Females in medicine: Having children

[missdoctor]

For those of you who are females in medical school and intend on having children at some point, how do you plan on it all working out? Do you anticipate your children essentially being raised by a babysitter during their earlier years, and then still hardly being around as they grow older? Is that the sacrifice that must be made for females in medicine who want children, or is there some way around it? I do not want to imply that being a full-time physician isn't important by any means, because it very much so is. But what if you value both- family and medicine?

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[alwaysaangel]

For those of you who are females in medical school and intend on having children at some point, how do you plan on it all working out? Do you anticipate your children essentially being raised by a babysitter during their earlier years, and then still hardly being around as they grow older? Is that the sacrifice that must be made for females in medicine who want children, or is there some way around it? I do not want to imply that being a full-time physician isn't important by any means, because it very much so is. But what if you value both- family and medicine?

This is one of the biggest reasons that I'm going into EM. (but my ADD personality helps too). The hours suck for living, and you'll probably die younger (they've done studies...shift work kills), but you're home when your kids are.

Our former residency director spoke to me about this and she told me that her neighbors think she's a stay at home mom because she's always there in the daytime to take him to classes, etc (he's only 2 or 3).

There are always ways to do it but its going to depend on the specialty you go into and what you want out of it. Many women work part-time, especially when their kids are young, but that can be tough if you have 200k of debt looming over your shoulder. Some women take time off between medical school and residency but again, the 200k debt makes this hard unless your husband is rich, and I've heard it makes your first year of internship ROUGH because things aren't as fresh. Some women go the nanny route. I plan to have a nanny just so there is always someone there and its never like "omg who is going to take care of the kids I have to go." But I don't want her raising my kids.

Overall its a personal decision how to handle it, in general, if family is a big priority for you, you can pretty much guarantee you won't be going into surgery or similarly time intensive specialties. But there are plenty of ways to do it and most hospitals work with women who want to have kids. Although, as with any job the more marketable skills you have the more valuable you are and the more you will be able to bargain to stay home with your kids. Thats why I plan on doing a fellowship after residency, so I can have a little something that makes them need me. That way when it comes down to it, if I want to have weekends off to be with my kids or something, it won't be a ridiculous request.

 

[sindadel]

opcorn:

You know, it's not as black and white as you paint it and you can take your inspiration from people in other fields as well. Being a physician is not the only career path which would require a lot of childcare in order to keep current with it. What about a dad who is flexibly employed? Taking a year off between M2 and M3 to do research and be flexibly available to an infant? Hiring a nanny who brings your kids to have a daily meal at the hospital with you?

I chose to have my kids first, before applying to medical school. I'm happy with that decision, but it does have costs. A woman who chooses to have kids during med school or residency will have different tradeoffs and payoffs.

It's also rather insulting to presuppose that women who stay full time after having kids and use child care do not value family. Do you suppose that men who work full time after having kids do not value their family life?

In the end, if this is bothering you a lot, and you do not see how you would balance the needs of two demanding vocations, then sequence them. If you have a partner and are in a place to, I would recommend starting with the kids - it makes more sense biologically.

I recommend this book: http://www.amazon.com/Sequencing-Arlene-Rossen-Cardoza/dp/0965123804

 

[missdoctor]

opcorn:

You know, it's not as black and white as you paint it and you can take your inspiration from people in other fields as well. Being a physician is not the only career path which would require a lot of childcare in order to keep current with it. What about a dad who is flexibly employed? Taking a year off between M2 and M3 to do research and be flexibly available to an infant? Hiring a nanny who brings your kids to have a daily meal at the hospital with you?

I chose to have my kids first, before applying to medical school. I'm happy with that decision, but it does have costs. A woman who chooses to have kids during med school or residency will have different tradeoffs and payoffs.

It's also rather insulting to presuppose that women who stay full time after having kids and use child care do not value family. Do you suppose that men who work full time after having kids do not value their family life?

In the end, if this is bothering you a lot, and you do not see how you would balance the needs of two demanding vocations, then sequence them. If you have a partner and are in a place to, I would recommend starting with the kids - it makes more sense biologically.

I recommend this book: http://www.amazon.com/Sequencing-Arlene-Rossen-Cardoza/dp/0965123804

I did not mean to say that women who work full-time do not value family, I don't think that at all. But thank you otherwise for the insight- and for the book recommendation!

 

[Coastie]

I did not mean to say that women who work full-time do not value family, I don't think that at all. But thank you otherwise for the insight- and for the book recommendation!

Best time is before you start the path to becoming a doctor.

After that, best time is as a medical student.

After that, it really drops down....residency is slightly better than PP, but not by much.

 

[Slow]

lalala

 

[alwaysaangel]

I think you'll need to decide what your priority is. If spending lots of time with your future children is near the top of your list, you may decide that a field like nursing will be more fulfilling: the education process requires significantly less time and money, so you can start earlier, leave the job when you want, and return when you are ready. That's probably not what you or anyone else wants to hear, but that's reality.

This is actually a really good point. I went back and forth between nursing (eventual NP hopefully) and MD right before I took the MCAT. Ultimately because I wasn't in a relationship and didn't feel like I was anywhere near having kids I decided to go for the MD and worry about kids when the time came.

But if you're already there and its a huge concern for you - going NP may not be a bad idea, you can get a lot of autonomy depending on where you work and ultimately will have more flexibility.

 

[yadayadadude]

For those of you who are females in medical school and intend to have children at some point, how do you plan on it all working out?

I had my first baby in medical school. I'm starting residency next month. I hope to have a second baby sometime during residency.

Do you anticipate your children essentially being raised by a babysitter during their earlier years, and then still hardly being around as they grow older?

No. I anticipate that my son will be raised by his mother and his father. We will have help from a high quality daycare center and from our extended family. I plan to work part-time once I'm finished with training.

Is that the sacrifice that must be made for females in medicine who want children, or is there some way around it?

The solution here is a partner who is a true co-parent. My husband does half, if not more than half, of the work of parenting. He's an amazing dad.

But what if you value both family and medicine?

Then do both. What's the problem?

 

[DrJosephKim]

My wife is also in medicine and I see that some of these questions can be directed at the entire family. We are fortunate enough to have family close by. They watch our kids during the day and my wife is lucky enough to be working a fairly light schedule (roughly 20 hrs/week). She really enjoys her work but also wishes to spend a lot of time at home.

I also know many people who do rely on baby sitters (or day care). The reality is that you must make some sacrifices during those early years when your children are very young. I also know many physicians who choose to do some non-clinical work from home during those years when their children are young. They try to keep up with their clinical skills by moonlighting in the ER and urgent care clinics during the weekend. Then, once their kids are older, they go back into a clinical practice where they can balance work/family according to their needs.

 

[OttawaPremed88]

Wouldn`t it be great if hospitals provided day-care facilities? You work, come stop by to see your kids throughout the day. Go to lunch and take them out with you, and pick them up at the end to go home at the end of the day having seen them throughout it already.

 

[missdoctor]

This is actually a really good point. I went back and forth between nursing (eventual NP hopefully) and MD right before I took the MCAT. Ultimately because I wasn't in a relationship and didn't feel like I was anywhere near having kids I decided to go for the MD and worry about kids when the time came.

But if you're already there and its a huge concern for you - going NP may not be a bad idea, you can get a lot of autonomy depending on where you work and ultimately will have more flexibility.

and what about being a PA? the schooling isn't nearly as lengthy and the debt would be less. I would imagine you'd have much more flexibility depending on the specialty too. I don't know though, I really see myself as being a physician and not assisting one. I think if you want both, physician and family, you WILL find a way to make it work.

 

[Lil Mick]

I'm going into academic medicine. I'll be able to work from home on most of my studies and pick the times to teach. Also, my husband will be working from home, as well, so both of us will be able to parent our children.

 

[Ariee]

This is such a great thread!

How bout those of you out there who are fellows or in some of the more-male dominated, less family-friendly fields? Any success stories?

Can you really have it all?

 

[Tigerz_Fan]

This is such a great thread!

How bout those of you out there who are fellows or in some of the more-male dominated, less family-friendly fields? Any success stories?

Can you really have it all?

Ariee,

I'll let you know after I deliver in Jan. Right now, it's been really rough. I am high-risk and have been on bedrest twice now.....doesn't exactly make it easy to work.

 

[Pemberley]

This is such a great thread!

How bout those of you out there who are fellows or in some of the more-male dominated, less family-friendly fields? Any success stories?

Can you really have it all?

A senior surgery resident gave a talk to our women's medical student group last year. She emphasized over and over that it really is possible to "have it all" and talked about how she'd had a child early during her residency, gone back after two weeks, and everybody was doing fine.

She didn't get into the details, pros/cons, etc., of raising a child while working (officially) 80-hour weeks. When asked what if she'd wanted to have another, she screeched "TWO children!?!?!? That's the kind of decision-making that gives women a bad name!!!!"

So, my conclusion from her talk (disclaimer: not based on firsthand knowledge) was this: you can only "have it all" in that kind of career field if you define "it all" very, very selectively.

Personally, I'm accepting (and my husband has accepted) that there will be at least two very rough years (3rd year and intern year), that juggling the rest of residency (and I'm talking the other 2 years, here, I'm not even opening my mind to something like surgery) will be non-trivial -- and after that, total work hours will be a large consideration in my employment. I still daydream about chucking it all and going to nursing school, of course, on my tired days.

Probably the biggest thing that I might otherwise have wanted to do that I might have to give up (surgery probably wouldn't have been my field anyway) is thought of an academic career. The two guys I've done research for over the summer worked extremely long hours; one of them, in his own words, "tried to spend Sunday afternoons with his children" -- if this turns out to be representative of academic work (I'm still hoping it's not) then I won't be staying in academics. Pity, because I love teaching and rather enjoyed my research.

I don't expect to have to choose between being a good doctor and being a good mother. I do expect to have to choose between being a famous, important, and super-rich doctor and being a good mother -- and that's no choice at all. Somebody else can be famous and important.

Thank goodness I'm married to a wonderful man who is NOT also in the medical field.

 

[jinx520]

I have had my kids in daycare, and also been a stay-at-home mom, and I'd like to address the issue that comes up re: having someone else "raise" them. I know that mothers feel guilt over every thing they can't shield their kids from, every thing they can't provide for their kids, every moment that they aren't there with their babies. Putting your children in daycare (or utilizing a nanny, au-pair, or grandparent) is guilt-inducing, any way you look at it. And as a stay-at-home mom I felt guilty for wanting to have a fulfilling career that would take even one minute away from my kids.

However, let's face it: no matter what you do, you will never be able to be everything and do everything for your children, nor is it healthy for them for you to do so in the long run. As a stay-at-home mom I always felt like a vital part of me was being unacknowledged, no matter how much I loved my kids. My view is that if you sacrifice your own dreams in order to be 110% there for your family you will ultimately not be happy on some level and therefore, not be the best mom you could possibly be.

Having said all that, having someone else WATCH your kids is not the same thing as having someone else RAISE your kids. No matter how many hours they are in daycare, and no matter how young they are, they WILL know the difference between their daycare teacher, their grandma, and their mom. You can be aloof, uninterested, and unloving as a stay-at-home mom, and you can be involved, loving, and demonstrative to your kids as a working mom or full-time student. And THAT is what makes the difference to your children; they aren't carrying around a logbook keeping track of how many minutes you spend with them in order to evaluate whether or not you are a good mommy.

Do what you need to do in order to take care of your family. But realize that taking care of your family means taking care of yourself, too. If one of your children wanted to be a doctor, would you tell her she couldn't because she had more than one thing on her plate? Of course you wouldn't. You'd be her biggest cheerleader. Honor yourself in the same way. Every family's situation is different; some people wait until their kids are older, some people have their kids before med school, others have them while students. Still others have them in residency or wait until they're attendings. Do what will work for you, you're the one that has to live with your choices, and ignore what the rest of the world might say.

 

[NursingJobsUK]

A friend of mine's mother had a nurse job, and they got to spend a lot of quality family time together. But if you are set on becoming a doctor then it may require more of your "personal" time. Work-life balance can be hard. But if you become a GP in the UK then you can work mon-frinday 8am-6pm and then you still have evenings and weekends with your family and no shift work as such.

 

[JAWSCIENCE]

This is an issue many of the women in my MD-PhD program are currently grappling with. Many of us have decided the best time to have kids is during our research years when our schedules are somewhat flexible. Many utilize the "granny-nanny" if they have that option available to them. Others use local daycare and nannies/au pairs. One real concern around here is the expense of quality childcare and we are pushing the school to start offering some form of childcare assistance.

One very important part of the equation is your spouse. Why is it assumed that you are responsible for all the child raising? If you both have careers then you both should be splitting the childcare. I know one couple where the husband was a stay at home dad while the wife was in medical school and now that she is starting residency he is beginning graduate school. Each couple has individual needs and priorities that must be worked out. No partner should feel they are giving up their dreams for the sake of the kids because this can lead to frustration and eventually resentment of both spouse and children. Is an angry, bitter mom really better than a fulfilled mom who uses a nanny?

Different specialties also present different benefits and challenges. There is also a lot of variation between programs. Choose wisely. Having a child during your intern/residency years is tough because you feel like you are letting your colleagues down as they have to pick up the slack while you are on maternity leave. The patient load is the same but there's one less member of the house staff around.

 

[savi]

My view is that if you sacrifice your own dreams in order to be 110% there for your family you will ultimately not be happy on some level and therefore, not be the best mom you could possibly be
Having said all that, having someone else WATCH your kids is not the same thing as having someone else RAISE your kids. No matter how many hours they are in daycare, and no matter how young they are, they WILL know the difference between their daycare teacher, their grandma, and their mom. You can be aloof, uninterested, and unloving as a stay-at-home mom, and you can be involved, loving, and demonstrative to your kids as a working mom or full-time student. And THAT is what makes the difference to your children; they aren't carrying around a logbook keeping track of how many minutes you spend with them in order to evaluate whether or not you are a good mommy.

Well said. I can't agree more. Mum worked >80hrs/week during and after IM residency while raising us 2 young kids. She technically had very little time with us, and I would always remember nights when she was off duty and sleep would be interrupted because she had to go back to the hospital. But she somehow managed to still have energy to play or pray or occasionally help with brother's homework. also, a supportive husband helped a lot. When mom was on call, dad would bring us kids to the hospital to have dinner or see mom for 10mins before we went to bed.
Little time, but lots of affection. She also made us understand that her work was very important to her, and that it was something she also enjoyed doing a lot and that it was noble. So she never made us feel like we were lacking anything, and when she was absent, we also understood she was doing something great in her work.

Do what you need to do in order to take care of your family. But realize that taking care of your family means taking care of yourself, too. If one of your children wanted to be a doctor, would you tell her she couldn't because she had more than one thing on her plate? Of course you wouldn't. You'd be her biggest cheerleader. Honor yourself in the same way. Every family's situation is different; some people wait until their kids are older, some people have their kids before med school, others have them while students. Still others have them in residency or wait until they're attendings. Do what will work for you, you're the one that has to live with your choices, and ignore what the rest of the world might say.

Exactly. Mom remembers being criticized (for not going home early to help us kids study) by her female colleagues who were also in the same stage of training, had kids our age, and who left work much earlier to help their kids do homework--it still worked for her and for our family. So as a child of an MD and also as someone undergoing internship and now understanding the big sacrifices in medicine, I could say her success in her career and family life is because she approached things differently. And everyone's happy.
So I do believe it is possible to be successful on both fronts.

 

[SmKN808]

i'm gonna wait til i'm around 30~ish

 

[Staradmiral]

Call me sexist but i just don't think medicine and children are a good mix. My mom only worked part time when i was young, and i loved always having dinner ready when i got home from school and she was always there when i was home. She was always there for me.

Personally i do not believe in day care or nannies. If you wanna have kids, raise them. It does not have to be the woman who stays home. House husbands are cool too. I have no respect for parents who do not spend time with their kids. I find it hard to believe a person who spends 60+ hours a week in residency and a few hours with their kids truly loves their kids.

I wouldn't have it any other way for my kids.

 

[Geekchick921]

Wouldn`t it be great if hospitals provided day-care facilities? You work, come stop by to see your kids throughout the day. Go to lunch and take them out with you, and pick them up at the end to go home at the end of the day having seen them throughout it already.

Uh... many do! I currently work in a hospital with a daycare on campus that my daughter attends. The big teaching hospital a mile or two away also has a daycare center that contracts with them right across the street! Both offer discounted rates to the hospital employees, too.

Thing is, I wouldn't want to go see my daughter during lunch. She is only 17 months old and already gets upset when I leave in the morning and I don't want to upset her by coming by briefly and then leaving again. I love that she is just down the hill, though, and the daycare is great.

 

[christina30]

My mom, a nurse, works and has practically always worked (for as long as I can remember) 80 hours/week, and she never failed to make time for my brothers and I.

It all depends on the individual and how much sleep and other stuff you're willing to sacrifice in order to have a family.

 

[DadofDr2B]

The problems are important when the children are little but become even more of a problem when kids start to grow up. You can control the baby but what do you do with the 12-16 year olds when no one is at home when they get home from school. Latch key kids are a problem everywhere. They have money (both parents work) they have unsupervised time (after school) and they sometimes have parents who do not care or have the energy to parent them (say no and stand up to them). Kids get into trouble and the parents don't have a clue.

Having a real structure increases the odds of kids having a chance to succeed. Just my opinion.

It is not easy without grandparents, uncles, aunts, etc. around to take on some of the load. I would suggest to try to live near relatives that are interested in helping with the children if you have a choice. Many grandparents raise children with great success and it is what the grandparents want. Relatives can give unconditional love that can not be bought that gives the child security. At least consider location when starting a family.

I hope my daughter will let us help when she has a baby. It is what my wife and I would love to do.

 

[xscpx]

and what about being a PA? the schooling isn't nearly as lengthy and the debt would be less. I would imagine you'd have much more flexibility depending on the specialty too. I don't know though, I really see myself as being a physician and not assisting one. I think if you want both, physician and family, you WILL find a way to make it work.

This is actually right on. That is exactly what I did. I decided to go the PA route rather than medical school. The decision came from my priorities changing. When I was 19 and single, the sacrifices for med school were no big deal. Now that I am married, in my mid-20's, and wanting to start a family soon, it seemed a good compromise for me. Being a PA allows me to work in medicine, which is my passion, but allows me ample time and flexibility for my family, whom are my priority.

They are beginning to establish bridge programs (supposedly) for PA's whom have worked for "X" amount of years to complete an accelerated version on med school. That sounds nice to me because maybe one day, when my kids are older and my life is more stable, it would be nice to "go all the way".

Balancing family and work is difficult in any profession. If something is important to you, you make it work. I am lucky. PAs in my state have a very high level of autonomy and the job demand is high. I'm not sure what it is like where you live, but just keep in mind there are tons of options out there.

 

[traumachick]

I'm currently a 4th year GS resident with a 2 1/2 year old and it is do-able. Extremely hard at times, and I rely tremendously on my Mom who is in town and my non-medical (but still with demanding job) husband. We joke that even with 3-4 adults raising one child, we're all still exhausted.

Is it worth it -- yes, I love my work and only did it as nothing else was nearly as appealing. I'll be 37 when i finish training and wasn't willing to wait until then to start a family -- At times it is frustrating and I feel horrible for having to leave my daughter, but I know she is in good hands (either with my husband or mother) and i am just grateful to have the opportunity to "have it all"

 

[ItsNotLupus]

I just want to thank everyone for taking a second to respond to this thread in a a thoughtful and heartfelt way. My first few google searches returned some very angry, offensive, and obviously not very helpful threads from about 7 years ago.

As a young MSI, I've always been one of those people that plans their life about 5 years in advance and this topic has been wrenching at my heart! But I have a compassionate and dedicated man in my life that, especially after reading some of your posts, I know will be supportive co-parent and then some!

I want to just contribute quickly that as the a lot of this for me boils down to perspective. I'm the first person in my family to pursue medicine and it was a choice that came partly out of my academic interests and partly out of the fact that I wanted a better life for myself and my future children. My mother and father were home all the time to raise they kids....but unfortunately they were busy abusing drugs, alcohol, their children, and the welfare system.

We didn't join the medical profession because we thought it'd be easy, we knew it would hard but we all have our reasons for doing it and doing it well.

I think the same applies to having children in med school. It's not meant to be easy, but if it is important to you then it doesn't matter when it happens (because my understanding is that no time is really much better than any other ), you're just going to make it happen and do it right.

If you doubt that you can do it right, then don't do it yet.

And with that in mind, anyone who thinks we're wrong for wanting a family can't argue.

 

[Rexhina]

Wouldn`t it be great if hospitals provided day-care facilities? You work, come stop by to see your kids throughout the day. Go to lunch and take them out with you, and pick them up at the end to go home at the end of the day having seen them throughout it already.

that would be awsome

 

[wobit]

Is that the sacrifice that must be made for females in medicine who want children, or is there some way around it?

I'm glad that my more modern-minded male classmates now seem to have the same reservations. Once we get past the breastfeeding phase, parenting is an equal responsibility, divided by individual inclination, not pre-assigned role. This idea that it's the woman's lot to be solely responsible for the sense of "family" is horse manure.

However, since the gestation and lactation are undeniably going to fall on me, we decided to get them done when I have the most flexibility - for me, marrying at 29, that was medical school. I've had two babies, one during MS3 and one during MS4. I talked with my Dean of Student Affairs before conceiving in order to plan the best window and to make sure that I wouldn't run into surprises as far as loans. My school is very family-friendly and doesn't charge tuition for the extra year (which many students use for research or travel). Therefore I had generous maternity leaves (6 months) and got my clerkships with call done prior to delivering my baby. I lucked out on the health front.

My husband is nonmedical, but employed in a demanding, well-paid field. He doesn't love his work the way I love medicine, and the plan is for me to eventually provide the benefits and financial stability to allow him to pursue something more gratifying, and probably part-time as he has all along been involved in teaching cub scouts and that kind of thing and wants to do lots of it.

During my residency years, when our kids will be 1&4 through to 4&7, he will probably do a lot more of the parenting than I will. We take advantage of nearby family, and employ a nanny who during her interview with us emphasized that she wants to seamlessly continue our values and parenting style. That cuts down on time lost transporting kids to daycare.

Wanting to be with my kids has impacted my specialty choice (EM), though it wasn't the primary driver. Even during residency I will work fewer hours than many other MDs.

I adore my family. I am a very "attached" mother, in that granola-crunchy way. I'm an extended-nursing, babywearing touchy-feely mom. I fit right in at my local La Leche League. But the solid truth is that I'm a lousy, miserable homemaker. Meal planning, home decorating, shopping, housecleaning - I was seriously stir-crazy by the end of my maternity leaves. By working to put myself in a position where I can afford to hire those things out, I can be a fun, involved, energetic mom during the time that I'm home instead of being a cranky stressed out shrew. And I love medicine. I will graduate without debt - no pressure - and I cannot imagine not continuing my career as a physician.

Talk with the residents in your chosen field about specifics. Rarely, a woman shares a residency slot with another woman in order to be part-time. I don't know how I'd make it work if I felt the calling to be a surgeon or an OB. But don't buy it if someone else tries to tell you that you can't be a good mother and an MD. That's a decision that nobody but you can make.

 

[supergirl7561]

Honestly, I know as women we will all stress over this at some point if you want kids. I know it's hard, but you have to think of it from the kids' perspectives- as long as their mom is loving and supportive, they'll be fine. I went through periods of having a working mom and a stay-at-home mom, and I loved her equally at both points. Yes, it was nice to have her there all the time, but I was fine at daycare of after-school care, and actually learned a lot about interacting with kids more, which I wouldn't have if my mom was the only one who took care of me. I also got to know other family members better.

I think either way, you're going to feel guilty, it's just part of a lot of women's psyche. When she quit her job, my mom felt she was being a bad example for my sister and I by not following her dreams and being a career woman, that somehow we would learn as women not to have big goals for ourselves. Yet when she worked, she felt guilty for not being there for us all the time.

But it is definitely something to consider, as you need to be there at least some of the time for your kids. I don't think I would change schools JUST so I could more easily take care of my kids, but if that's more important to you or if you would basically have the same type of job, go for it. But maybe look into schools that do have daycare facilities, ask at interviews how they work with pregnant students to allow a reasonable maternity leave that doesn't put you too far behind, schedule when you have your kids by what you know about how difficult the curriculum will be at that time, and make sure your partner is willing to co-parent. But you don't need to give up your career, unless you want to.

 

[DrCoffeeBean]

Oh, this is my sore topic. I want to go into surgery, it's not just 'one of' on the list, it is the top thing on the list, with the rest of the specialties falling far behind.

Currently I am heading into my last year of med school, have a part time job with an ambulance service and live together with my boyfriend. Things as they are now, more often than not I'm exhausted! If I'm not in the hospital doing rotations, I am doing shifts with the ambulance or trying to squeeze in some sort of quality time with the significant other among the housework-sleeping-exams cramming.

Where do you get the energy from to have children with the frantic MD schedule?