Torn in Half

We also had a tremendous amount of enthusiasm about receiving our training here. We were both medical school graduates from Greece and had a lot of interest in the languages and lifestyles of other countries. Our twin daughters were born in March 2003, less than a year after we entered the States. Given our limited support system and my excitement about being a mother, I decided to postpone my academic plans and instead enjoy life as a "stay-at-home" mom. This was not an easy task, but it became the most rewarding and fun job I will ever have.

However, after spending 2 1/2 years with the twins at home, I realized that despite how satisfied I was in my role as "just a mother," there was something missing. I was brought up to believe that I could have it all: a great career, relationship, and family. But my mother (who was also a working mom) did not tell me the ugly truth about why it is difficult for women to prioritize personal life and work.

Now, as with a few other psychiatric residents in our program, I have 2 full-time jobs-I am a second-year psychiatrist-in-training and a mother of 4-year-old twins! I was lucky enough to connect with other resident-mothers, and it was very encouraging to share experiences (and motherhood tips) with them. I realize that I am not the only one who wakes up at 5 am, makes breakfast with her eyes closed, and puts on makeup while driving to work.

Some resident-mothers were even more courageous and became pregnant during residency. I have a great deal of admiration and respect for these women because I do not think it would be fun to work all night with subsequent morning sickness and ice-cream cravings.

How do we manage to multitask? Being both a mother and a resident is a tough combination. How do we balance these 2 roles and find the energy to take care of ourselves as well? And how do we find the strength to go on when this dual role becomes overwhelming?

It's a tough job...
What I have learned from other resident-mothers is that each has a special way of reconnecting with her children when she returns home. All resident-mothers know that as soon as they go home after a long day at the hospital, they have to "shut off" the resident role and become a loving, calm, and ready-to-play mom-you must be solely devoted to your family's needs (helping with homework and extracurricular activities, or just being with them). Although it feels great to return home to someone who has been missing you all day, sometimes it is not easy to meet all of your children's needs.

When you are a resident and a mother, returning home does not mean going straight to bed, having a long bath, or having dinner; it means starting your second job. What all resident-mothers have in common, besides sleep deprivation, are feelings of excessive guilt. In my case, I am fortunate to have a husband who, despite his hectic schedule and long work hours, has always been with our kids during overnight calls or unexpected ear infections.

I do not think you can really be a resident and a mother without having feelings of guilt. Actually, guilt becomes our middle name. How does a woman achieve a strong sense of pride and happiness when she is also consumed with feelings of guilt because she is constantly forced to make a choice between the 2 things that bring her joy-work and family?

I am sure other resident-mothers understand how it feels to be at work while worrying about your family and their health. And unfortunately, when you are with your family, you worry about work and getting ahead. I al-ways have this nagging feeling that I am not doing enough to satisfy both home and work obligations. These feelings keep me wondering whether I have made the right decision, and they diminish the pride I feel in my choice to be a member of the working society.

Guilt is something that we always carry with us, from the moment we wake up, until the time we go to bed. For me, it begins the moment I say goodbye to my kids in the morning, and it follows me for a large part of the day. I have developed the habit of mentally replaying the early morning scene, but I am unable to shake the guilt, even when I tell myself that I am doing the right thing and that my daughters will be proud of my choice to be a productive and ambitious woman. It stays with me when I am at work and am trying to remember what activities my children have at day care and how much of their lives I am missing. And sometimes, when I finally go to bed and think about the day, I do not feel guilty about my children (or my husband); instead, I feel guilty about myself and cannot help but think that I deserve some time alone for pure relaxation or fun.

It isn't always easy
One day I was returning home late in the evening after a busy short call. I was tired, hungry, irritable, and had to do the final preparation for a presentation the next day. When I arrived home, I faced a messy living room and unwashed dishes in the sink. My husband had to go because he was running late for his night shift. My daughters were so excited to see me and wanted to share with me how "beautiful" butterflies are and how "Anna" (one of their peers at day care) spilled their chocolate milk.

I decided then that they should go to bed early and quickly started their bedtime routine. "Here is your milk, drink it up, brush your teeth, go to bed!" But my daughters reminded me that I had forgotten to read them a story. I gave in and began reading the first book I could find. "Hey, this is not my favorite book, mommy," Eleni complained. Maria added, "I want the Elmo goes to the doctor book." I was still in my scrubs and now had a headache. They started to argue about what book mommy should read.

I tried to stay cool and negotiate by choosing another book. "This is not fair," Eleni stated. Just then Maria realized that she had forgotten her "precious" pink hat at school and suggested that I should go and get it! By now, images of the dirty dishes in the sink and the next day's presentation popped into my mind, and I lost my cool.

As fast as I could, I put them to bed, covered them, and announced in a loud voice that they would not have a bedtime story. They were shocked that mommy did not follow the usual routine, and I am sure that in their childish minds they could not find a good explanation for my strange behavior. On my way out of their room I heard Maria crying and calling for me, and then I heard Eleni's voice cry, "Laura, I want my Laura."

Laura is a teacher at the day-care center and has been involved in the care of my children for the past 2 years. She is remarkably sweet and loving and has supported me in many ways. My daughters love her, and I feel very grateful that she is a part of their lives. Eleni and Maria spend at least 8 hours with her each day.

When I heard Eleni calling out Laura's name, it felt like I had been kicked in the stomach; then guilt, my old friend, came back, and this time it was intolerable. I ran back to their room, quickly reassured Maria, and turned to Eleni, who looked scared and upset. I tried to reassure her, but she kept crying and calling Laura's name, refusing to come to me.

It took about half an hour to calm them down, but I am not sure how long it will be until I forget that night. There I was, the working "omnipotent" mom, exhausted and irritable, discovering that someone else was more important to her kids than she was.

Being a mother and a resident is very tough, and I am not sure I would have the courage if I had to do it over again. After 2 years as a resi- dent, I do not know if I will ever be able to conquer my feelings of guilt, although I hope to learn how to deal with them. Until then, I have learned that to manage my guilt, I have to accept my choices and feel good about them. When I am happy, my family is happy.

I am hopeful there will be a day when I will be successful in my search for the "perfect" balance between work and family, sans guilt. And I won't be a resident forever. In life after residency, I hope to have more time for my children and for myself.