When I entered medical school, I had the same naive and universal goal as young future physicians in short white coats everywhere. I wanted to connect with patients and help them make meaningful changes in their lives. I wanted to sit with them, ushering them through their most challenging moments.
Then came residency: gruelling 30-hour call shifts, 80-hour workweeks, and inpatient hospital rotations carrying three pagers and two dozen patients. As a family doctor in training, I was doing what I always wanted: bearing witness to the most meaningful moments in my patients’ lives. That included births and deaths, serious diagnoses, illnesses and recoveries. But there were limited hours in the day and limitless tasks on my to-do list. So I focused on being efficient, the metric that every resident is secretly graded on more than diagnostic acumen or bedside manner.
It turned out that I was good at being efficient. I’m a New Yorker. I talk fast and I walk fast. My brain likes working in parallel on multiple tasks at once, and I figured out how to page a consult, check a potassium level and scarf down graham crackers that I had stolen from the nurses’ station all at once.
I became addicted to the mental high-fives that I gave myself as an efficient working parent. I could simultaneously pack snacks, check the hours for the children’s museum and shove mouthfuls of oatmeal into my toddler’s mouth.
Then, at the end of residency, I had a baby, and I was back at work after five weeks. The multitasking skills I had acquired were invaluable as I slogged through those early months as a working parent. I bought a car adapter for my breast pump so I could pump on the way to and from work. Even the dreaded 30-minute infant nap was enough time to throw a load of laundry in the wash and take half a shower.
As time went on and residency turned into a grown-up doctor job and one baby turned into two, I became addicted to the mental high-fives that I gave myself as an efficient working parent. I could simultaneously pack snacks, check the hours for the children’s museum and shove mouthfuls of oatmeal into my toddler’s mouth. I could get through all of my patients in a day of clinic, answer the messages in my in-basket and complete all of my charts, rushing out no later than 5:30 to make it home for dinner.
Challenges of parenting
But at home, I felt like all I was ever doing was telling my kids to get dressed or get undressed, to move from one place or another, to get in the car so we could go do something fun. At work, I was half listening to my patients’ deepest fears and anxieties while I simultaneously ordered their mammograms and cholesterol tests.
One day last spring, our friends visited us in San Francisco from New York with their twin toddlers. (If you ever want to feel bad complaining about how hard it is to parent young children, hang out with the parents of twin toddlers.)
As we walked to the playground, a walk that was approximately half a mile and took almost an hour, we chatted about the challenges of parenting young children. My friend posed the problem as an issue of different speeds. “I’m at work all day running around, trying to get things done as quickly and efficiently as possible, and then I get home and it’s hard to turn that off, to switch to toddler speed.”
Patience was missing
That night we went to see one of my favourite local Bay Area musicians, Scott Gagner, play a show at a cosy, velour-clad bar in the Mission. Gagner is one of the finest purveyors of the “Dad Love Song” genre, and that night he played Hummingbird Heart, one of my favourites, about trying to get his young son to wind down at the end of the day. But the mantra of the song, “And I try to slow down your hummingbird heart,” intended for his son, resonated as a call to action for myself.
Patience was what was missing in my life. It turns out that the seedy underbelly to extreme efficiency is that it creates a ruthless way of moving through the world that can feel devoid of joy, connection and spaciousness.
I tried to make a change at home, internalising the idea of shifting speeds when I walked in the door. When my toddler wanted to linger an extra few minutes to try to put on his own pants rather than letting me help him, I tried to take deep breaths and be patient while he fumbled. I sat and coloured with my 5-year-old an extra 10 minutes, even if it meant dinner was getting cold. We started taking Sunday mornings to laze around the house in pyjamas, making French toast and building Magna-Tiles towers instead of rushing off to the children’s museum.
I try to convey to them [residents] that the joy in doctoring, much like the joy in parenting, is in the small pauses when you help someone feel heard and supported.
My time with my kids started feeling more rewarding, so I thought I’d try to take some of the patience that I had been so desperately cultivating at home, and bring it back to work.
During my residency, one of our most beloved teachers pioneered a column on the sign-out sheet called “ascriptus humanis,” a made-up Latin term that was meant to be an opportunity to share something you had learnt about patients, totally apart from their disease. It was a way to help us remember that we were healing whole people, not just treating diseases. Somewhere along the way I had forgotten about the ascriptus humanis.
I started asking patients more about their families, their hobbies and their passions, to find out what was important to them. If they wanted to take an extra few minutes going further back in the history of their knee pain than was necessary, I would let them, rather than trying to move the conversation forward as efficiently as possible.
Efficiency addiction
As a family doctor, I see prenatal patients and young children. The templates for my visits include questions about a lot of things — symptoms of labour or pre-eclampsia, milestones for growth and development. But they don’t include anything about how my patients are actually doing. So now, I ask them.
When I’m teaching residents, I see the efficiency addiction in their bloodshot eyes and frantically typing fingers. I try to convey to them that the joy in doctoring, much like the joy in parenting, is in the small pauses when you help someone feel heard and supported.
I’m not perfect. I still get annoyed when my little ones ask for yet another sip of water at bedtime. And I still rush through clinic visits sometimes, intentionally not asking how patients’ kids are doing because I need to get home to my own. But I’m trying. And on a good day, if I breathe right, I can try to slow down my own hummingbird heart.
— Washington Post
Alison Block is a family doctor, mother of two and writer living in the San Francisco Bay area.
