Sound of Silence: Why Doctor Moms are Burning Out 13


 

 

This week is ACOG’s Physician Wellness Week, dedicated to raising awareness and emphasizing the importance of physician wellness. This piece describes a common source of burnout for doctor moms, the illusion of “having it all.” Details of this story have been changed to protect privacy.

 

By Georgia Ragonetti-Zebell, MD

 

I receive the announcement with less than a week’s notice. It comes home with my son’s preschool paintings. “Your child’s birthday blessing will be Monday at 8:30am.”

 

I sigh. It always feels like a slap in the face when school events are scheduled during the day with such short notice. I know many of the other mommas stay at home, but my schedule is done months in advance to plan for surgeries and call days and office patients. I usually miss out on these special events, like class plays, Muffins with Mom, etc.

 

“Aren’t you off that day?” my husband says, peering over my shoulder. I check my calendar, and he’s right…sort of. I’m post-call, meaning I will work the 24 hours before, ending my shift eight hours into the day at 8am. That should give me just enough time to make it to the preschool for the birthday blessing.

 

“Tomorrow is…my birthday!” my little one says. “I know!” I beam back at him. “On Monday, I’ll come to your school, and we can have cupcakes, ok?” “Yay!” he yells as he runs off. He knows I’m a doctor, and that I have to work a lot. He doesn’t quite understand what I do.

“Like when you go to the doctor- except I’m a doctor for mommies. I help them get the babies out of the their tummies,” I tell him.

“So, you fix the babies? How do they break?”

Um, maybe I’ll try to explain it again when you’re older.

 

Sunday afternoon comes around, and I’m sitting at the nurses station when a patient walks up to the desk. “I haven’t felt my baby move in the last two hours.” She fills out the info sheet, and a nurse quickly moves her to a room. I watch the monitor in the nurse’s station, waiting for the heart rate tracing to appear. I can hear the Doppler whooshing loudly across the hall as the nurse searches for the baby.

 

The call light rings. “Can you come with the ultrasound?” My heart sinks, and the prayers begin running through my brain. “Please let there be a heartbeat. Please let there be a heartbeat,” I think as I wheel the machine into her room.

 

I ask her for more details as I spread the warm ultrasound gel on her belly. I listen to her story as I scan around, looking for movement. I try to keep her talking as I search. There is the head, low in the pelvis, as she is a couple days past her due date. The spine and ribs appear as I move the probe up along baby’s body. And, there, where there should be movement, there is none.

 

“Can you find his heartbeat?” she asks me. “I’m having a hard time.” I say. I keep scanning, knowing that I won’t find what I’m looking for, but not ready to let go of hope just yet. I see the stomach, liver, bladder and legs, all still, inside momma. As much as I want to keep searching, as much as I want to say “There it is!” I know I have to tell this momma the news that she is dreading.

“I’m so sorry. There is no heartbeat.”

 

Labor and delivery is full of sounds. There is the galloping of fetal monitors. The random beeping of IV pumps. The occasional alarm of a blood pressure cuff. The hum of computers and the chatter of patient assessments and reports. There is the incessant click-click-click of the computer mouse and the rapid tapping on the keyboard as staff document in the medical record. Papers are shuffled as birth certificates forms are filled out. Phones ring and pages sound.

 

A few times a day, a momma comes up to the desk, panting that she is in labor. She is put into a room, and her sounds echo down the hall as she brings her baby into the world. A cry is heard and cheers and laughter of family and friends fill the air. One of my favorite sounds is the sound of spontaneous applause when a momma has finally finished her hard work and baby is here. But the sound of a baby’s first cry will always be the best sound in the world.

 

However, there is a sound that no doctor forgets. The sound of a mother who has lost her child. It is a sound we hear too often, a sound we work to prevent every day. It comes from such a deep place, you can feel it in your soul, because it comes from hers. You never forget that sound. It is a sound I hear that day.

 

She labors through the night, and begins pushing right around 7:30am. Her perfect baby boy is born just after 8am on Monday morning. The delivery room is silent, an eerie feeling in a room usually so full of noise. There are hushed whispers and prayers. Sniffles and tears falling. There is no applause.

 

I check out to my partner around 8:30. I rush to the preschool, mascara smeared and hair in a greasy bun. I arrive as the birthday blessing ends. My son sees me as he is walking back to his classroom.

 

“You missed it, Mom!” he says with a downturned mouth and tears welling in his eyes. “I know, darling. There was a mommy that needed me. But I’m here now, and we can have cupcakes.” We share a cupcake and I head back to my car. The tears start before I unlock the door.

 

I’m crying for my sweet boy, who tried to hold in his tears. My mother wasn’t a doctor, but her job was unpredictable at times. I remember my own anxiety the occasional days she was late to pick me up. I would fake a stomach ache so the school would have to call her to come get me. As an adult, of course, I now understand the stress she felt on those days. But I hate that my calling affects my boy the same way.

 

I’m crying for myself. I feel stretched in so many directions. I want to be a good mom, a good doctor, a good wife, daughter, partner, and on and on. I don’t know how long I’ll be able to keep this pace I’ve created, but I know it isn’t sustainable. I feel guilty for missing my boy’s day, and even guiltier for leaving my patient so soon.

I’m crying because I still hear the voice of my attending, “You can’t be a mother and a doctor. Pick one.”

I’m crying because I can’t.

 

And most of all, I’m crying for this momma who will leave the hospital with empty arms. Over the next few weeks, I will pore over her medical records, trying to find what I missed, what I could have done differently to prevent this. My heart breaks for her and for the baby I couldn’t fix.

 

 

Georgia Ragonetti-Zebell, MD is an OB/GYN practicing in Upstate South Carolina, and is mommy to four (yes, FOUR) boys. She is a graduate of the Women’s Health Pathway at Drexel University College of Medicine in Philadelphia, Pennsylvania and completed her residency in Obstetrics and Gynecology with the Greenville Health System in Greenville, South Carolina. She has a special interest in natural childbirth, breastfeeding, and alternative methods in labor and delivery. She enjoys yoga, crochet, and reading, but spends most of her free time cleaning up poop while trying not to step on Legos.


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13 thoughts on “Sound of Silence: Why Doctor Moms are Burning Out

  • Melisa

    Georgia, This is such a raw and honest account of the life we choose. The guilt – the love – the hopes – the sadness – the victories. On this “doctors’ day,” I was just telling another mommadoc friend how lucky we are to do what we do, but also how horribly isolating it can be at times because it’s hard for others to understand, and it’s also too hard to express sometimes. Thank you for sharing the spectrum of your “moments” – including the humility, the rough patches, the joy, and the pain. It’s messy. And you’re right; sometimes it’s not sustainable. It wasn’t for me. I think each of us has different thresholds for figuring out when our presence and availability to other moms becomes more stressful (to multiple facets of our lives) than fulfilling (and it is so often incredibly fulfilling). But all of the mommadocs I know have also been very thoughtful and intentional about making a decision to change – or not – and at just the right time for each of them and their families. Self care matters, and it helps to know we are never “stuck;” we always have options if we pay attention and stay open to new possibilities or even just slight tweaks. I admire your insight and your passion for your family and your patients.

  • Gina Hopkins

    Hey Georgia! I was one of your med students a while back when you were a resident, and one of my friends posted this article! I had the pleasure of being able to say, “I know her, and she’s badass!” Didn’t realize you were a mom to so many boys! (Maybe you weren’t back then.)

  • Jill mcdonald

    I am a women’s health Nurse Practitioner in NJ, a Drexel alumnus… I am a former L&D nurse at TJUH, currently an NP in a large, very busy – but wonderful private practice. Many female providers, many of us with young children… I myself have two boys under 3yo, this brought tears to my eyes for so many reasons. Thank you for sharing.

  • Susanne RM Adamson

    I am an Ob/Gyn I am now 58 years old and have four children. My husband is a peadiafric oncologist and a global leader in pediatric oncology he has always traveled the world and is not home much, but that does not mean he is not involved. He has the highest flight status and at any given time has over 500.000 frequent flier miles. We have no family in the area where we live. Until my youngest was 4 I worked part time because I felt you never get those years back. My children are now 25,23,21,and 19. They are all increadbly compassionate caring and well adjusted. This is what I want to convey to the young doctors. Do not compare yourself with the stay at home moms and feel guilty!!!! Ever!!!! You can give your children sooo much. One of the most important thing your children will learn from you is that things do not always happen exactly the way they predicted or thought it would be, but it is still OK. You may it be there for the prayer but you are there for the cup cakes. That does not mean you care any less. You set a tremedous example for your children, and they know they can always turn to you no matter what. My oldest would email his college essay to my husband when he was in Australia for a meeting, to get his opinion. As siblings they become increadably close. They call text and visit each other all the time. Do not feel guilty. Enjoy the time you have with your children, cherish them, and arrange for LOTS of carpools.

  • Robert J Fucigna MD

    WoW every day we forget how many pieces of the pie need to be sliced up by the people around us, especially devoted women in medicine. They truly are saints, rarely complaining, always reaching for the stars. BTW, I know ’cause I married one, and she truly is a saint, mom wife sister daughter in Law and OB colleague , friend and of course Doctor

  • Allyson McDonough

    Tears falling…the pain and the guilt are deep. It is impossible to be everything to everyone and yet each pafient and each child expects and deserves your undivided attention. How to find a way with breaking yourself?

  • Joss Naron

    How incredibly unfair to be haunted by the words of your attending who told you you couldn’t do both, be a mother and a doctor.

    Because you ARE a mother and a doctor and you DO NOT meed to pick one. Be amazing and be both. And please remember that we all feel guilty being moms. I’m a nurse and a mom and I’m sure some people think I can’t be both, but I can’t let their opinions haunt my own guilt when I can’t be at everything for my children.

    None of us are perfect, but we CAN be both!
    Hugs mama! Xo

  • Lauren H RN

    As a doctors wife and an OB nurse, thank you for your deep caring for your patient. Your heart is clearly in a good place and I’m willing to bet you’re an excellent mom and an excellent physician. Thank you for serving in both roles.

  • Casey M

    Dr Ragonetti-Zebel is my daughter’s Dr. She has a great personality and you can tell she cares for her patients. I see her being a dedicated dr. and admire that. I’m a postpartum (mom/baby) nurse who also sometimes works with moms after a demise. I work 40,50,60 hours per week and struggle with the guilt of missing out on my children’s lives (18,16 & 8) but also feel the reward of helping patients in the brightest and sometimes darkest hours. The guilt is a heavy burden when you tell your child “I can’t. I have to go to work.” My hope is one day they’ll realize what the sacrifice was for. Someday I hope to look back and say it was worth it. Dr. Ragonetti touches so many lives I’m sure her children will look back with pride on their mom’s sacrifice. She is making a difference in so many lives.

  • Cat Robinson

    Seems strange the school wouldn’t be a little more accomodating and delay the blessing for 15 minutes. After all, is the school doing the blessing for them or the child? I am a doctor mum and frequently have to call ahead to tell people I am running late but on my way – it is amazing how accomodating people will be if they only knew.

  • Martha T

    Thank you very much for sharing, I feel I am not alone now that I am trying to get some time blocked in 3 days for my daughter’s school event ( and getting the invitation yesterday!) .