Professionalism

I made the call when BG vomited for the third time the three ounces of formula we’d just given her: She’s not going to daycare tomorrow. Which mean that I need to call in sick.

Residents don’t call in sick. And they especially don’t call in sick by proxy. But the thought of my daughter crying for comfort and a hand to hold, alone as they caregivers at her daycare are busy for the moment looking after other babies, seems inherently wrong. We have ten sick days for the three or four years we’re in residency. My case is a little different in that it’s four years instead of three, and whether or not the sick day counts toward the 10 depends on what service I’m on. Regardless, it’s about three sick days a year.

Calling in sick is a formal process in which I email no less than eight people to inform them. Usually nobody emails me back; I keep any emotion behind the petition minimal as it’s going to evaporate into the either anyway. But some vulnerability must be admitted in order to make that selfish, last minute request be honest but also justified.

“My daughter is sick. She can’t keep down fluids. I worry for her safety in the care of daycare or a last minute sitter. I’m trying to avoid a situation in which I have to bring her to the hospital and have them start an IV to get her rehydrated.”

My email is titled “clinic absence, 2 of 10 remaining” as a reminder to myself and my tally. I tsk at the number. Already two absences and it’s only my first year in dermatology.

Why any of this matters is because of the rules that determine if a resident is to be considered “board eligible.” You are allowed 60 total days away for any reason. Recently that number changed to 70 if the extra days are used for paternal leave. So 70 days for vacation, illness, family emergency, funeral, personal time, recovering from surgery, anything. I am trying to budget for a situation in which I have another child in residency.

Parental leave is six weeks in residency, or 30 days, which eats up nearly half of your time. Still, I remember with BG how raw I was for a number of weeks following my unplanned C section and her birth. How it took four weeks again before I felt like something close to normal.

Many people for this reason wait until after residency to start a family. I’m about to turn 32, and will be 35 when I’m finally board certified. Several mothers start happy, healthy families way into their late 30s and even early 40s and beyond. So why didn’t I? Because for all of those “advanced maternal age” parents, there is at least statistically a greater number of miscarriages, genetic and medical complications, and inability to conceive. I know myself well enough to know that such would be emotionally devastating. Im trying to protect myself from heartbreak that I know I’m not strong enough to bear. Some are fine, and others aren’t.

BG moans with little shaking sobs and looks at me as if to say “why?” I draw up a syringe of Pedialyte to trickle into her mouth. She sucks it down like a baby bird and cries for more. My cursory research said no more than 15 mL in 5 minutes to start, but I cave and give her more, praying that she keeps it down this time.

I’m already the resident who, despite her best efforts, shows up five minutes late to clinic as she can’t seem to drop off my kid at daycare any faster. The one who is constantly over the 24-hour period that’s stipulated for completing her clinic notes, as when her job as a resident doctor is over, her second job as a mother begins. I imagine at the faculty meetings that I’m something of the problem student, something I’m in no way used to being. I struggle with the seemingly inherent incompatibility of my job as a mother and as a physician.

I’m holding up my phone letting BG indulge in Cocomelon despite my usual reservations about screen time. BG’s eyes get heavy and she turns her head away, finally drifting off to sleep.

Maybe this will cost me a fellowship. Maybe I’ll have to extend my training. Maybe this makes me… unprofessional. I cringe at the word, but remember the words of my PD: “Sometimes you’re just going to disappoint people, and that’s ok.”

Professionalism, the unspoken price of motherhood. If that’s the case, so be it. I’d pay for it a hundred times over for my daughter.

Being unashamed of that choice is what I need to work on.