Thread by @lkshawn

I have been thinking a lot about the @nytimes piece on #womeninmedicine . On the surface that article could have been written about me. Friends &family have said I have the ultimate work/life balance, but they don't understand the guilt & frustration that came with it (thread)

@nytimes 2/I was (am) that super smart, self motivated, high achieving person who became a doctor. 1st choice college, med school, residency (EM), & fellowship (Tox). And now I only work per diem in the ED- not a bad thing, but not where I thought I'd be. How did it happen?

@nytimes 3/ I got pregnant in my 2nd yr of fellowship. I was the first female fellow in a decade to be pregnant during training. People were supportive, but after watching how my pregnant co-residents were treated I assumed my pregnancy was a liability on the job trail

@nytimes 4/ I was due right after fellowship ended, I was afraid to negotiate a later start date for maternity leave. I didn't have anyone to help guide me on these things. I felt very alone. My training told me that trying to get into the boys club was better than advocating for myself

@nytimes 5/The added stress was that my husband was a jr corporate law associate working 7d a week- sometimes sleeping on the floor of his office. If I wanted to work, I would need 24/7 full time live in help. We didn't have the space in our apt for that. family wasn't a real option.

@nytimes 6/It all felt overwhelming and impossible. So I ended up finishing fellowship w/o a job. I fell off the track. People told me how lucky I was to have all this time with my baby and it was great but I felt like a failure. I was home for almost a year until I got a part time job.

@nytimes 7/I was working 0.6FTE in an academic EM program and for a while it was great. I loved the people there. It felt like a great fit until I started hitting walls.

@nytimes 8/I had my 2nd kid and was fortunate to take a 5mos maternity leave, but the downside was that when I came back it felt like I was forgotten. It was harder to get lecture spots because I wasn't Core Faculty. I would ask about committees but often was told I wasn't needed

@nytimes 9/The 45min commute each way started to feel longer. I had told myself it was worth it because I was doing some academics, but then it felt like I was barely doing that. Coupled w/ a culture of only valuing the $ we were generating & asking us to do more w/ less. I was breaking

@nytimes 10/The moment hit me at #FIX18. The talks at this conference can make you cry, think, feel inspired. But I was crying out of sadness. I couldn't even talk about the conference with anyone for days. Then I had realized what it was-

@nytimes 11/ I was watching these women, many of whom were moms, killing it at their careers. Their life was chaotic &stressful, but they had something they were passionate about and the support system to help them do it

@nytimes 12/I have a terrific and supportive husband, but his job is demanding and crazy. We talked about hiring a second nanny to help me out more, but that felt overwhelming and ultimately the mental load of managing multiple people would fall on me.

@nytimes 13/ The more painful truth I also realized was that there wasn't anything in the traditional academic medicine framework that made me want to disrupt my life further, add more chaos. It was not what I imagined myself ever thinking, but it was the truth.

@nytimes 14/ So I made an exit strategy. I started investigating per diem work closer to my home. I signed up for consulting gigs. I give my chairman 6 months notice that I would only stay on as per diem. I was scared but hopeful

@nytimes 15/ So now I work per diem. The upside is that I fell back in love w/ EM, but I feel guilt over the fact that I'm not nearly working to my full potential. But- this is a transition/ a needed reset. The door to academics likely has closed, but there will be other opportunities.

@nytimes 16/ Sometimes I wonder if I had a had the real practical support & sponsorship during my training- would things be different? Maybe, but I'd probably still be stuck making tough decisions about childcare/finances that don't seem to affect men nearly as much as women in medicine