The Doctor as Single Parent

 

by Alison Delory

The Medical Post

March 8, 2005

While marriage breakups are becoming common, raising kids as a single parent isn't getting any easier and huge time demands have doctor-parents suffering burnout.

Dr. Lorna Adams says at the end of her marriage she felt like she was in a wind tunnel. "I needed to just put my head down and keep going and not look up too much, or I would get blown off course. I couldn't continue to work full time and raise three children if I looked around too much."

It was 1992; her son Dylan was four, daughter Leah was six and daughter Kaili was 10. She was also managing a New­market, Ont., family medical practice, and says she just tried to think about how to get from point A to point B and be there in an appropriate manner for her patients and her kids. "I thought initially it would take about six months for me to start feeling like myself again, but it took an awful lot longer than that."

Today there are likely more single parent doctors than at any other point in history. Ac­cording to Dr. Mamta Gautam, an Ottawa psychiatrist who specializes in treating physi­cian-patients, with about half of all marriages now ending in divorce, it's no surprise doctors are part of the demographic.

"Thirty years ago, reviews showed while many doctors were unhappy in their mar­riages, most did not leave," says Dr. Gautam. This was partly due to high social visibility, she says, but also be­cause doctors were men who could "escape" into their work. But times have changed, di­vorce is more socially accept­able and there are more women doctors with the finan­cial means to support them­selves without a husband.

While it may be a growing trend, raising kids as a single parent MD is not getting easier. About one-quarter of Dr. Gau­tam's patients are single parent doctors, and she says they're commonly suffering from burnout, with huge demands on their time, and from guilt.

"Becoming a single parent through divorce or death is generally a shock, and a large amount of grief comes along with the territory," says Dr. Adams, who notes the grieving period signified the end of a lot of her hopes and dreams. There were also the practical concerns of how to get chil­dren to three different soccer games in three different towns all at the same time. "You can't feel guilty because you can't watch all three of them at once. You must decide that you will ask for help in car pooling and you will reciprocate when you can, if you can."

Though she holds the most powerful position in public health in Canada's largest province, Dr. Sheela Basrur, Ontario's chief medical officer, also puzzles over how to make time to take her daugh­ter to judo classes while managing issues like the threat of avian flu. Dr. Basrur is a sin­gle mom to 14-year-old Simone, and con­stantly struggles with work-life balance.

I wish I had more time at home. I wish I could be more 100% present when I am home," says Dr. Basrur. Managing the SARS crisis of 2003, while still the medical of­ficer of health for Toronto, Dr. Basrur found herself working 18 hours a day, seven days a week--for 14 weeks running.  "It was the largest cri­sis I faced in my life ... not just my career," says Dr. Basrur. "It was an international health issue, the me­dia attention was re­lentless and the organizational response enormous. We were literally dealing with life-and­ death issues every day."

Dr. Basrur says she is lucky Simone's father lives just 10 minutes away, and that their arrangement since separating in 1999 has been that either will step in on short notice when the other is too busy to it all themselves for longer. Women are busier, as kids of­ten turn to their mothers for nurturance and help with homework or projects," says Dr. Gautam. Another interest­ing note, says Dr. Gautam, is that women who have to leave work early report they can be accommodated but are unsup­ported, left out of department matters and decisions, and subtly discriminated against. Men who leave work early to care for kids are seen as heroes and fabulous dads.

"One of the most difficult things for type A personality MDs is to acknowledge when it is impossible to do it all," says Dr. Adams. Sacrifices have been made by her and her chil­dren. "I could no longer con­tinue to deliver babies, which was the thing I most loved about practicing medicine. When two kids were offered spots on the rep (elite level sports) team, I knew that would simply be impossible, and had to disappoint them terribly. You have to learn your limit and stick to it."

Dr. Gautam is a strong pro­ponent of asking for assis­tance, be it at work, in terms of child care or from a support system of relatives, friends and neighbours. Accept all offers of help," she advises. "Doctors are better at giving help than receiving it."

Dr. Basrur says she's fortu­nate to have 200 staff. "In an or­ganization, especially when you're the head of it, you have people you can delegate to," says Dr. Basrur. "From time to time there are command per­formances, such as a cabinet meeting, but I'm lucky to have staff that will step in .... Peo­ple are cognizant of my com­peting demands. Also, I can call in from home, or use e­mail to keep the river flowing when I'm officially off."

PARENTAL ADVICE

Advice from Dr. Mamta Gautam for single par­ent doctors feeling overwhelmed by demands:

         Acknowledge it is harder and give yourself credit.

         Identify what you need from work and ask for it, e.g., reduced or flexible hours.

         Approach others from work who are in the same situation. Seek advice and mentorship, share information and resources.

         Get good, reliable child care. Pay well to keep your caregiver happy to be with your kids . Find good babysitters; use them without guilt.

         Organize and streamline routines-morn­ings, after school, dinner, homework, bedtime.

         Have a support system in place-relatives, friends and neighbours.

         Organize kid exchanges with friends and neighbours. Also, organize time with other friends and their kids. You tan enjoy time with a friend and the kids can enjoy new dynamics with other children.

         Don't try to do it all and be an "Irondoc" (Irondoc is Dr. Gautam's new book on balancing life). Set priorities and let some things remain undone. There will be lots of time to clean and organize once the children are older.

         Hire people to do things you do not enjoy, e.g., cleaning, gardening, shoveling, cooking. Take this found time to spend with the kids hav­ing fun, exercising or doing a special activity .

         Try to give each child one-on-one time, e.g., a special bedtime ritual.

        Ensure there is time for yourself at the end of each day. Get the kids to bed early. When they are older, let them know you are only avail­able for them until a certain time and that you need time for yourself.