delegate responsibilities when it comes to
child rearing. That means someone else makes many decisions for your
children.

So, you have to spend some time thinking: is that really what you want?
Someone else will be taking care of your children. Someone else besides you
or your ex-spouse will be making choices for your children. In a lot of ways,
someone else will bond with your children. Someone, besides the other
parent, may feel comfortable enough to tell you how you should raise your
children. Is that what you really want? No, most parents would say it is not.
However, there are times when it is simply the only choice available.

In all honesty, I have never loved the idea of hiring a nanny to look after my
children. I have already mentioned a couple of stories that still bother me to
this day. Hiring a nanny at any point of my children’s lives did bring a sense
of guilt. Initially it was to get ahead with career, income, then out of
necessity.

However, when I was a single parent, it was truly the only choice I could
make. I needed to work, not just for myself, but also so that my children
would be taken care of and could continue the lifestyle they were used to.
However, working long hours with shiftwork meant I wasn’t there. Since my
kids had school, extracurricular activities, the need for meals and clean
clothes, I simply couldn’t juggle it all. So, a nanny with a drivers license, was
a necessity. Interestingly, the Federal government just removed the live-in-
care giver program in Canada as of July 4, 2015, which will leave many
families scrambling for childcare.

I think that, ultimately, this is a decision that everyone will have to

in a single parent household. You have to truly evaluate your situation and
ask yourself: What will be in the best interests of my children? Do I
realistically
I ok with someone else being so involved in raising my children? Do I have

Of course, there are no right or wrong answers to those questions. And,

likely, after you answer them and make a decision, you will have days where
you wonder if you made the right choice. You may even have days when you
doubt it completely.

I know for me, I have always wondered if I made the right decisions. I have
felt incredible guilt. I have second guessed myself. However, all in all, I
know that I did what I had to do.

Being a single parent is never easy and making hard decisions like that makes
it all the worse. However, all you can do is try your best to make the right
choices in the moment and go forward knowing you did everything you
could.

Working Part Time

of reasons, including my responsibilities at home and the actual position that
was available.
A part-time gross income in anesthesia is around $200,000 (around
also things that you must factor in. They all have a massive impact on how
much money you actually net ($115,000), including:
• Taxes - 50%
• Insurance (malpractice and disability). This can be as high as 20%
• Licensing Expenses (around $12,000 a year)

• Three children in private school at $20,000 per year each. (Yes, I realize
this is a complete luxury and impossible for most single par ents)

• Full-time often live in help when children are under 5 at another

Overall, with just the taxes and licensing, you net less than half of what you
earn on paper. Then, there are the other expenses, like the “luxury” of private
school and the full-time help so you can make it to work! At the end of the
day, you are not left with much savings.
This is what many people simply do not understand. They think that since I
earn, according to my blue book salary, $200,000 a year, then I should not
even be considering alimony or child support. However, the money is
stretched thin and that is the bottom line. Many physicians are working past
65 years because they have not contributed regularly for retirement savings
and there is no pension plan.

After everything has been deducted from the paycheck just to do per

• School expenses
• Clothes and sporting equipment
• Food
• School, instruments, and sport supplies
• Extracurricular Activities

The list could go on and on. It simply doesn’t leave much leftover. However,
We make a good income, but what about the single mothers living below the
poverty line. No wonder so many women are stuck in unhappy marriages.

Since job sharing is not an option with many employers yet (which I hope
will change very soon), part-time is likely the only option when trying to
parent while having a career in medicine. When women walk into an
interview, they know that they need to work part-time despite not making as
much money as they may need. And, there are so many hurdles associated
with it:

• The money doesn’t cover nearly as much as one would expect.

• Most employers look down on the concept of hiring someone part- time.
• Women already have a stigma on them that they won’t be serious about
their job.
erview, knowing that their employer likely will not understand or will stop
considering them immediately.
This is something we just have to face and deal with unfortunately. There
have been numerous times in my life when part time was the only option as I
found

The Problem of Specialist Positions for Women Have you ever noticed that
women often seem to be putting the same work hours, doing the same
amount of work, but yet get paid less? This is a very subtle problem, but it
exists in many specialist positions.
I chose a very challenging subspecialty in anesthesiology: trauma. As I
mentioned previously, I was always looking for that extra challenge. As I
write this book, I am learning about my own personality and I am not thrilled
about it!

that in some ways, it would be a little easier to follow through with while
raising a family. However, easy isn’t the right word since nothing about any
part
option.

So, getting back to the problem, women often make conscious or unconscious
decisions to choose the paths that they perceive aren’t as time conwhile
raising children. By selecting less complex surgeries, they can save time,
have more predictability with schedules, but also, they lose money.

Doctors of British Columbia actually do offer maternity or paternity

responsibility to their patients and colleagues as well as for the income.
employees receive 100% of their income for one year of maternity or
paternity leave.

I have come to believe that when young, ambitious girls choose medicine and
then a subspecialty, they sometimes think as young children – in the moment
– without the capacity to think about the future and what it will be like to
spend the next 30 years in this type of position. If those next 30 years include
a spouse and children along with solid relationships, then it can be

One of my nursing colleagues once said her husband, who is a surgeon, told
her that when they were dating he would never be available for her or the
kids, so she had to think long and hard before making a commitment to him.
She fell for him without much thinking. And now, 4 children later, she is

We do make choices from time to time in order to make things easier. For
example, since I have worked in daycare anesthesiology, the job itself isn’t
quite as demanding and all-consuming, but it doesn’t pay as well either. So,
women choose these options, leaving the higher paying surgeries, night and
weekend call to their male counterparts. As a result, we women just don’t
make as much income. Although it seems quite unfair, it is simply a
tradeoff… one that we usually have no other choice but to make.

Many female ophthalmologists, for these reasons, choose to have a non-

surgical practice. They don’t have to deal with the operating room hours, the
stress of surgery or post operative complications and the added on call

other words, it is a tradeoff for working mothers in many different

professions and specialties.

The Cost of Delegation

Think about it. If you are in the operating room from seven to four every
single day and then on-call the two days of the weekend, then there is simply
no time for anything. Who is going to pick up the kids or get them to school?
Who is going to do the laundry? Who is going to cook meals, buy groceries,
etc? Who is going to take kids to a sporting event?

That’s not all either. We all need hobbies. We all need things in our lives that
will allow us to enrich ourselves and allow us to get away from the stresses of
daily life. While having to delegate responsibilities is a must, especially for
women who are working to raise their children on their own, they come with
expenses as well.

Hiring someone to take care of the kids, the yard work, and everything else
does add up and it takes away even more from a single parent salary. And, of
course, there is no way to delegate hobbies and exercise, those simply get put
on the back burner.

What I Came to Understand as a Woman This is something I wish I had

realized earlier on in my career. However, although I didn’t, others can. It is
impossible for women to compete with the men in the strictest sense. We
women have something completely different to offer than our male
counterparts. And, even though it is different, that doesn’t mean it is any less
valuable.

As a result, women have to stop looking at things in the same perspective.

We often think that being on the same level as men means making equal
income, working the same hours, and living the same lifestyle. This is just
not possible. However, women offer something else. They offer a different
perspective, have different life experience, are very organized and great at
problem solving. Men do not get pregnant and give childbirth. Men cannot
nurse those children. Men do not usually have the same capacity to raise
children and run the household, or if they do, they are reluctant to do so.

This is simply BIOLOGY and nature. So, instead of women constantly

feeling as if they are worth less than men unless they put in the same hours
and commitment to the job, they need to realize early on that this is not the
answer and this will not resolve the issue.

The only resolution is to realize for women that they have many more
responsibilities than just their careers that go far beyond the scope of what
men do. Why is it so important to come to terms with this? It was only when
I made

that I wanted to work part-time. When I realized it was time to stop

competing with the men in the sense that I had been, I also realized that I did
so much more anyway. So, I am now very aware of what I want, what I need,
and what my family needs. And, that need comes from working part-time.

Hopefully, the working environment is changing and it will become

want to work part-time without anyone adding a stigma to this.

Malcom Gladwell’s book Outliers, The Story of Success (2008) says to be an

expert at anything, I assume this includes surgical career, one must work at it
for 10,000 hours. He claims Mozart and The Beatles are not so much innate
musical prodigies, but grinders who thrived only after 10,000 hours of
practice. Maybe there is something to that, and this may worry women who
do want to work part-time from the very beginning. However, there is much
more to it than this.

I genuinely believe there are people who simply have a natural aptitude for
their specialty. Some anesthesiologists just deal with crisis situations much
more easily than others no matter how many hours they have invested in their
trade. In those cases, it simply doesn’t matter how many hours have been put
into practicing the trade. So, choosing the right specialty is incredibly
important.
Beyond that, I think sometimes it is best to have a rested specialist who may
not have experience with as many cases, but is ready to do the job, than to
have an overworked specialist who is exhausted with lots of experience.
Someone who has worked the whole day, night, and the following day will be
worn out, fatigued and not alert or motivated enough to do the best job. So,
saying that clocking the hours is the most important for competence is not
necessarily the best answer. As the job is now, specialists will commonly
work 10- to12-hour days. 24-hour shifts in obstetrics are common too.

If you look at any other profession, things are different. Someone would
never be able to work those types of shifts in the airline industry, for
must get their rest between shifts.

It begs the question why people who handle other lives every single day can
work for hours on end without a break, and this is what is expected of them.
The answer comes in changing the way we are expected to work – allowing
people breaks and personal time, allowing part-time work, and allowing job
sharing.

easier to do the job while raising a family. Most “part-time” work in medicine

We talk about the importance of choosing the right specialty. Residency

programs often do residents a disservice by not being blunt with them from
the start and not honestly telling them when they are not cut out for the job.

Honestly, every teacher, medical school, and residency program fears

wrongful dismissal and litigation. I believe that residents who are weak
should be dismissed from their residency program and offered counseling so
that they can pursue other areas of medicine more suited for their personality
and skillset.

That sounds harsh, but it could be the thing that saves people a great deal of
trouble later on. If residents do not know what they are in for and no one has
laid out the blunt truth, then they may pursue a career they are not able for
early residents to pursue another path that will better suit them and then
ensure they do have a career that works for them.

Unfortunately, this doesn’t happen nearly often enough in Canada. In

especially in specialist positions, is common.

These are all things I didn’t fully realize until later in life, but I do hope that
more young women will understand them while they are early in their career.
This will allow them to make the right decisions from the get-go
– to say that working part-time is the best decision after having a family.

The Continuing Problem

Speaking of the need to make changes in the way the work environment is
currently handled reminds me of something I experienced a long time ago.
About 12 years ago, a very accomplished, very successful anesthesiolo

42 of us together and distributed small sheets of paper and told us all to write
down a few things we would do to try and improve the department. Of
course,
could change about the department.

At that time, a senior, male, anesthetic colleague leaned over to his buddy
and this is what I heard him say, “What a pile of crap. This is what happens
when you put a woman in charge: all this touchy feely nonsense.”

And, unfortunately, that is how women are viewed. Although we have come
a long way when it comes to equality, there is still a certain stereotype that
follows us wherever we go.

• If we choose to work part-time, someone says “Of course, she never really
did anything but play at a job.”
• If we choose to work full-time after having children, then people will say,
“Wow, she is not being a good mother.”
• If we don’t have children and focus solely on our careers, then people say
“Well, I guess she got her priorities mixed up.”

• And, if we do manage to accomplish a great deal in our careers, those same

guys are perplexed and make silly, nervous remarks at tempting to be
humorous.

It’s simply a no-win situation for us. No matter what we do, there will be
people criticizing us. And, we already have so much stress on us just trying to
get everything done that this added stress is really not required. I do hope that
the stigma changes. I hope that people realize they cannot continue telling
their daughters that girls can be anything and do anything, but then judge
them when they try to go out there and do just that.

Competition in the Job

full time level. If I didn’t, it would be very hard to get a position. Being on
ma

but I was also anxious that I should not take too much time off.
-
dence in the OR environment. I have seen this same thing happen to many
new
mothers trying to return to work. It is imperative that we all support them as
best we can so that this doesn’t happen. However, they don’t get that support.
People lose respect for them – their colleagues and even the nursing staff. As
a result, women feel like they have to get back on the saddle as
soon as possible.
-
ample, there are summer holidays. They last two and a half months. Working
mothers are faced with a dilemma of what to do with the children for those
two
and a half months. You may be able to take about two weeks off for holiday,
but what then? You have to get a nanny and send the kids to camp for the
summer time.
These are not always things young women think about when they are
competing for the job. Instead, they think about the moment and how to get
the
position.
I have noticed that women in senior leadership positions have fought
very hard to get where they are, but unfortunately, they actually have little
empathy for the young mothers in surgical specialties. They seem to forget
just

that since they were able to do it everyone else should have to as well.

Chapter 11
The Blind Date
I-
cult the weeks I didn’t have my children. I travelled. I windsurfed. I
exercised. I dated…dating wasn’t for me. It was awkward attending social
functions solo, and I lost many friends as they didn’t want to take sides, or
the wives perceived me as a threat. My friend set me up on a blind date, and I
have to admit things were pretty instant. I met him. I saw him. I liked him.
The thing about getting into a relationship at a later stage in life is that you
know exactly what you want and don’t want. You are able to spot the right
person so much more easily.

So, three months after that blind date,

-
raise the children together, this one thing remained simple. I knew what I
liked and needed, and I had found it.

As a result, I remarried, and now I have a unique, blended family: three sons
of my own and two more children. Again, life hasn’t always been easy.
However, this time around, I know I made the right decision in choosing
someone who was and still is actually right for me. As a result, I have the
kind

me as I am, actually helps around the house and with raising the children
andmakes me happy (or allows me to be happy, so to speak). We’ve grown
together as a family as he was widowed and we raised 5 wonderful children,
all unique, with unique personalities and emotional needs.

More Maturity
Sometimes, I wonder if it would be better for everyone if they all just waited
a little later in life to make such big decisions, like whom they will

rushed into something because it certainly seemed like a good idea. I wanted
the whole dream with the husband, children and white picket fence. He was
there. We got along well. Why not get married and have children?
The problem is I was young and probably a bit immature when it came to
matters like that. I didn’t fully know what I wanted and needed. I didn’t know
the things I just would not be able to tolerate. Instead, I saw this man in front
of me who wanted to get married. I was in love with him and the idea of
starting a family.

It was not until I was much older and more mature that I saw the problems.
And, as I grew older, I was able to see things for myself. I realized I wasn’t
happy and I realized he simply wasn’t the right person for me.

- ber of things:
• I knew I could be independent even if I didn’t enjoy being alone.
• I knew I could live on my own and raise my children on my own.
• I didn’t have to have a husband. Getting married again would be a choice,
not a necessity. I was lucky I had a good career.
• And I knew that I didn’t have to settle for anything less.

This is such a good way to look at getting married. Young people say their
vows often because they are infatuated. They get married because they are in
a hurry to have a family. Whatever the reason, they probably don’t really
know what they want or need from a marriage. As a result, it dissolves very
quickly.

By waiting before I met my second husband, I was in no rush. I knew exactly

what I needed and expected. I also knew that I didn’t have to get married. I
could handle things on my own and I wasn’t afraid of being alone anymore.
Choosing to get engaged and later remarried was just that – a choice. It was
one I made fully aware that I didn’t have to. Again I heard my father, “You’ll
never be lonely you’ll always have your children”. True enough, but I wanted
to share my life with another person. And, that, I think, is the secret to a
successful marriage.

The Changes from Self-Sufficiency

One thing that I have noticed this time around is that there are things that are
each other, have independent careers and interests, and yet complement each
other.

As I mentioned earlier, I have tried on many different hats in the last few
years. I have tried my hand at being a baker, a cook, a gardener, a wife being
pampered at the spa, an anesthesiologist (as always), a parent (as always),
and many other things. Thanks to being able to do this, I have come to learn
so

current husband has helped me so much with that by being supportive.

been raising my three boys with very little help from my ex-husband except
chaos. I had been working and I knew that I could manage everything on my
own. And my widowed husband was in similar circumstances.

that had a big impact on the dynamic of our marriage. In the past, maybe I
depended on someone else too much, and when he was never around, it
continued to let me down. In the past, an unequal marriage meant so much
stress for me. An unhappy marriage can be lonelier than being in your own
company.

Now, I am with an equal partner. My husband tends to deny saying it,

life, he feels like he actually has an equal partner. That’s the big difference.
We are equals. We are not one over the other, and that means a better
relationship overall.

Why does this matter so much? I was talking to one of my girlfriends

home mom as others may mostly because she had invested so much time and
hired nannies and drivers as her children were very accomplished athletes.
And she still ran the household.

When her specialist husband left, she said it wasn’t her career that broke it,
but other factors and she is so grateful now to have that career so that she
continues to have earning potential. If she had been on unequal ground with
her husband, then she would have been left with nothing. As hers, like

that balance with each other.

I was speaking with another colleague who always wanted equality in
concept, especially for many men.

They often mean well, but many things that mothers are able to do at home
are simply intuitive. We do them without thinking about them because I truly
believe it is in our biology. Feminists will likely hate me for saying that! For
men, the intuition is not the same. They may not know what to just auto

into our system. We give. We nurture. We take care of others.

So, going back to that colleague who wanted equality in her relationship, her
ex did not want that. It simply was not what he was looking for and instead of
staying married to her and dealing with a more equal relationship, he simply
chose to leave.

That likely happens more often than we realize. Some people do want the
equality. Others are not the least bit interested in it. Some relationships do
balance are the ones that fall apart the most easily.
current one. And, it is a balance that has changed the whole perspective on
the relationship for the better.

Interestingly enough, my lesbian friends comment how easy it is at home

even if both have full time careers. They say “It’s intuitive in the kitchen”…
neither has to point out what to do, the work just gets done!

Chapter 12
Blending Families
Blending families is never easy on anyone even if everyone gets along fair
that can stand in the way.

You take two separate families that are used to doing things their own way
and you put them together. As a result, many things have to change about the
way things have been done in the household. It takes some negotiation. But,
that isn’t all either. You are putting a newly married couple together and they
haven’t had a chance to get used to living with each other yet because they
have to continue being parents.

On top of that, there are the children. In my situation, I have the three boys
and my husband is widowed and has a son and daughter. Getting married and
blending families means making sure everyone is taken care of and every

The fact that we both work full-time complicates matters even more.

to extracurricular activities, and get to and from school. The list goes on. So,
yes, in some ways, it is easier to be married than to handle things as a single
parent. However, at the same time, things can be harder too.

Through all of the stress of making things work, knowing that this time, I
chose the right spouse, who takes parenting as seriously as investing
Having Five Kids
As I have mentioned throughout this book, juggling a medical career

school or take them to school, for that matter. I couldn’t always get them to
extracurricular activities and was always running late. I often couldn’t go
grocery shopping or take care of the household. I had to depend so often on
someone “step” so there were 4 sons and a daughter. I never had a daughter. I
didn’t know girls were so emotional and yet gave back so much! I feel so
blessed to have Christina in my life.

I won’t lie and say it was easy. Now, there were even more people I was
responsible for, and it was stressful. However, having a spouse who was very
involved with his children, and respected by mine, made it much easier.

My Oldest Son
I am not sure my oldest son, who is currently traveling in Europe, will be
pleased with what I am about to write. However, Alec came to live with us
when he was thirteen. His father remarried to a woman who already had four
kids. And my son made the decision to live with me and my husband after his
father displaced the boys into the garage while the new kids were relocated to
the bedrooms.

Alec is an exceptional child. Cars are his passion. Even before he could talk
he could identify car symbols yelling out “Audi, Mercedes, Toyota,
Chevrolet, Porsche, BMW”… he saw the symbol once and he knew how to
identify the make.

rugby, and running. He has a wicked sense of humor and so many friends.
When he was in eleventh grade, he was always in the scurm, and kept getting
injured. By twelfth grade, I told him he probably shouldn’t pursue rugby
anymore. Although he does play sports well, he grew very quickly, was
somewhat of a klutz, and I genuinely worried about concussions.

In fact, one weekend when Alec was ten years old and spending a weekend
with his dad, he was simply getting out of the car and broke his front tooth. It
was these types of accidents that made me worry rugby might not be the best
activity for him to be involved in as a teenager.

Alec always had trouble concentrating, and just like me, I would think he
probably has mild ADHD. Honestly, the family doctor was actually very
concerned that he would start experimenting with drugs and attempting to
selfmedicate. So, we decided to try him on Ritalin-type drugs when he was in
grade twelve.

He continued to be a little out of control. It wasn’t anything major. He just

wasn’t sticking to curfew, always testing the limits, and other minor things of
this type. I thought, ok he has graduated. Why doesn’t he go live with his

back to live with us.

We have worked on learning techniques to deal with anxiety and at

coping well without medication. I learned through all of this that medication
isn’t really a solution. Or, at least, in his case, it wasn’t. Learning strategies
and mechanisms of coping and dealing with his energy have been much more
effective.

He copes by going to the gym and weight training, running, and prob
My Middle Son

most vulnerable age. He remained loyal to his dad as well as myself. And, he
has been going back and forth between the two of us for the past ten years.
- volved in activities. He is a part of the rowing team at school and we signed
up for guitar lessons. He really enjoys the latter as he is very musical.

His passion as a young boy were BUGS. I always thought he would be a

scientist or an entomologist. He knew everything about so many insects, their
life cycles, mating habits, and environments. He would be fascinated with
maggots, bringing them home and referring to them affectionately as his
“little magnets”.

He was a voracious reader and an expert Lego engineer. He has seen

about private school, etc. As a result, my son has always somewhat marched
to his own drummer and he has decided to join the Armed Forces. At present,
he is doing his basic training, and then attending Royal Military College in
the fall.
My Youngest Son

The youngest boy has one passion…sports. As I write this, my youngest son
has decided that he wants to be at one household only. He just turned thirteen
and he says he has researched his legal rights and the implication of his
decision and doesn’t want to continue moving between households.

He is very driven and competitive and athletic and he thinks it would be the
best decision. As a result, I stay busy driving him to all his sporting

Following a long day of surgery, making dinner, dealing with an irritable

teenage daughter, and handling other chores, I must go pick him up from his
basketball practice at seven at night.

Will says if he cannot make it as a professional basketball player he will be a

general surgeon because “they do everything.” And he probably will!
My Husband’s Perspective
I wanted to get my husband’s point of view too. We have been together for
seven years and I think he has been there through the times when I have
actually come to realize that there is an art to the balance, but it doesn’t
involve having it all.

I would like to share his perception of my job too.

the types of people that I have become a lot more familiar with now,
especially those involved in the specialty side of medicine.

There never seems to be enough specialists. There never seems to be enough

people. The system is designed in a way that these individuals will work crazy
hours. They will work 12-15 hours at a time and sometimes as much as 24. I
just don’t know how the system handles it or how the people handle it.

Anna will go to work at seven in the morning. Then she will want to come
home. When she comes home, she wants to play the role of mom and wife.
She wants to cook, look after the kids, clean and all these things and it’s just
relentless.

Oftentimes, the stress is so severe that you can just tell she needs a break and
doesn’t know how to handle that. It’s interesting to see.
Once in our early stage, she came home and she was just wired. I watched
her for several days, she was wired and she would get pretty excited.
I said to her, “Honey you’re just losing it. Why don’t you just stop doing all
this work that you are trying to do and just go for a run? Go for a run
because it will make you feel better.”
She was so upset at me for telling her to do such a thing, because she hadn’t
even thought about that. She was so busy and she wouldn’t do it.
Finally, the second or third time I told her to go for a run, she actually did it.
She came home and had a really busy day. She went for a run. When she
came back and said, “Oh my god, I can’t believe how much better I feel.
Thank you so much. I wish I had started this sooner.”

no bathroom breaks. No food breaks. Probably low blood sugar. If there is

not
time.

You can imagine how this affects relationships in the long term. Can you
imagine having two doctors being married to each other, both trying to
maintain this busy lifestyle? The divorce rate must be extremely high.

driven for so long. Over exercise, under exercise, overwork, underwork (very
rarely underwork). You can often tell on the men’s side of the equation, as
they are very out of shape when they get older. Women look like they have
been stressed to death in their sixties.

There is way too much requirement, illness, calamity, trauma. It is

an individual’s wellbeing. Knowing how to deal with that is not very easy.

People just don’t have a realization of what they are getting into and good
habits are absolutely essential. They must be developed at a young age, but
who is going to tell them? Who is going to do it? Really, probably the system
should be better. They should have a better understanding and try to help
these situations, so people understand what they are going to deal with.

I have a sneaking suspicion they don’t do that. They just teach medicine.
They teach how to deal with the patients. They don’t teach how to deal with
themselves and how to get a better quality of life. They don’t teach them how
to maintain their own health and wellbeing or their family’s wellbeing for the
long term.

Particularly for a woman, it is an unbelievable vocation. Stressful.

-
they come up against and no one prepares them for it. Without a good social
network around them - parents, grandparents,
resentment builds up. I can see that in friends and peers. When you hear the
through.
I don’t know what the answer is. I think the system needs to try to deal

shortage of women and they contribute greatly to the profession because it is

a different viewpoint. Men and women are not the same no matter what
anyone thinks. Nor do they bring the same qualities to the job. In some
instance, if they are cutting someone, it can be all the same. The reality is
there is a difference by the role.

to understand that there are times when it is time to be a mom if they choose
to go in that direction. There has to be better accommodation on how they go
about that and deal with these instinctive pressures of extraordinary stress
and expectations that a mom, a professional, a doctor, and a wife has.

is no understanding and sharing.”

Caregiver
I wish I could say that I have always been the perfect caregiver for my
children. And, knowing that I haven’t been brings a great deal of guilt. I have
had to turn my children over to nannies for much of their lives. I hate
knowing I wasn’t there for them. I hate knowing that someone else made
their breakfast, took them to school, picked them up from school, and took
them to extracurricular activities.

However, this is a part of working, especially in the surgical world. When I

married for the second time, things changed for me drastically. No longer
was I just the caregiver for my own three children, but I also became a
caregiver for my step-son and step-daughter. It was a new role in my life, and
beyond that, I was still working my job.

As a result, I learned how to juggle things even more, and that was
all three of them.
They call the women my age the Sandwich Generation for good rea

what happened in the emergency room that evening. Today I was trying to
help my 76 year old father with a medical issue and again I was told to keep
my nose out of it! We are stuck in the middle trying to help the generations
before and after us but maybe we should just mind our own business.

Chapter 13
Back to Career
O

ne of the things about being a woman in the medical profession is putting up

with some level of misogynistic behavior. It is a shame to say so, but now
that I have been in my job for a very long time, I have even heard statements
like:
“Why should we hire more women? They don’t want to work anyway.”

Not only does this make me incredibly frustrated, but it also makes me
realize how women are viewed in the workplace. No one really considers that
we do want to work. We are just torn between two lives that have to compete
against each other.

Young Women Today

I look at the young women who are recent hires in the surgery department.
They have been exceptional in their jobs, making them excellent choices as
new hires. However, that old misogynistic way is still around. People wonder
why they would be hired. They question it. They look at these young
professionals, many of who have just had children, and question whether it
was a good idea or not.

Then, the young hires are questioning their own choices too. They just cannot
see how they will be able to continue in their jobs while raising a family.
They see that they will have to give up something, and they just don’t know
what to do. For these women, I have advice, and that is one of the purposes of
this book.

I have always been extremely hard on myself. I have always expected myself
to do too much – to be Superwoman, in a sense.

• I wanted to be the one cooking dinners. There is nothing more satisfying

than when a kid tells you, “Mommy, I really love your cooking”.

• I wanted to be at their sporting events to cheer them on.

• I wanted to take the kids to school, kiss them good bye and pick them up.

• I wanted to watch their school concerts and plays.

everything, and that is what I would advise the younger generation to under
a busy schedule. And, many colleagues, especially male ones, will not
understand what you are trying to do.

In a way, I have become just another woman on the job. In fact, I am pretty
sure many people look at women as a risk. They think at any moment, that
woman could up and quit because she had decided it is just too hard to do
everything; not perform the job well because her mind is somewhere else;
spend too much time at home instead of doing her job right or have to leave
at a moment’s notice to go take care of the kids.

As a result, many people do not see women as dependable in their profession.

As a result, there are plenty of people who dislike the idea of even

cardiac anesthesiologist, following the birth of twins, simply quit because she
had no opportunity to work less than full time. The unfortunate thing is that
she never went back to her profession.

Advice to Others
But, the one thing that I do hope young women understand over everything
else is that you cannot let those stereotypes get to you. You cannot give up,
especially if you have been so focused on medicine for so long that you know
this is the path you want to take. And, honestly, that goes for any profession a
young woman may choose.

You are going to face opposition in the working world as well as from within
yourself. People are going to tell you that you are “just another woman trying
to play at a job.” The old fashioned belief that women should stay home and
raise the babies still holds true to some extent. You will have to overcome
that concept.

But the battle isn’t just in the outside world. It is within yourself too.

I thought I would be okay leaving him with a nanny and then going back to
work. But, my emotions and feelings were totally not within my power.
Instead, hormones erupted like a dormant to active volcano. Our hormones
play an enormous role in helping us bond with our babies.
As a result, my hormones were wreaking havoc on my mind and emotions,
telling me I needed to be home with my children. Telling me I needed to do
everything for this new baby I had. The feeling of absolute bliss, from an
oxytocin surge, when nursing an infant, is something one can only understand
from personal experience.

And, when you couple that with the idea that I felt like I had to do it
for my career, I also needed to work.

The point I am getting to is this: Women today can be working professionals.

They should not be looked down on, but they are. For some reason, people
tend to forget that men play a role in fathering the child. However, it is the
woman who carries the pregnancy, gives birth, nurses the child, and who has
the very powerful hormonal attachment. As a result, the vast majority of
parenthood rests on women.

However, I am here to tell you this: I did it. Not perfectly, obviously.

raised three sons and am a parent of some sort to two more children. I went
through one marriage that didn’t and one that is working well. And, through
all of that, I have been an anesthesiologist for over 20 years, sometimes full
time, sometimes three quarter time and sometimes part time depending on the
needs of my family. I feel that I am accomplished in my career no matter
what any naysayers may have thought on the issue.

as I did, but they can have a career, have a happy marriage, raise children,
and everything else if they set their mind to it. That’s my advice to young
women. My advice to men is a little different. To begin with, they need to
understand there is a difference between: “Don’t want to work” and “can’t
work.”

Women who pursue careers most certainly do want to work. But, they

saying that it is different. As a general rule, men do not have to choose

between work and raising a family, between going to the job and being there
for their kids.
work in these positions are so rarely ever home. It is no wonder their wives
get bored or lonely.

What I am trying to say is that men traditionally have it differently. Women

are expected to do everything, including their job and their home life. Men
don’t have quite the same expectations. They also develop relationships with
their “work wives” which often start out platonic and evolve to romantic.

And, the moment a woman has a baby and goes back to her job, people will
immediately be wondering when she will give it up and go home. People
assume that the woman will not be able to stand being away from her baby or
that she will not be able to think clearly in her job. So, they just wait for the
other shoe to drop.

It’s not fair, but it is reality. I had more than one stay at home mom ask me,
“Why would you go back to work, doesn’t your husband make enough
money?”

My Own Career
Getting back to a full-time career after everything I had been through
– three children and a divorce and then a remarriage – wasn’t necessarily
easy. Yes, I had to live through the same stigma as every other woman.
People would wonder how long I would last. People would question my
ability to do my job and handle a home life. People wondered if I could
possibly be good at my job.

Going back to a full throttle career is never easy when you have so many
extraneous factors equally, perhaps more, important.

If Anyone Ever Had a Calling…

Reading the Globe and Mail I came across the obituary of a physician. Her
name was Bluma Tischler and she was 90 years old. She worked as a
pediatrician and medical researcher.

If anyone ever had a calling to be a physician, it was Polish-born Bluma

Tischler. Through luck, courage, and persistence, she vaulted over all
obstacles in studying medicine. She fought poverty, war, anti-Semitism in the
post-war confusion of Europe. She began her medical education in Russian in
Tajikistan. Then, she continued in Polish in her homeland, then German in

Montreal. She was also the mother of two sons. One of whom is an
ophthalmologist.
I really related to her. Obviously, she was much more accomplished than
myself. But I related to her in that medicine has always been, in some

would have ever, in a million years, dreamt of giving it up. But, at the same
time, I also wanted to have children and a family. I never actually dreamed I
- reer. As a result, all of this has landed on my plate. It has been a juggle –
but it is a rewarding juggle for certain.

The Problem of Childcare

I see it happen all the time, especially now that I am older and have been at
the job for over 20 years. We encourage young women to get educated. We
tell them they can be equal to men. We tell them to go after everything they
want in a career and become economically independent.

However, ultimately, if those young women choose to have a family, then

they simply cannot do everything on their own. They will deal with:
• People who think they cannot handle their career.
• People who don’t want to hire them because they have children.
• The realization that they cannot do it all without some type of family
support.

These women who try to follow the career driven path and have children will
need support from the family. They will actually need a husband who will
probably work too. And, really, this puts the women in a problematic
situation. They are expected to be the ones who take care of the children and
work. The childcare doesn’t fall on the husbands in most situations. As a
result, the responsibility must be delegated, but women in a family simply
don’t have many options. We need better childcare options in Canada.

We need daycares that are better and more affordable. Otherwise, working
women often cannot afford to put their children in daycare because the cost
would essentially eat up their entire salary.

the workforce. And Canada needs them to be there – the country expects to
have a million job vacancies in the near future. Since women now account for

“For myself and my friends, we’re professional, educated women who want
to do the jobs we were trained for and think we are good at,” says Devyn
Cousineau, a legal-aid lawyer and Vancouver mother of two. “If we don’t
have access to care, we can’t contribute. For Canada to even take that risk is a
huge mistake, a huge lost opportunity.”

That’s a serious problem because Canada needs the skilled labour that
affordable child care can create. Ottawa spends billions of dollars on Old Age
Security, but high-quality, early childhood education – which experts agree
would help mothers pursue careers, boost the birth rate, ease family stress,
reduce poverty and improve success in school – isn’t even on the table.

“The kind of strain and stress and worry and cost, with all of its personal and
social consequences, is enormous in this country, and largely invisible to
policymakers,” says Susan Prentice, a childcare researcher at the University
of Manitoba. “It’s tragic for children and families. And it spills over into our
economy, and into our civic life together.”1
1 The case for publicly funded child care in Canada - www.theglobeandmail.com › Life › Parenting

And, if daycare is not an option, then I go back to my original opinion that

the best solution comes from part-time options and juggling childcare with
family and other moms in similar circumstances. When women are allowed
to work part-time without this harming their career choices or without this
put

balance in their lives – to raise children and work – to take care of themselves
and work too.
Right now, as I have seen it and as I have experienced throughout my
way. Right now, women have to give up so much and they do so in an
attempt to stay in the competition.

They should not feel as if they are losing out on the game simply because
they do not put in the same hours as men. Instead, they should feel like they
can accomplish both caring for the children without regrets in that sense and
working too.
So, there has to be changes in Canada. I cannot speak for other countries, but
I do see what is going on here. I would love to see the day when:
• Women are fully respected for what they do.
• Women who are pregnant or already have children have just as many
opportunities as anyone else regardless of how much they work.
• Women can consider working part time without cutting their career
opportunities completely.
- ance.

I’ll never forget being at a conference with another female anesthesiologist.

We were having dinner with a number of respected American
anesthesiologists. One of them leaned over toward us and with a straight face
asked, “So do you girls actually give anesthetics?” Seriously?

Learning from TED Talks

Somewhere along the line, I watched the TED Talk on Hard Choices. I would
recommend others watch it as well because it made me think of some things.

An immigrant woman decided to be an attorney instead of a philosopher,

which was her true passion. Why did she do that? It was the secure

- cess too. We don’t necessarily pursue our passion. Instead, we go after what
will give us the most stability in terms of income.

an anesthesiologist, and nothing else. I continued with my ambitions in that

subspecialty – which I now admit is what makes me my own worst enemy.

Honestly, there was so much security and stable income in performing dental
sedations or private cosmetic surgery, which would have offered fewer and
more stable hours. Instead, I had to have the challenge of trauma,
cardiothoracic surgery or the big general and neurosurgery cases. I needed
the challenge. I needed the adrenaline rush. And I was ambitious. This is why
in a two tier system most specialists will still choose the fee for service model
dealing

rewarding but incredibly dull and monotonous.

And, as I put my thoughts down on paper, I realize that this was part of my
problem. My decision making was based on drive and always pursuing the
and that was the backbone of all my decision making.

I tend to do the same thing at home, too. I always want to the best mom, wife,
housekeeper, cook, etc. The problem is, at home, I am usually mentally and
physically tired. As a result, I am often sloppy with dinner and abrupt with
the children. I don’t mean to be, but it does happen. Sometimes I even want
to take on the garden…how hard can that be? I ask myself.

Honestly, these days, I am always happy to have a day off work when we
have extra staff! That day often means I can have coffee with my husband. I
can go to the gym, grocery shop, make a nice meal, etc.

In the beginning, I didn’t worry so much about all of those things. I wanted to
work and work and work. Now, 20 years later, I am still striving to
for the night because I want to go cuddle with my 13-year-old and read a
book while he falls asleep. That’s where my priorities lie now.

Today
It is a Thursday. I have a thoracic surgery today. It is a complex
esophagectomy with double lumen tube, lung separation, thoracic epidural
for pain management, and central venous catheter. Cases like this are very
specialized and very satisfying for anesthesiologists. It is booked for six
hours.

When I was less experienced and when my children were younger, days like
these would be very tiring because all of the mental work that was involved
in this type of surgery.

If there were issues at home during my younger days – if the teenagers or

marriage needed my attention, it was best not to be scheduled for those types
of procedures. They were just too much and required a great deal of

These days, I have two kids graduating and it is very busy with a variety of
different grad-related social events. Life is full. And I am grateful that I have
managed to keep this career. The kids don’t seem to have suffered

and children are very challenging, but it does get better.

The girl who had young kids and wanted to quit – the one with mild
postpartum depression – she is not here anymore because I have actually
found somewhat of balance in my life. My advice to any woman who has
kids and is in the medical profession would be to pace yourself. Slow things
down when the kids are young. Never let go of something so important and
so hard to achieve.

It may seem like it is something you will be able to get back later, but it isn’t.
You have to choose what you value the most. You have to determine what
you worked so hard to achieve. Then, you have to hang on to it.

You may be young now, but there will come a time when you are so glad you
were able to hang on to it. When I read with my son, when I watch
job without struggling to have it all, I know that I have hung on to the right
things.

Friday
And what comes after Thursday? Friday, of course. So, what happens day-to-
day for me? After that long and exhaustive surgery on Thursday, things do
not slow down on the next day.

I got up at 6:30 in the morning and since I have the 13-year-old, I still needed
to get breakfast ready for him. Then, I have to get his lunch ready as well as
mine and I have to take care of the dog. Then, I can head off to work.

This is what I call a typical vascular day involving six hours of COPD,
smoking, obstructive sleep apnea, hypertension, diabetes, obesity, and alco

from my ex-husband, my husband, and the 13-year-old, who turns out to only
have a half day of school. There is no one there to pick him up because my
husband is in the middle of a large development project and is swamped. So,
I arrange for my stepson to pick up my son from school.

Then, the obese patient obstructing his airway is in the recovery room when I
start on the next case. This one is another obese, smoker, hypertensive with
bad vascular disease.

There is no time for lunch today because I have to get out of the OR and to a
grad BBQ. Of course, I volunteered to make a salad for the event and I am
slated to supervise the bouncy castle.

The 13-year-old has a concert tonight at the same time just to make things
really interesting.
My oldest son is in Europe for three more months and I worry about him
because I know how much he likes a good party.

Life at the OR
Throughout this book, I have discussed how hard it is to balance the demands
of both family and a career in the operating room. What I haven’t mentioned
is that there is so much more to it. Add to that –

• A child with a chronic or acute illness such as leukemia

• A teenager with a head injury from a car accident
• A spouse battling cancer
These are all real life stories from the OR family I know. And those things all
involve really hard choices.

Not to trivialize problems at home, but the issues we see at work really do
trivialize everything to some extent. There is the woman with metastatic
breast cancer. There is the man with a swollen brain from a motorcycle
accident. There is the 28-year-old with inoperable lung cancer.

They make the problems at home seem so small in comparison, but to our
children, they are big. They have their own schedules, achievements, sports,
friendship dramas, etc. The things that matter to them. Moms send emails
about listing ingredients for school salads (yes, I had to do this because a
label had to be created) for a grade 12 BBQ, which just seems ludicrous to

was if by grade 12 you can’t take the responsibility of your sesame or peanut
allergy then don’t eat at the BBQ!
Then, it is 15:30 (3:30 pm) and the neck is exposed. The carotid artery
already started. I am not there with my salad. I am not supervising the bouncy
castle.

My 13-year-old is home alone and his grade 7 graduation and concert is at

6:00 pm. I am resigned to not making anything. This is the story of the past
20 years of my career. This is the reality of the OR.

recovery room nurses are available. There are no beds. Essentially, there is no
room at the inn. It is the fee we pay for a universal health care system. There
is never enough room. Never enough resources.

I sent a text delegating the ex to handle the bouncy castle. He arrives late.
Then he leaves 10 minutes after arrival because he is on call and gets

called for an emergency.

My 13-year-old keeps calling me and making me feel guilty: “When r u

home?”
“I am a little hungry.”

As usual, I start thinking that doctor-doctor marriages, especially specialist

physicians, are headed to Splitsville after the children are born unless one
parent compromises ambition and that is usually the mom.

I know that because I have been there. And, today is just another example of
this. It is a part of life when it comes to juggling the career and the children,
and I only have one child that really depends on me anymore. But, it is still a
balancing act all of the time.

Women faculty members and partners should be asked what they want and
need to progress in their careers and practices to make them enjoyable,

how they want to work their day. We, as leaders, should not react as if their
requests are not appropriate, condemn their requests, or talk about them
among others. The environment must be made more amenable for women.

Part 2
The Lives of Others
A

s I mentioned, one thing I wanted to include in this book is the perspective of

other professional working women. I don’t want anyone to think that I
assume I have all the answers based solely on my life and experiences. I

interviews I completed with these women, I have come to some conclusions.

Interestingly enough, I still fully believe that the only way a woman can
work, take care of her family, grow professionally and have a personal life is
through a job sharing agreement. I am not the only one who thinks this either.
In fact, the Nursing Association is bargaining for just this in our province. It’s
clear that plenty of people believe the job sharing method will work best in
order to ensure women can balance work and their personal life.

The Nursing Association is bargaining for this: as a general principle,

- lective agreement. Each employee in the job sharing agreement is treated as
a

This is important in the nursing world for a very good reason.

Disproportionately, most nurses are women. Nurses are often hired as casual
workers
-

Royal Bank of Canada and job shared with another woman for many years.
In fact, often, job sharing individuals put out a great deal more work than
they would if they were individually working full-time because they are
willing to

likely be completing 1.5 jobs.

my partner would work the latter half. Of course, when colleagues were in
as taking extra call.
I believe that women shouldn’t be afraid to admit they would prefer to work
part-time. However, at this time, that’s exactly how they feel. Most
they will not get the job. If job sharing were more widely accepted, then this
would no longer be an issue. Women could stand up for themselves, state
they wanted to work part-time and then be able to balance work and home
more easily.

To better understand what the working world really is like for women,
- er, a radiologist, and an ultrasonographer. This way, I can share with you
the perspectives of women in a wide array of different positions. You will
likely notice a common theme running through no matter the job too.

So, in this section, I will share stories, insights, bits of wisdom, and other
information that these women provided to many along with their own
perspective on women trying to balance a professional career along with a
personal life.

Other Lives
Before we get to that, though, here are some snippets of others’ lives. I have a
friend who is a general surgeon. She works at a very busy tertiary care
hospital. In addition, she has a two-year-old child. When I called her tonight,
she told me her life was “absolutely crazy.”

I feel for her because I have been in her shoes. I am very familiar with that
feeling. I don’t think it is anything young mothers or children should be
subjected to.

of success.
this pushes young, ambitious and energetic women to press on.
My Friends
I have a few very close friends who are in a wide variety of different
professions, many of whom I will be interviewing for this section. But, as I
in one form or another. They do not have it all and they do not have the
balance
ways, but it does all come down to the same thing: something gives. I have
determined this: everyone has to make their own choices. They
will put the most importance on. I don’t know what the actual answer is, and
I believe that I can give some advice to women, especially those in medicine
who are entering demanding subspecialties, because I have been there. Many
of these subspecialties have been male-dominated in the past because they
require incredible dedication, time, and commitment. One of my friends is a
nurse married to a vascular surgeon. They have
doing this on her own. In fact, at one point in his career, his wife had sold the
house and moved and he actually didn’t know where he lived.

- other time, they were robbed and there was furniture on the lawn. He
thought his wife was redecorating.

These stories seem really far-fetched, but this is how life was in the surgical
specialties 20 years ago.
My Police Officer Friend
Also before I get into the actual interviews, I would like to tell some of the
stories I know.
- ents. She did not have children herself until she was in her late thirties.
Because she was so excited to start a family, she completely gave up
-
That’s something that plagues every woman who has to choose between
career and family.

My Social Worker Friend

I have another friend who is a social worker. When her children were
younger, she spent most of the time as a mother and only dabbled in her
career. Luckily, she did spend some time ensuring she kept up with her skill
set. Because when here children were ages ten and eight, her husband had an
affair. At least, when the divorce went through, she had something to fall
back on.

Now she is a single parent, since the children reside with her. However, she is
managing to make ends meet and remain self-reliant.
If she had not at least maintained some of her career when she was

had limited job prospects and it would have been very hard for her to raise
her children and support the household. She may have very little time to
spend by herself, but she is managing to take care of things.

My Real Estate Lawyer Friend

I met my friend who is a real estate lawyer when we were both pregnant. I
was pregnant with my third son, and she with her second child. We met at the
swimming pool. She was well-kept, intelligent and very funny. She stood out
from the other ladies at the community pool. I was immediately drawn to her
conversation and we became close friends.

I soon found out she was an attorney and she was on maternity leave. Then
she went back in full force following the birth of her second child when her
girl was six months old.

would seem as if she has it all. However, she always seems to be under a
great deal of stress. Her children have learning disabilities that require special
attention. There always seems to be some chaos in the household.

So, despite on the outside everything looking rosy and good, there are

to relax. And, since her children need special attention, she has to devote
even more to them while not giving up her career. In that balance, there is
only one thing that can give, and it is herself.

My Dentist Friend
successful dentistry practice and is married with three children. Life is busy
and full of challenges. One of the biggest challenges is that because she is so
life. Her husband never signed up for being “the stay at home dad” and both

My Pediatrician/Radiologist Friend
I have another friend I have mentioned previously in this book. She is a
pediatrician, but dealing with oncology and cancer in the pediatric ward was
something that she just could not continue doing.

So, she moved over to radiology and then specialized in ultrasonography. She
then moved on to pediatric ultrasonography before completely quitting
medicine so that she could focus on her family: her husband and four boys.

Now, she works in nutritional and health counseling, so she has managed to
maintain a job, but she found out, as so many other women do, that it

I don’t know many women who have had very successful subspecialty
careers without something imploding – and that something is usually their
marriage or their children.
On the other hand, I know several women who have focused on family and
relationships, who have then had a mediocre career because they don’t have
to focus on both. They have settled for this and been happy with their

Then, then there are certain subspecialties. These include anesthesiology,

surgical, and invasive radiology. They are becoming more challenging. There
is a great deal of on-call work and shift work involved, much like emergency
medicine, and that is very disruptive to trying to raise a family and run a
normal household.

The only reason why anesthesiologists don’t mind shift work is that
example, I can earn as much in one weekend as I do working a full week.

I remember one time I picked up a book from the bookstore called “I Don’t
Know How She Does It.” I believe they also made a movie with the same
name.

My conclusion: She doesn’t. She fakes it! Honestly, I have come to the
conclusion that this is all just smoke and mirrors. I look at my friends and I
see that every single one of them has had to give something up. On the
outside, it
Chapter 1
My Son
B

efore I get into the interviews with the other working professional women, I
want to tell you about a discussion I had with my 12-year-old son. I think it
shows another perspective in giving you an idea of what actually goes
through the minds of children when both of their parents work.

Dealing with Illness

To give you some back story, here is what was going on. At the time I am
writing this, we believe my son has infectious mononucleosis. Since my
husband and I both work, no one was available to take him to the doctor. So,
he went to see the school doctor (neglectful parenting and another reason
why I am thankful I was able to send them to private school).

Now, with the requisition from the school doctor, we have the blood

pm at night. Dinner has not been prepared. We are not home yet. We haven’t
accomplished much of anything else. But, that is how things work when you
have a career and children.

I know now that I am making the right decisions. Even though I wasn’t there
to originally take my son to the doctor, now I am able to ensure he gets the
medical care he needs. I am with him now and though it may mean supper
might not get on the table, it does mean I am doing what I need to for my
child.

But, it does make me think of the women who do take on the full-time
careers without anyone to help them and with very few options. They have to
work. They may not be able to afford extracurricular activities or they may
not have a way to get their children to those activities. As a result, the child is
left home alone, and that likely means when they get sick with something like
this, they are left alone to deal with it. That certainly isn’t fair to the children
and could result in worsening problems too.
Talking to My Son
So, I decided to take that time while my son was in the car with me to get
some of his perspective on what it is like to have a working, very busy
mother who isn’t always available to do the things that some may expect of a
mother.

Me: What are your thoughts on your mother never really being fully available
to you?
My Son: She’s always been available. It would be dysfunctional if she was
always there for me all the time.
Me: Oh, it would be? So, you don’t really want one of those moms who
would look after you all day long and has the household spick
wonderful lunches, back massages and cookies?
My Son: I like the back massages. But, no.
ever consider a career in medicine?
My Son: Oh yeah!
Me: Why?
My Son: For the money
Maybe we need to have a little chat!

Getting Perspective
My son is used to how we have been doing things. In a way, although I may
have felt guilty for not being there all the time when they needed me, it may
also be a good thing. I have raised independent children who know how to
take care of themselves.

However, at the same time, I have learned through my years of work

always be an important part of my life. But, like I said earlier, work is only
one of the aspects of my life. When I leave my job, I likely won’t be
remembered. Who will remember me one day is my family. They are the
ones who matter. So, while I will continue to live a busy life, juggling the
home and the work, I have changed where my emphasis lies. And, although I
will likely never be the

out how to be there when my kids need me the most while still maintaining
my career as well.
His Own Words
I decided to let my son say what his life is like in his very own words, so I
gave the recorder to him and allowed him to say what he would like. This is
what I found out, coming from my thirteen-year-old.

Hi,
My name is Will. I am the youngest kid of three of my mother, Anna. I feel my
life is busy but perfectly balanced at the moment. But, it has been a
practices for a provincial team, and I’ve been traveling with school. It’s just
been overall a bit stressful.

Today is, I believe, Thursday the 11th of June and I had a very bad basketball
practice. Didn’t really go my way. Just wasn’t focused. And, yeah.
But I would like to talk about my childhood. My parents were divorced when
I was at a young age. I believe I was three. I recall a bit. I was sad, but not
overly sad. I didn’t really understand. And, I personally think that a divorce
has to happen, has to be when the kid is young, so that he doesn’t understand
fully and he grows up into it, or when a kid is old enough to fully understand,
like age 18 and up. Because it can still be troublesome at age 16 and 17 I
believe.

would go week and week. This worked for a while. Now, I am deciding a
house to live at. Not to live at though. I would like to do school days at one
house and then weekends at another just so I can keep my crap at another
house.

But, what really was troublesome with my childhood was my brothers.

Alex is fun, but he is good at hiding it. I feel he is on his way. I feel Anthony is
on his way too because he is in a good university.
But the problem is he doesn’t really control his feelings well and he thinks
everything involves him.

Back to me. This message from my son serves to demonstrate that kids
survive despite their parents. They are capable of thriving even though we as
parents deal with so many things that truly get in the way of ensuring our
children have everything they need. We do our best, but at times it doesn’t
work out well. And, despite all of that, our children are able to thrive.
Chapter 2
The Police Officer
S
ometimes, we even lead such busy and frazzled lives that we have a hard time
even making sense of what we have been through and the balance we

I have been a doctor’s wife, a career professional in a male dominated

profession, and I am looking at my future. At the moment, I’m in the present
and I’m dancing. My only concern is that I’m tripping over my feet. And,
Anna, when I am able to focus, I will give you more than you need.

Focus – it is a hard thing to come by when you lead a busy life as a

professional, a mother, a wife, and many, many other things.
Pregnancy and Policing

Hi Anna, another tidbit when you are talking about pregnancy and policing.
I was working on a shift with 18 men, and I had been there for 18 years. And,
interesting comparison there. Then we had a young woman come along and
join the police department. She had been there for approximately two years
or a year and a half when she announced she was pregnant. The police
department could not handle that at all, from the bottom ranks to the top.
They would even come to me and say, it would be different. You have put in
your time. You could have a child.
Well, about six months after the other girl was pregnant, so was I. So, I chose
to leave and she stayed. I recall telling people that: that I may very well go
and she may have a full career, which she has.

How Many Women Were on the Police Force During Those Years? At
that time? Well, maybe…thinking off the top of my head…probably
about six.

Out of How Many?

Out of 140. And she had courage. She had some courage. Yeah.

And You Gave Up Your Career to Raise Your Children Because It Was
Time to Have Children?
Exactly. I had that opportunity and working with a husband that worked
more hours than one could comprehend. (Doctor’s Wife?) Yes, a doctor’s
wife. I am put in that category, yeah.

Regrets
I also asked her if she had any regrets for her decision to quit her job
completely and raise a family.

Absolutely none.
But, I will tell you about getting my …I went to the management when I was
pregnant and they said that I would need…this is a cute story…that I would
need either a maternity uniform, which Vancouver Police provided for their
members or I would need a plain clothes allowance. Neither of which they
were willing to provide, telling me it was my choice to get pregnant.
So, I said that they had three options. One, they could provide me with a
maternity uniform. Two, they could provide me with a plain clothes
allowance. Or, three, they could talk to my lawyer.
I had my plain clothes allowance the next day.

Married to a Physician
As a physician myself, I thought it would be interesting to get the view from
the other side of things, so I asked her if being married to a physician was
everything she thought it would be.

I didn’t see much of him. Laughs

So, I don’t know.
Laughs again
I am sorry.

Now Fast Forward 20 Years?

It is a very lonely lifestyle. Looking back, my experience in life has been more
sequential. I had my career and I enjoyed it very much. And, hopefully I
would like to continue with it. Then I had my children. Now it’s time for
divorce and to move on with the next chapter.

- ters of Career, Mother, Time to Be Single and Being Independent. I

Always Struggled with Trying to Have a Career and Relationships
Simultaneously.

Whereas my struggle would be that I am full-time at work and I am full-time

with my children and there is longing for that freedom as well that I would
have had with work. And my time. And balance. And believing there would be
a partnership with my husband, which I don’t really feel there was. It was
more like a sense of servitude, which I didn’t respond to very well.

Probably Because You Were Too Independent. Not too independent.

Incredibly independent.
Incredibly Independent from the Start. Yeah, too independent is wrong.
I would agree with her on that. There is no such thing as too independent.
are independent, this creates problems with the dynamic that so much of the
world is used to.
Chapter 3
The Social Worker
I

n this section, I have asked my social worker friend about her experiences in
life as a working woman. I wanted to make sure that in this section of the
book, I talked to women in a variety of different positions, many of which are

to show how this is a problem for women across the board in any type of job
that they may have.
So, without saying any more, I would like to go into the interview with her.
What Were You Good At in High School?

In high school, I was good at being social. I didn’t have a lot of career goals.
I enjoyed just being. I was that little cute girl looking for a husband whom
you talked about. My parents always said that they hoped I found a good
husband, but they also had huge expectations about school.

some sort of marketing. My parents didn’t think that was a good idea. I had
to do something more focused. So, I decided to originally do law with my
undergrad in social work.

After I got my social work degree, I applied to law and did my LSATs. And,
then I decided I would take a year off to work, and I never went back. And, I
am glad I didn’t go to law school.

Are You Glad You Took a Year Off?

-
ate degree right away. Because then life happens and it’s harder to go back
to
school.

Ok, and Then You Met Your Husband?

I did. I met him about two years after I graduated university and I was almost
30 and I think that I thought we looked really great on paper. We made sense
on paper. He was established. He had a house. He wanted children. He
was…he wasn’t passionate. But, he was easy.

And It was Time?

It was time. I was almost 30. So we decided, well we were only together six
months and then engaged and married in nine (months). We never lived
together.

And the Living Together Was a Catholic Issue Like Mine? Absolutely.
Same issue. My parents would have been very upset.
What Then?

Then, we decided to start thinking about having children. We did the thing
about making sure we were healthy and off birth control. I got pregnant right
away, which was a bit of a shock.

I think that I faced the thing that every woman does. Is it cheaper? Can you
afford daycare if you are going to work? How much was it worth to get a
fulltime nanny with all the stress of having to run around and do everything.

Was it worth working for very little every month? Or, was it better just to
budget and stay home?
So, the decision was it was better to budget and stay home.

I knew the marriage wasn’t very good. I knew that right away. But, I knew I
loved being a mom. So most of my kudos came from being a mom. And then I
decided that I still wanted to work. I think I knew when my second son was
about two years old.

Two Years Old?

Two years old. I thought I don’t know how I am going to do this for the
next 30 years.

So, Did You Manage to Go Back Part-Time in Your Department?

I did. I was really lucky because I had worked at the hospital before. So, I
called and I said, “Can I just come on as a casual?” So, what I did in the
beginning was I really didn’t work that much. I worked basically if my
husband was off; I would pick up a four-hour shift.

I did is I kept a really small private practice. So I always kept my license up,
which is important.

And, the marriage continued to fail. There were business things that
happened. I decided to go back part-time, and that was the smartest thing I
did. It was tough on the family. |124{
And, we did that for three years. I worked the weekends and he worked
Monday to Friday. And, it worked well for us because we never had to see
each other.

But, it was really hard because I did have a special needs kid. So, on top of
all that, it was having to struggle with a child who was having panic attacks
and anxiety and things like that.

And then, it actually took me a couple of years after we separated to get a

full-time position. Because it’s like you could have great skills and
background, but you can’t just walk in and say, “I would like you to give me
a full time position now. Yeah. I’m ready.”

So, you know, in all of the hospital, there’s probably only, where I work, 25
positions. So, it’s pretty competitive to get a full-time position. You have to
wait until somebody retires.

So, Then, the End of the Marriage, Can We Talk about That? And Being
on Your Own? And the Challenges of Parenting?
One of the biggest challenges is that, you know, when you choose to stay
home and you have a partner that’s the primary breadwinner, they don’t
know their children.
And, I think for me, I really knew my children. So, the difference became so
black and white. He wasn’t a terrible dad. He just wasn’t an active dad.
He didn’t know what time they go to bed, bathe. He didn’t know what their
favorite foods were, how many drinks they needed per day…he didn’t know
any of that stuff.

And Then When You Decided to Split, He Also Wanted to Take the
Money?
Absolutely. He took all the…yeah.
So, you know we had a business. And the money and lifestyle was gone.
So, it became a decision about how are we going to divide our assets. It was
a horrible process, spending, probably between the two of us, over $100,000
in lawyers for the same outcome.

And Now You’re Stuck Being the Breadwinner, the Career Woman, and
the Mother

And the mother is being the psychologist, the mediator, the event planner, the
structurer, the teacher. Everything. I’m their maid. I’m their housekeeper.
I’m their cook.

I’m also a gardener. I’m a painter. I do it all, and it is really tough. Most of
the time, God love them, they want more.

Can You Talk about How Draining Your Job Can Be as Well Because
You Work in the Cancer Clinic. Emotionally, That Must Be Very
Draining. Then You Have to Come Home and Deal with Everything
Else?

I do. I work in oncology, and I work in a medical oncology, and that’s not,
you know, that’s not a necessarily happy place. There’s not a lot of hope.
People come in when things have gone desperately wrong. Good work with
the family means you are probably there when they die.

So, it’s important work and I love my team. But, I have to come home, and all
of the sudden, soon as I walk in, I might have had a day where I had literally
two people pass away and they (the kids) say,

“What’s for dinner?”

And you have to say, “Ok, mom just needs a minute.”
And sometimes they will be…they don’t really understand. They will

be like, “Well you chose this job. You do it. Why is that my issue? I want
chicken!”
Do You Ever Feel You Were Penalized, Because if You Hadn’t Worked,
He Would Have to, According to Canadian Law, Pay Some Sort of
Spousal and Child Support? I Certainly Felt Like I was Penalized
Because I Had a Career…

Yes and no. I could have had spousal support, and it probably would have
been close to my child support based on the length of my marriage. But, I
don’t know if it was just how my parents were raised, I did not want to
depend on him. I really didn’t.

My mother always said to never depend on a man. When poverty comes in the
door, love goes out the window.
I just thought, you know, I need to stand on my own two feet.
And I didn’t want to depend on him. I didn’t want to sit there, like we have a
friend who waits for that support check to come in.

And, That Probably Stops Her from Meeting Her Full Potential. Yeah. I
wanted it over. You know, take care of your kids. And even

My Friend Says That Even Though It Sounds So Unbelievably

Romantic, Because She Has Seen So Many Different Situations in Her
Work, This Is What She Suggests to Young Women That Are Madly in
Love:

When you’re madly in love, I think before you do anything, you need to get a
cohabitation agreement or a prenuptial agreement that tells you what
or your partner makes them.
I also think if you are going to have children, create a co-parenting
agreement before you have them and say, “Ok this is what we need to have.”
other more than you love your children.

It’s Frightening That, Sometimes, One Has No Insight into What It’s
Going to Be Like Until One Is in That Situation with the Children. And I
Know that if I Had Created Some Kind of a Co-parenting Agreement
with My Ex-husband, He Probably Would Not Have Stuck to it Anyway,
Because That’s the Issue. He Doesn’t Stick to Anything. He Is, as I
Mentioned Before, a Yes Guy. He Doesn’t Follow Through.
As you can see from this interview, it is not easy. No matter the type of job, a
woman trying to be a professional and trying to raise a family – es
she had not at least maintained some connection, it would have been all the
harder when she and her husband split up. As it was, because she chose to go
to full-time when she needed to.

Things are not as easy as they seem. They just aren’t. You can’t walk into a
company, and say “give me my full-time job back.” It doesn’t work that way.
Chapter 4
The Teacher
T

his interview is with a full professor at the university. She has already raised
her children and she currently lives on her own. Again, I wanted to get the
perspective of many different people on what it is like to work full-time and
raise children. So, let’s jump right into this one.

If you start to take women seriously, as an important part of organizational

activity, and then we really listen to what a woman needs to participate in an
organization in a way that allows her to balance her life around participating
in work, addressing the needs of her family, and still sustaining a reasonable
social life.

If you take all that seriously, then the way women do work in the organization
will necessarily change. The structure. And, if we start to then consider
adapting some of our policies and protocols in ways that women can work in
the institution to sustain these balances, then what will inevitably happen is
that we will humanize the organizations. And, the policies, the mechanisms of
governance within our organizations will become, they will just become
humanized.

And we will institutionalize listening-type mechanisms within our… what will

that mean in a real practical way? It means that when we work, and how we
work, and the work that we do to contribute to the organizations is just going
to change.

The scheduling will change.

Scheduling Is Important
Yeah.
The amount of work will change. The way we work out timelines. The

way we share our workloads will change.

And, if we start to do those kinds of things, if we are receptive to those
concerns and needs of women, we will create innovation in our
organizations.
What about Those Professions Where You Need to Practice a Skill Over
Women Who Want to Have Children?

Then, we need to build in buffers so they can still stay competent and they
can still contribute to the workload. The amount you work shouldn’t change
how skilled you are in that profession.
So, in the long term, there will be cost savings. There just will. Because
you’ve got better quality, rested and abled workers.

People liking their work. They’re going to… I mean when we consider
we create in the workplace.
Which We Do a Lot Of

Yeah, it’s like we don’t have a frontal lobe when we make these decisions. We
need to think in the longer term about what sustains an organizations.

Just One Other Thing. In the ‘80s, All Those Women That Were…
Feminism Was Big. And, How Did Those Women End Up?

Well, I don’t know what the numbers are. But, I do know a lot of them tried to
do it all. They bought into the feminist ideal. They said, “Ok, I will get a
family. I will keep my own name. I will get trained up and I will work
fulltime. And I can hire help.”

We know that women continued to do 90% of the work in the household. So,
they have a household to manage, children to raise, and a full-time job. So,
that’s three full-time jobs.

And, Trying to Stay Married… Yeah, the relationship, exactly.

So, Nobody Succeeded?
Sure, a lot of breakdowns with women.
So, Then, the Pendulum Swung in the Other Direction. What’s in Store
Now for Women? What Should I Advise an 18-Year-Old?
Well, I think a lot of them are, when I look at what they are doing
career ambition are deciding not to raise families.
Or, they put them off for much longer so that they can jump in both feet
forward with the career thing. Then they pull back in their late 30’s or 40’s
to attend to the family thing. Which, in a way, is more sensible. It’s changed
that childbearing age.

But I think this cohort understands the challenges of being able to do the
juggle and the wear it will have on their health and relationships or
compromise their ability to do the work.

So, I mean there is only so much of us to go around.

I do think, in the 80’s, a lot of us bought into that. It was so politicized and
became a part of our unconscious ambition of what we were. I think we
- ers who stayed home and were just mothers. It was almost disparaging. And
we sought to overcome that and be modern and you know, get the suit and
high heels.

I still remember that image of that’s where I wanted to go and I never really
understood where it came from until decades after. Because you understand
what the cost is.

So, I guess now, I think the young women are being more conscious because
they are seeing the messes and the challenges. They never bought into that
myth, I don’t think.

And, they’re being more thoughtful and being more contemplative.

When You Picked What You Studied, How Did You Pick It? In
Psychology?
we do a lot of caretaking with younger siblings, and help support them, and
skill around that to do that in my future life.
Was That a Good Choice? And, Once You Had Children, Would You Do
It Again?
off in university and I didn’t like that. Then, I went into hospital and worked.
Then, eventually, I didn’t like working in that, so I went into private practice
Flexibility – it’s what I keep talking about. Flexibility is so important
it is nearly impossible to be a mother and a full-time worker. Those who can
balance in their lives.
I look at a woman like this, who has been through it all – who raised the
children and had the job – and I see someone who can offer a great deal of
insight to younger generations.

These are the women we can learn from, especially since she has seen the
role of women change so much in the past few decades.

Chapter 5
The Family Physician
S

o, we are going to interview now a family physician who works in a rural

community in North British Columbia and has four children. I want to make
it clear that I know every story is not like mine. People have different
motivating factors and different situations arise. So, I wanted to talk to other
women in medicine as well.

How Did You Decide When You Were 18 to Do Medicine?

I was in Newfoundland and I had lived there my whole life. My mom decided
while I was in high school that it would be good for me to leave the island
and go somewhere to university. And I decided to go to Queens because I got
a scholarship there.

And while I was at Queens, I was interested to do veterinary medicine. But

then the longer I was there, the more I realized I didn’t like animals so much.
And I wanted to go back to Newfoundland because they had a good medical
school. So, I thought I would apply to medical school and I was accepted. So,
I went back to Newfoundland and did medicine there.

While doing medicine, I realized that I really liked family practice, but I also
really liked surgery. But when I looked around at the quality of life that
general surgeons had, it didn’t really look all that great for the long-term.
And for me to have a family, I decided to do family medicine and surgery. So
I did a two year rural family practice residency and an additional one year in
surgery with the view of working in a small community.

And By This Time Were You in a Relationship? Married? Or Single? I

was single. Then, when I decided to move to a small town, I moved
there mostly because they had a small volume OR program. And I moved
there
knowing I would be the only person there, but not truly understanding
what that me .
I got there and I met my partner and we had four children together.

So, Tell Me a Little Bit about That. About Getting Pregnant the First
Time and Still Trying to Carry on Being the Only Physician in that
Community.

ended up being on bed rest from 16 weeks. And then bedrest at BC women’s
hospital for quite a while by myself. And I ended up having an emergency
Csection at 28 weeks and we were in the NICU for four months. So, we lived
away from home.

baby and we only had one baby. One of the babies was only at 500 grams, so
super hard for us and we were back and forth to Vancouver at least once
every two weeks.

So, Not Only Was it Stressful Because You Couldn’t Provide a Service to
Your Patients, but Stressful Too Because You Couldn’t Always Be There
for the Babies. And, Probably Financially Very Stressful.

-
and paying for it.

And, I think there was a lack of understanding from my colleagues about why
I couldn’t come back to work full time and why working in emergency for 24
hour shifts was challenging.

And, then to come back and do surgery not having done surgery for
Tell Me Exactly How That Felt. So, How Long Can You Have a Gap
with a Profession Like That and Still Feel Competent?

I felt really uncomfortable, so what I arranged to do was go to a larger

center and I arranged to work for a month there doing only surgery, and I
did some stuff in emergency as well because we have to do emergency
medicine every third or fourth night.

hard. Then, I said if I had any more children, I wouldn’t take that much time
off. That was sort of what I had decided that if I ever wanted to go back to
emergency surgery and obstetrics, the most I could take off was three or four
months.

Other than that, it was too stressful.

And, Then So You Have Managed Your Career with Children Who Are
14 and Four, I Guess. And How Have You Managed All of That…
Working in a Small Community, Taking Call, Looking After the Kids?

raised the children. So, without that, it would have been very different. So,

I ended up doing things like in the middle of the night, sometimes having to
bring the kids with me to the hospital, things like bringing the baby to the
hospital and wearing it in a carrier while doing a trauma or putting on a
cast. That was just a way of life.

Any Regrets about Your Profession? Any Regrets about Having

Children When You Had Them? Any Regrets at All?

I think the regret that I would have is not necessarily the children. More so…
the volume of the emergency call. Not as much the surgery because
emergency call is always 24 hours and it is always being called in the middle
of the night. And with nursing and breastfeeding for two years with each of
the children, it was just a little bit too much. Too much for lack of sleep.

And I would say towards the end with my last set of twins, which were also
born prematurely and we ended up being in the NICU for three and a half
months.

All Things That One Can’t Predict…

Right. And then, that faced me with that decision when I went back. Do I go
back to work right away knowing that the consequence if I take more time off
is to do more procedural stuff out of the community before I come back to
work. So, I decided to come back to work right away because I knew from
before it was too hard.

And, Do You Have Any Regrets on Moving to a Rural Community? No, I

think it was easier. The community has been really supportive
of both myself and my family. And I think if they hadn’t been … if I hadn’t felt
appreciated, I probably would have left. But the community would do things
like, when I had my second set of twins and went back, the community had a
fundraiser and bought me a big stand up freezer for all the breastmilk. And
they had it shipped so it was ready and waiting in my garage for me when I
came home.

to do anything.

So, You Felt Appreciated and That Made It Worthwhile?

I think so. And the community would do things like when I forgot to
pick my kids up from school, they would actually bring them home for me.

Thought about Surgery. Any Advice to Those Women That Are Now
Finishing Surgery. When Is a Good Time to Have Children?
I think I don’t really know that. But I know what is most important to me is
that when I looked for role models and looked for mentors, it was really

actually see myself in their shoes. And I looked at being 50, having a family
in those specialties. There wasn’t anyone I looked at and wanted to be like. I
didn’t want to be like that.

I Understand What You Are Saying and for Me, I Always Looked at
PartTime Women in Anesthesia and How Often They Were Looked
Upon as Not as Competent as the Men, Working.

I suffered a little bit from that because I work in a community that has all the
other physicians are males. I am the only female there. So, there’s
committed.

And I had some pushback from the male physicians about doing full call, so it
was basically said to me you either do full call or you don’t work here. So
those are the choices. That would have been easier for me if there was
another option. It was that option that made it the most challenging.

I see the same things over and over again. Women are always looked at
differently. Thoughts abound such as:
• She is going to want kids, so we can’t depend on her.

• She has kids and now we have to make special concessions for her.
• She will never be as fully competent because she is not so committed to the
job.

And, I see these types of thoughts no matter what type of job the woman is
in. It seems especially obvious in the medical profession, but it does happen
virtually anywhere.

Chapter 5
The General Practitioner
A

fter speaking with my friend who works in a rural setting, I thought it would
be also interesting to get the perspective of someone who works in a city.
That’s why I interviewed my friend who is a general practitioner in a slightly
more urban environment.

I am a GP in a medium sized city. I decided to go into medicine because I

had been good at biology and had sciences and had high marks. The most
likely options for good students were doctors, lawyers, accountants, teachers.
My family was very supportive, so I continued on that route.

I got into university, and during my undergraduate, didn’t have good reasons
to go in that direction. Couldn’t really list out my reasons anymore. So, I
decided not to go into medicine. I decided to do research in biology, which I
enjoyed.

One summer, I discovered I was sitting alone in a lab and hated it because
there was no one to talk to, so I came back to the decision of going into
medicine.

I could be closest to my family. I ended up getting married halfway through

medical school.

The only reason I got married between second and third year was because I
had enough time off to do it. I would have preferred to have had a whole lot
of time off, but couldn’t get any.

I decided on family medicine because I like the variety of different cases you
could get. I liked having control over my practice and not being at the
dictates of a hospital or privileging.

I consciously decided not to work full time so that I could have kids and raise
my family and get to most of their activities. But, the reality is that you miss a
lot.
But Working Less Than Full Time Is Still How Many Hours a Week?
But I still was working 35-40 hours with being on call, taking paperup kids
from daycare or school.
If you are doing obstetrics nothing goes on time. Babies don’t come on time. I
would be watching clocks in an absolute panic that my kids were wait

They would be dragged incessantly on rounds in the hospital.

They dislike going to hospitals now because of their early memories
although they have no fear of anything in medicine either. So, that is a plus.

Would They Ever Consider Medicine?

Neither of them would consider medicine. They have also seen the toll it has
taken. Despite having control over my hours, I still missed a lot of events,
soccer games, etc.

Yes. So, if you have a group practice you can control that a lot more. You
don’t make the same money as a surgeon or working those hours. But, quite
honestly, they don’t have the time to spend the money anywhere because they
are working so much.

And, family medicine, the other thing is, you have so many different
problems that you will see day in and day out for years. Which would bore
me to death. And that is why I picked family medicine.
And Advice to Young Women Considering Having a Family? You need to
think about it because you are balancing completing your
And practicing.

But the reality is, as you age, your fertility is dropping. And you get tired as
you get older. And the older moms, they don’t have as much energy for those
kids.

The nights are hard and they get harder and harder as you get older. And
your kids are really going to need you, particularly when they are teenagers.

And When You Were Covering All Your Obstetrics, How Often Would
You Have to Do Call?
I was in a big call group, so we were on one in every ten weeks. But you are
on for a week at a time. But, because you do your own obstetrics, I would be
getting called out once or twice a week, so you are tired.

And, Could You Have Done What You Did without a Supportive
Spouse? No. The kids would be raised by nannies. So, that’s the thing you
have to balYou have to consciously think about that. Because it will not fall
into place on its own.

Can You Comment Generally the Different Salary Ranges for Female
Physicians, Female Family Doctors – Take Home Pay?

Ok, my take home pay, in an established practice, doing a moderate amount

of obstetrics, is probably $175,000. I see patients 20-25 hours and obstetrics
on top of that. And third party billing. There’s a lot of paperwork that goes
into that and more and more in the 20 years since I have started.

And for Those Young Family Doctors Who Go out in the Workforce and
Work 40 Hours a Week without Doing Obstetrics. What Could Their
Take Home Pay Be?

that.
-
hoping to break even. And it really gets to the point where you just want some
going to lose money having a locum in and you won’t cover your overhead.
My Understanding Is It is Very Hard to Find a Locum These Days…
That’s in a Moderate City…
You have to want to do this. And I do. I love doing it. But, I would go
be. The impact it will have on a family life is huge. So, you have to decide
what
I wasn’t aware of the family stuff.
It’s organizational stuff. It’s just being present.

And, that is what I wasn’t aware of either. I didn’t know how consuming it
would be to have a family. It’s not as simple as having a child and going to
work. There is so much more to it. And, in this case, my friend has had the
help of a partner. She isn’t doing it alone. Yet still, it takes a lot out of her
and
And, that certainly is a recurring theme.

Family takes attention even if you have a nanny, even if you have a
supportive spouse. You have to be there for your children, and that can be so
hard while juggling work responsibilities too.
Chapter 6
The Dentist
I always wanted to do medicine in high school. In Grade 10, I thought I
would become a plastic surgeon. I was dating a guy who was in medical
school and visiting him at UBC, it looked like a lot of fun! That relationship
didn’t last but my ambition didn’t fade and I took Sciences at university. I
was passionate about music but I decided on science because I wanted to be
practical from the career point of view.

During the time I was making up my mind whether to do medicine or

dentistry, the NDP government was in power and they were limiting billing
numbers to physicians in British Columbia. Family Physicians were forced to
buy practices and pay for billing numbers and their salaries were being
“capped”.

At this time we had an exodus of physicians to the United States. So on my

girlfriend’s advice I wrote both the MCAT and the DAT exams.
I did better on the dentistry admission test as it was more didactic.
I was accepted to both and decided on dentistry with the plan on becoming
an oral maxillofacial surgeon. It seemed I could accomplish this faster than
completing medicine and residency in plastic surgery and then being capped
or unemployed when ready to work.
In dental school 20 years ago there were 7 of us (women) out of 40. It wasn’t
the greatest process, but I fell in love with my career and what I was doing.
I wanted to work in Victoria because that is where my family was and I was
scared of buying a business from the beginning because I felt I had no idea
what I was doing.
I worked as an associate for a dentist who went travelling. I was 29 when I
started working as a dentist, and I was 34 when I married.
I met my husband in a running clinic and he asked me what my lifelong
dreams and plans were? I had no clue, because I was much more
spontaneous.
I bought into the dental business (half the practice). Nowadays, to buy a
practice you need anywhere from
school have a debt of $240-260,000. So without family support it is very
challenging.
My debt was $60,000 which was still manageable. I paid $450,000 for my
half of the practice and didn’t even own a house.
I had planned to stay on maternity for 6 months, but there are not

and delivered 10 days late. I went back to work 6 weeks post partum, full
time, because of the bills!
I had a scooter and my husband jokingly called me the milk maid as I
scootered home for scheduled appointments to nurse my baby boy. I had com

and sick.
Second pregnancy I gained a horrendous amount of weight…70 lbs.
I was likely diabetic, but I never took that test. My baby was over 10 lbs.
Third baby, it was a bit easier.
What kept me going? My personality and my pride telling me I could
do it all.
Was I really doing that? No, I’m from a family of three girls and I think
amongst ourselves we competed.
I am now tired with work and three busy boys. Balancing that with a
husband who never asked to be a stay at home dad! I guess he’s come to the
conclusion that is the only way we can make things work.
He does all the school stuff, he gets to all the school activities, and I
try and have my mom there, but yes, I do miss all of that. Looking back, yes, I
have missed an awful lot.
If I was 18 again, I would probably do it all again because I wouldn’t
have known any different.
I love my work and I love my family but it is a bit of a treadmill. At
this point in my career I am trying to make things simpler but kids want you,
patients need you and your husband needs a break.
My mom was a stay at home mom and she went back to school to do
nursing. She had the drive but she didn’t have the same opportunities. I don’t
know how my life would have been different because I always had my mom at
home.
Conclusion
H

onestly, I have no real answers. I just know that it is all about choices. There
may be women who, on the surface, seem to have it all – the job, the
children, the home, the husband – but the bottom line is something gives.
Something always suffers.

Most of the very successful women in medicine are divorced. In fact, divorce
rates among doctors are very high. It is simply impossible to have two full-on
busy careers and have any type of good relationship. That’s especially true if
children are involved.

Only individual people can make choices for themselves as to what they want
and need in their lives. It is not up to anyone else, but rather to each person,
whether to allow the job to give or allow something in their personal life to.
After all, something will, and it is either you make a conscious decision
which it will be, or it will be decided for you and you may not like the results.

Competitive Job Markets

I felt the pressure to work full time and then some or I wouldn’t be doing
enough career-wise. In addition, I felt the self-imposed pressure to both be
competent and relaxed with my skill set.

What I do know is this. The job market was quite competitive when my
career began in earnest (it still is) and I felt like the only way I could make it
in the job and advance would be to work more than full-time. I truly felt that
it was the only choice I could make.

However, I also felt that I was compromising the children. I felt like I wasn’t
there for them when I should have been. However, at the same time, when I
was actually at home with my children such as during maternity leave,

to feel whole and complete.

So, for me, the job was a must. The family was a must too. I still completely
love medicine, and I am completely devoted to my children too. I am grateful
for my husband who completely understands me too. But, what I have
learned is this: all of the different areas of my life are like little gardens. They
need nurturing and they need my presence. And, they are not the only
gardens in my life.

My parents are getting older, and I feel a tremendous responsibility to give

back to them.
I feel like all of the many aspects of my life are full and it is a struggle to tend
to them as they need. However, they are all parts of my garden, and I will
continue to strive to properly tend to them.
In reality, I am actually a pretty hopeless gardener. I never make the time to
really enjoy the process. At the end of it all, there is a question: If you pick a
very challenging career and want to keep doing it, how much of your family
and home life are you willing to outsource? The gardening? The cooking?
Your husband to the nanny or the nanny’s girlfriend? Your kids and all of
their extracurricular activities? Everyone wants to give up laundry and
cleaning!
You actually do have to think about these things. You have to determine what
you are willing to give up. Because if you don’t make that decision for
yourself, life will make that decision for you. And, you might not like the
outcome. Instead, determine how you are going to handle things so that you
can make sure you are good with your choices. You probably won’t be totally
happy since you will be giving something up, but you should make the
choices for yourself instead of letting life decide for you.
I honestly am not ambitious about my work anymore. I see people retire or
fall ill and no one remembers them as they come in for a hip replacement 10
years later. A job is a job. Family, on the other hand, gives enormous
satisfaction even though I may not have looked after it as much as I should
have. I made an effort to work part-time during the teenage years to make
sure the boys didn’t fall off track. They did anyway (and maybe that is just a
part

reached a point of no return with alcohol, drugs, or criminal records.

My decisions have never been easy, and maybe I have made the wrong ones
at times. However, I have done the best I could and I know now where my
priorities lie.

Essentially, there are no easy answers to these questions. There is no simple

solution or easy method of dealing with anything.
I just know that certain careers – certain subspecialties within medicine – are
incredibly demanding. This is especially true of careers that take place in the
operating room. This includes surgeons and support specialties like
anesthesia.
Operating rooms start up very early in the morning. Working mothers will
never be able to drive children to school. They end at very unpredictable
hours, so working mothers will never be able to pick up the children from
school. Someone will always have to cook the dinners. Someone else will
have to do the grocery shopping. Someone else will have to run the
household. Your only other option in this type of career is to spend all hours
of the night running yourself completely ragged trying to shop for groceries,
put together meals, wash clothes, and do everything else. Doing all of that is
going to accomplish only one thing:
“

out the mentor that will be best able to help them accomplish their personal
and professional goals. Attaining a controllable lifestyle was intimately
associated with perceived success. The business literature suggests that it is
not whether someone works full- or part-time that is important. It is whether
or not they can control, within their work hours, their daily activities.

Women have historically played a vital role in medicine and surgery, even
during the times that they were barred from legally practising. American and
Canadian women have faced numerous obstacles and achieved great strides
over the last 100 years. The number of women in surgery is proportionately
increasing, but not to the same extent as the number of women in medical
school. Lifestyle considerations such as the pursuit of a controllable lifestyle
will help reduce this discrepancy.”1

Advice to Companies
If I could give advice to companies and employers, I would love to do just
that. I would say that they:
handle their children and career.
• The employers need to understand that when they offer this to the young
women, they will give back more than anyone could imagine to their
employer.

I would love to ask why operating rooms start at 7:30 in the morning instead
of at 8:30. If they started just an hour later, then this would allow working
parents to get their children to school.

Also why during long operations lasting 6 to 8 hours why no one relieves us
for a bathroom or nutrition break? What about those surgeons who are
supposed to be superhuman and never need to eat or pee? Let alone take a
break for pumping breastmilk? As Donald Trump was quoted saying “that is
disgusting”.

I recently met a mother who had a child in ICU for several weeks. She
child, which ended up being a new one every week. Then, she realized that
1 Can J Surg. 2009 Aug; 52(4): 317–320. PMCID: PMC2724816 The history of women in surgery. Debrah A. Wirtzfeld, MD

each individual had something different to offer and some unique idea that
could help.

One thing that I wish employers could understand is that patients realize we
are human. They know we have personal lives and we need breaks for our
sanity. They know that giving these breaks will ensure we offer the best care
for them.

Several specialists looking after one patient isn’t substandard care. In

obstetric practices in Canada. There were eight different obstetricians in one

practice and over the course of a pregnancy, the patient would meet all eight
of them.

That way, when the woman was ready for delivery, she would see a familiar
face no matter which doctor responded.
The Cancer Clinic has a similar concept that they use with oncologists.
Oncology jobs have a very high burnout rate because of the complex and
emotional cases they deal with. By allowing the doctors actual time off, they
can cut down on the number of burnouts they experience.2
So, this is what I would like to tell those who hire and those who employ:
they need to learn what works best for doctors and the patients. Think about it
this way.
Imagine you are a patient. Which would you rather have?

• A doctor who has been working exhaustively for hours and hours already,
who hasn’t had any time to spend
with their family and who is distracted because their child is home sick.

Or

• A doctor who has had a day or two off, who is fresh from their rest and has
spent time with their children and who has gotten plenty of sleep.

The answer here is obvious. Patients want to know their doctors will do a
good job. Doctors need rest and a personal life to do that. This is what
employers need to understand. Expecting someone to work inordinate hours
and not have any personal life is a good way to ensure no one is happy with
the scenario.

Efforts at changing the institution of medicine, and in surgery in particular,

through quotas for hiring, woman to woman mentoring, and guaranteed
maternity leave, cannot be effective unless the institution is changed to
support the changed cultural view.3

The number of doctors in is Canada rising, as are payments for their services.
$22 billion paid to physicians in 2012.4 Visit the online store to download
these reports:

• Supply, Distribution and Migration of Canadian Physicians 2012

• National Physician Database, 2011-2012 Data Release

Canada had more than 75,000 physicians working in 2012, a 4% increase

over the prior year—and growth is likely to continue for some time. A major
factor for 2012’s growth is the increased number of medical graduates, which
has grown every year since 2001.

And yet, we are more overworked than ever! Wait lists for surgery are longer
than ever in history! Our health care system is cracking.
Having It All
These days, we as women are told we can have it all. It is a progressive
society where women are given just as many opportunities as men. We can
go to college, get our degrees and we can take big steps in our careers. It
seems ideal.

Then, though, at the same time, we are expected to be caregivers. We have:

• Our husbands (and oftentimes, that means caring for another indi
vidual who acts, at least occasionally, like one of the children).

• Our children (who depend on us completely in their early years and then
still depend very strongly on us as they grow older).
• The household (which is always needing something: cooking, clean ing,
laundry, etc.).
• Our parents (who we feel a deep sense of responsibility to, especially as
they grow older).

It’s so much for one person to handle. There’s simply not enough time in the
day to get everything done, and there isn’t enough energy in our bodies to
handle it all.

So, people look at these working professional women and they assume these
women have it all. They have the career and the family. They have the house
and the nice car. They have the seemingly perfect life.

But, as I have said before, and as someone who has been through it for two
decades, there is no way to have that perfect life. Something is going to give
in some way. And, it is up to you to determine what will give as well as how
much you will allow it to give.
4 Canadian Institute for Health Information (CIHI)

made every single day for every single working woman out there. If you look
toward a woman and assume that she has it all perfectly laid out, then you are
only seeing the surface. You aren’t seeing what is actually happening. She is

It may be that she doesn’t work as much as she really needs to and

music recitals. It may be that she doesn’t get to cook dinner for her family.
Perhaps she doesn’t have a husband at home anymore. Perhaps she doesn’t
take care of herself anymore because she just doesn’t have time to go
exercise or get a good night’s sleep.

If you are a working woman, then I challenge you to do this. Decide what
you are willing to give up in life. It will not be a hard decision. However, it is
a decision that you absolutely need to make on your own for yourself. Don’t
let anyone else make the decision for you. Don’t let fate make the decision
for you. Don’t let it fall to a roll of the dice. You are going to give up
something. And, you need to decide what it is in advance. That way, you will
get the results you would prefer. Leaving it up to anyone else or just allowing
the chips to fall as they may will not leave you happy in any way. You will
be

Taking charge of your decisions is the best thing you can do. And is
- cessful career, exceptional children and a strong relationship.5

Getting the Answer

I truly cannot answer anything in your own life. Instead, I can only offer you
perspective, and I hope that is what this book has been able to do for you. By
seeing what someone else has been through, perhaps you can view your own
life and own choices more easily.

But, to get the answers, ask yourself these questions:

• What is the most important thing to you?
• Do you want to juggle a family and a career?
• Are you willing to let something give in one way or another?
• Have you considered all of your options?
• Have you looked into job sharing? Is it available where you work?
Answer those questions and you can get to the answer yourself.
5 Sinoway, E.C. No, You Can’t Have it All. Harvard Business Review. October 2012.

There is an art form to balancing a life, kids, a medical career – and doing it
all without medication – and it is an art form that is balanced on a very
touchy scale. One thing, one little grain of sand, is enough to push that scale
in one direction or another.

operating room and being a mom means a failure on both ends. Yep. That’s
how she feels and I understand why. Then, there are times when things go
right or she receives a heartfelt card from a patient and this changes things.
Then, you go home and your little one stretches out his arms to you and
smiles. And, you think, I have the coolest job in the world and I have this
amazing creature that will one day look at me in awe and be proud of me and
say that “My mummy is a doctor.” That has certainly happened with my
boys.

So, yes, there are days when everything seems like a failure, but none of it
compares to those days when things go so right. So, you have to look at the
positives – look at the amazing children and the amazing things you can
accomplish and you will see that it is worth it all.

I have spent 20 years living on that scale and I know how easily it can be
tipped. I hope through my own experiences, as well as those of the women I
interviewed, you can see that you live on your own scale too. It will never
balance perfectly, but you can decide how it will be tipped. It really is your
decision.

The Eligibility Requirements

I thought it might be helpful to provide you with more information about the
PLP available to physicians in British Columbia. As I mentioned in the book,

parents. However, it does still leave some concerns that have pregnant
women working too many hours or people coming back to the job sooner
than they should have to.

There are certain criteria that must be met in order for this leave program to
even be available. The following are the eligibility requirements:

• The person must have been paid through billed medical services on a fee-
for-service or sessional basis. Or, the person must have been paid for non-
salaried service.

• The pay had to have been in the calendar year prior to the leave re- quest.

• Physicians who had no eligible income in the calendar year may have leave
calculated based on the 12 months directly prior to the start of the leave.
• Anyone who is pregnant, soon to be a parent, adopting, or serving as a
surrogate is eligible for the leave.

So, in other words, your leave is calculated by the amount of money you
made for the last year.
How It Works
Now, let’s talk about some of the details associated with the program. This
gives you an idea of how it works and some of the loopholes that can

• The leave pay will be 50% of your income up to $1,000 a week for a grand
total of $4,000 a month at the highest cap.
• You can choose to start leave up to 11 weeks before the baby is due or
before the placement of the child in case of adoptions.

birth of the child.

• If you work for 15 hours or more in a week, then you will only be
• If you do not return to work after the 17 weeks, then you will need
As you can see, there are some very strict rules on how the money will be
given out. However, one nice thing is that you can break up the 17 weeks
the placement of an adopted child.
How to Apply
apply and there are rules about this as well. They include:

• You must complete, sign, and date an application for PLP no more than
eight weeks after the birth of your child or the placement of an adopted child.

• The application will need to be approved and then you will need to declare
the money you have earned through your practice as well as through other
maternity or parental leave programs. This declaration

• Payment will not be paid until the information above has been sub mitted.
• Payment is only made through direct deposit to bank accounts and in no
other form.
Again, you have to cross your t’s and dot your i’s in order to get the
will be delayed or you may not receive them at all.
If you are in the medical profession and you are considering having a

you will be able to take time off to spend with your newborn while still
getting paid. However, keep in mind you can only receive half of your
income and there is a limit to how much will be paid out. Plus, there is also
only 17 weeks

that before you have the baby or do your best to wait and use all of it after the
baby is born.

While I do think all of this is a step in the right direction, I am not sure it is
the full answer. In fact, the bottom line is that since it only pays out 50% and
there is a cap per week, many people cannot afford to not work. So, they
don’t get to spend much time with their new baby before going right back so
they can make money. Since it has a limited time frame, many people who
want to spend more time with their new child are forced to make the decision
to quit.

It is not the perfect solution, but at least it does offer something that was
better than what was available when my children were born.
Appendix
Rinaldi, Jessica.Working moms have more successful daughters and more
caring sons (Harvard Business School study) Globe and Mail July 10, 2015
Miller, Claire C. Mounting Evidence of Advantages for Children of Working
Mothers. New York Times May 15, 2015
Gladwell, Malcom. Outliers,The Story of Success. 2008
Johns Hopkins School of Medicine. Upper Respiratory Infection (URI or
Common Cold) in Children
Grose, Jessica. Male Executives Don’t Feel Guilt, See Work-Life Balance as
a Women’s Problem (Harvard Business Review) July 2015
Rogers, Shane. The Career Advice I Had at 25. Queensland Editor at The
Australian.
Rollman, B.L. Medical Specialty and the Incidence of Divorce. New England
Journal of Medicine 1997; 336:800-803
Miller, Claire C. More Than Their Mothers, Young Women Plan Career
Pauses. New York Times, July 22, 2015
Balch CM, Shanafelt T. Combating stress and burnout in surgical practice: a
review. Adv Surgery. 2010; 44: 29-47
Generation Status: Canadian born children of immigrants www12.statcan.

Pyrillis, Rita. Democrats and Republicans Agree-Workplace Flexibility Key

to
-
crats-and-republicans.

Working Mothers Research Institute.

Sinoway, E.C. No, You Can’t Have it All. Harvard Business Review,
October 2012. hd-ds@statcan.gc.ca
The Feminization of Medicine and Population Health Susan P. Phillips, MD,
MSc, CCFP; Emily B. Austin, MSc
Weg, Thomas. Ann R Coll Surg Engl. 2006 Sep; 88(5): 429–432.
Teaching and Assessing Surgical Competence WEG Thomas
Personal Finance | Tue Dec 24, 2013 7:05am EST
Related: Money
More men get alimony from their ex-wives By Geoff Williams

Reproductive health and burn-out among female physicians: nationwide,

representative study from Hungary
-

square 4, H-1089 Budapest, Hungary

2 Department of Obstetrics and Gynecology, University of Szeged,
Semmelweis st. 1Szeged, H-6725 Szeged, Hungary
3 Health Services Management Training Centre, Semmelweis University,
Kútvölgyi st 2, 1125 Budapest, Hungary

The electronic version of this article is the complete one and can be found
Obstetrics & Gynecology:
May 2009 - Volume 113 - Issue 5 - pp 1008-1017
Original Research
Associations of Unscavenged Anesthetic Gases and Long Working Hours
With Preterm Delivery in Female Veterinarians
Shirangi, Adeleh MPH, PhD1; Fritschi, Lin MBBS, PhD2; Holman, C
D’Arcy J. MBBS, PhD1

Why Gender Balance Is Important to Us :: Mule

Why Gender Balance Is Important to Us. Posted on January 08, 2013 by

Mike Monteiro. Q: Mule has a pretty balanced gender split. Is this a
conscious decision?

BoardLinks | Why is gender balance on boards important?

Gender equality is about enabling women and men to reach their full
potential
-
ticipation. Women’s equal participation in high level decision-making roles is
an important and visible form of participation.

Why is gender balance important? | AusGovBoards

Gender equality is about enabling all people to reach their full potential to
-
pation. Women’s equal participation in high level decision-making roles is an
important and visible form of participation.

Academic Outcomes of Public and Private High School Students: What Lies

Behind the Differences?

by Marc Frenette and Ping Ching Winnie Chan
Social Analysis and Modelling Division, Statistics Canada

The case for publicly funded child care in Canada - The ...
www.theglobeandmail.com › Life › Parenting

Number of doctors in Canada rising, as are payments for their services $22
billion paid to physicians in 2012
Visit the online store to download these reports:
• Supply, Distribution and Migration of Canadian Physicians 2012
• National Physician Database, 2011-2012 Data Release

September 26, 2013—The number of physicians in Canada is at an all-time

high and payments by government health plans have continued to rise,
reaching $22 billion in 2012, according to the Canadian Institute for Health
Information (CIHI).

The Status of Alternative Payment Programs for Physicians ...

Healthy Living
Women Choosing Careers before Motherhood Are More Vulnerable to
Postnatal Depression
Mar 21, 2012 02:24 PM By Christine Hsu
BMJ 2015;350:h706 Divorce rates among female physicians.

Can J Surg. 2009 Aug; 52(4): 317–320. The history of women in surgery

Debrah A. Wirtzfeld, MD
Yale J Biol Med. 2008 Dec; 81(4): 203–204. Published online 2008 Dec.
Women Surgeons — Still in a Male-Dominated World Julie A. Freischlag,
MD
About the Author
A
nna Sylwestrowicz is an anesthesiologist and a mom on Vancouver Island.
She was born in Poland, grew up in Nigeria, Newfoundland, Manito
children and their dog. Her parents continue to encourage her, but their focus
has shifted to their grandchildren and it’s their turn to try and impress them.