Not too long ago, my daughter, you asked me what you should be when you grow up. Over the years you’ve entertained the normal litany of ideas- artist, teacher, and even a doctor like your mom. I will answer your question the same way my mother did. You can do anything, and I will be proud. You are getting to an age when big life questions are starting to enter your awareness. Even as your limbs lengthen and your cheeks lose the pudgy contours of early childhood, your ability for self-reflection and discovery are developing. I hear in the recounting of your school days the initial thought processes of decisions that will affect your future. What kind of friend and sister and daughter am I and what kind would I like to be? What kind of work ethic will I have? What are my strengths, weaknesses, likes and dislikes? What should I be when I grow up?
You’ve watched our family transition through different households, states and job descriptions. You’ve seen your father go to work close to home and you’ve experienced his absence on deployment. You’ve seen me work long days and nights in a hospital, shorter and fewer days in a clinic, and even experienced having a mother whose energy is entirely focused on home and family. You’ve seen me work and parent in concert with your father, and you’ve seen me cobble together resources to work and parent alone. I wonder how all these influences will guide you. I see your aptitude for science and your natural propensity to leadership and I wonder if you will ever decide to be a physician like your mom.
As you will learn when approaching any decision, my daughter, you must weigh the good against the bad, or as many doctors will describe their daily choices; evaluate the risks and the benefits. Just as my mother riding the crest of women’s liberation in the 70’s didn’t know what the world would hold for me, I do not know how the world will receive you when you embark on your professional career. Additionally, I cannot know how the world will accept you as both female and mixed cultural background. Besides your female gender, you will have an additional “otherness” to contend with that will be unfamiliar to me. I can tell you that it has only been during my career that the prevalence of women in medicine has started to equal that of men. I can also tell you that despite the growing number of women in medicine, we are still undervalued, underpaid, and underestimated professionally. I hope in the years to come that gender wage gaps will close and that women of all backgrounds will be valued for their unique and relevant perspectives.
As a woman, you must take other factors into consideration when you weigh your professional goals. Will you be a wife? Will you be a mother? Will your spouse be flexible or demand traditional family roles in your household? These, sadly, are still questions that women from all walks of life must consider. Despite huge inroads into the professional world, women doctors are still expected to split their attention between home and work, patient and child, boss and spouse. There are increasingly more family-friendly scheduling choices for physicians with the advent of hour restrictions, nocturnists and hospitalists, and slowly increasing acceptance of part-time work schedules. You will likely have the income to outsource some of your domestic duties, but your heart will still lie heavy when you miss your child’s bedtime.
Becoming a doctor is a long road with many hours of study and work. It requires you to assimilate an astounding breadth of knowledge and experience. At one point in time the title of “doctor” itself commanded respect, but now the status of the “white coat” is yellowed and diminished. Mistrust of medical providers dilutes the respect that doctors once enjoyed. Now it is common to have your long hours of training questioned, and your integrity mocked. It will take additional fortitude to sidestep these attacks, and to avoid the doubt that will feed into imposter syndrome. Additionally, the practice of medicine itself is changing. Doctors must not only contend with the negative voices among their own patients, they are increasingly asked to defend themselves against the bureaucratic machines of insurance companies, proving repeatedly the validity of their knowledge and decision-making skills by completing Sisyphean mountains of paperwork. The precious time is spent with the patients they love is capitalized on and traded for dehumanizing clicks of computer keyboards.
My dear daughter, you must ask by now why do I practice medicine at all? What draws me to it? So far, I have painted a bleak picture, and based on this I would wholeheartedly steer you far away from a career in medicine. And yet, you’ve seen me walk away, and walk back again. The phases of my life as a woman and as your mother have pulled me through different phases in my career. But the power of this vocation has gravitas to it, much like the gravitational pull of the moon drawing the waves to the shore. It is a calling to practice medicine, my daughter. The love of healing and human connection provides a strength that fortifies you against the challenges that being a woman doctor presents. All the negatives are quickly eliminated by one small success; a cured infection, a healed wound, a comforted patient, a life saved. This is the WORK of being a doctor. It is the lasting effect you can put into the world- positive ripples that start with one patient and spread outward through a family and then a community.
If you asked me if I thought you should be a doctor, I would say no and smile in relief as you forged your own path. I would enjoy watching you grow, and I would share the joys and challenges of being a woman as you journey through life. If you told me you felt a calling to be a doctor, I would nod my head in understanding, hold your hand tightly, and walk alongside you on this rocky road. I would celebrate as you answer your calling, and as and you demonstrate the grit and resiliency of being a woman in medicine.
Dr. Alexandra Pinon, MD is a General Pediatrician, Navy wife, mother of four and a contributing author to the “Chronicles of Women in White Coats”. She lives in San Antonio, Texas with her family.
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