Physician, Scientist and Father?

[achamess]

Hi everyone,
I lurk around here a bit and I'm always impressed by the caliber of the advice and commentary that people make here. I am very grateful, and I am sure I speak for many other lurkers as well.

Anyhow, I want to know what your thoughts are on family and one's career as a physician-scientist. I am sure it is possible to be a PS and an excellent parent too, but possible and practical are different things. For those of you who are already physician-scientists, and for those of you already on your way, do you worry about being able to lead a successful career and being available for your family? More than anything, the thought that I will be absent during the growing years of my future family turns me off to this career path. My father worked very hard when I was growing up, but I didn't get to see the guy a lot. I am very worried that if I want to achieve the career goals I have set for myself as a PS, that I will end up being away from my family way too much, as my father was.

Do you all know physician-scientists who are able to be very involved with and available for their families, and at the same time, be successful scientists and clinicians? Or this is just an idealized image I have of what the life of a PS can and should be?

I realize that the answers to my questions are dependent on many variables, many of which are inherent to specific individuals and not generally, but I am sure I am not the first person to ponder these questions. I'm very interested in hearing what you all have to say.

-Alex

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[Chemdocx]

Most MD/PhDs I know have kids...the program is forever long. I have a kid, my wife doesn't totally hate me even though we have been married a while now , and I was able to churn out a double digit number of papers (some small time some bigger), make A's etc, while doing all types of stuff with my kid. The one hard year out of 8 (with respect to time) is third year of medical school. I do work at night alot when the wife and kid are asleep but its fun because its quiet. Best of luck.

 

[RxnMan]

I've met many phy-sci docs with families. However, it helps, in my mind, to have a clinic schedule that is conducive to spending time with them. The best I know of is an ICU doc who does a clinic month several times a year (long and uncontrollable hours), and then has regular 40-60 hr weeks the rest of the time.

Your choice of speciality is of most influence here. I imagine the same thing could be done as, say, a surgeon, you just have to have an appropriately narrowed scope of clinical practice.

 

[dl2dp2]

realistically, you are asking the wrong question.

(1) Would you rather have your father be a stay at home dad and be on welfare but be oh so 100% available to you?

(2) Did the fact that you didn't see your father much made much of a difference on how much you love him or how much he loves you? In fact, if you actually saw him more, would it have made any difference?

(3) Would you feel guilty if your father quit his job, or took a less prestigious job just because he had kids and needs to take care of the kids more? (I know I would.)

One doesn't have more than 24 hrs a day. If you want to be an outstanding researcher, you won't be able to spend as much time with your family. Being a scientist is not like having a trust fund. It isn't possible to have everything you want.

Sacrifices always have to be made. How good of a researcher do you want to be? It's all up to you in the end.

 

[LunderKind]

realistically, you are asking the wrong question.

(1) Would you rather have your father be a stay at home dad and be on welfare but be oh so 100% available to you?

(2) Did the fact that you didn't see your father much made much of a difference on how much you love him or how much he loves you? In fact, if you actually saw him more, would it have made any difference?

(3) Would you feel guilty if your father quit his job, or took a less prestigious job just because he had kids and needs to take care of the kids more? (I know I would.)

One doesn't have more than 24 hrs a day. If you want to be an outstanding researcher, you won't be able to spend as much time with your family. Being a scientist is not like having a trust fund. It isn't possible to have everything you want.

Sacrifices always have to be made. How good of a researcher do you want to be? It's all up to you in the end.

wow...

There's more to life than your career. I know a few physician scientists that have families as well as run successful labs and clinical practices. All seem to have developed a pretty good balance between their personal lives and careers. However, they are all men...physician-scientist mothers are much more rare.

 

[MedRower]

Just to play devil's advocate:

The most important thing you contribute to your kids' development is your DNA. Don't worry so much about how much time you will have to spend with them.

 

[Doodledog]

Hi everyone,

Do you all know physician-scientists who are able to be very involved with and available for their families, and at the same time, be successful scientists and clinicians? Or this is just an idealized image I have of what the life of a PS can and should be?

-Alex

Although there is certainly a lot of specialty-specific variability, in an of itself, being a physician scientist, with or without an MD/PhD or similar combination, shouldn't make having a family life more difficult than a pure research or a pure clinical career. Certainly doing the combination leads to some times when after finishing patient care there are things that need to be done in the lab or other research tasks. This is often balanced by doing less clinical time and spending fewer evenings pouring over patient information. I know many physician scientists and see no real difference in their overall family life and "home time" compared to pure clinicians.

At the point at which you move farther into your career, more of your research time will be spent doing tasks like reviewing papers, writing and reviewing grants and the like. Many of these can be done at home with your dog on your lap. Actually, come to think of it, I think my dog wants more attention than my adolescent children.

 

[kami333]

All the physician PIs I know (both MD/PhD and MD only) have kids, most of their spouses are stay-at-home.

My father is an MD/PhD and I trying to go MD/PhD as well so what does that tell you Although in our case he got is MD first then got his PhD while my sister and I were growing up so he was around a lot while we were little so the situation is a bit different. Looking back, it was a pretty enjoyable childhood, not much money, most of our vacations included some sort of camping (but we still skied a lot). It was only when we were older, around junior high, that he started working crazy clinical hours (attending at a trauma center) but even then that was only for about 5 years until he switched to a position at a university hospital. Once we were in college, it was kind of cool since his conferences tended to coincide with our breaks, aka fall break in Orlando, spring break in San Diego

Funny story I heard around the lab is apparently my PI's daughter asked him if he liked the lab better than her, since he spends most of his time here. It is probably hard when you are just trying to get your research going and your kids are small but it's only a few years.

 

[strangeglove]

There's definitely time for clinical work, research and family... but not a whole lot else. You will have to be very picky in terms of which friends you spend time with (they will more likely be the ones who have kids once you have your own) and what hobbies you pursue (they will more likely be the ones that don't require you to leave home on your own for long periods of time). Also, you tend to spend a lot less time reading novels and a lot more time reading children's books.

 

[solitude]

Actually, come to think of it, I think my dog wants more attention than my adolescent children.

as evidenced by your avatar.

 

[QofQuimica]

as evidenced by your avatar.

I'd take the dog over the adolescent children any day.

 

[mercaptovizadeh]

realistically, you are asking the wrong question.

(1) Would you rather have your father be a stay at home dad and be on welfare but be oh so 100% available to you?

(2) Did the fact that you didn't see your father much made much of a difference on how much you love him or how much he loves you? In fact, if you actually saw him more, would it have made any difference?

(3) Would you feel guilty if your father quit his job, or took a less prestigious job just because he had kids and needs to take care of the kids more? (I know I would.)

One doesn't have more than 24 hrs a day. If you want to be an outstanding researcher, you won't be able to spend as much time with your family. Being a scientist is not like having a trust fund. It isn't possible to have everything you want.

Sacrifices always have to be made. How good of a researcher do you want to be? It's all up to you in the end.

This is one of the stupidest posts I've ever seen. Spending time with family and especially with children is investing in human beings. The influence of a father or mother on a child (both for good and bad), especially in the crucial early years, is indescribably huge. You will be a primary influence as to the moral, emotional, and intellectual development of other human beings. If you think some mindless "research" that may end up not being of any relevance to improving the human condition or even human knowledge (let's face it, 95% of "research" ends up being fluff or minutiae - one smallpox vaccine arrived at by the simple observation of milkmaids by an English doctor has done a million times more for humanity than all the flashy Nature-published research of the past 30 years) is better than a meaningful and concrete positive involvement in the lives of others (money is not enough, time needs to be there too), then you will be in for a very big disappointment 60 years from now.

 

[sirrileydog]

This is one of the stupidest posts I've ever seen.

agreed

 

[QofQuimica]

Everyone is jumping all over sluox, but he does have a point--we can't have everything, because we are each a mortal man or woman, and there are only so many hours in a day and days in our lives. That being said, mercapto also has a point--each of us must answer the question of what our greatest priority and value in life is. I would agree that if you have children, they (hopefully) are the most valuable and important thing in your life. So, if you desire to have a family, and if your family is (understandably) the most important thing to you, then you and your spouse will have to sacrifice certain other things to give your children the attention they deserve. In other words, you will not be able to put the kind of time and energy into your career that a person who does not plan to ever have children can put into theirs.

I don't think there is anything wrong with either choice (i.e., choosing to have a family and being less career-oriented versus choosing to devote oneself to one's career and not have children). What I do think is tragic is when people go off maternity/paternity leave and their 3-month-old infants are being raised in day care centers by people who are being paid minimum wage and (probably?) view caring for those children as just a job. I realize that some people are not able to afford to stay home with their kids, and if that's the case, you do what you've got to do. But that doesn't make putting young children in daycare an ideal solution that everyone should emulate. I don't think it matters that much which parent chooses to cut back on their career (or maybe both decide to do it to some extent), but I confess that I don't understand the point of having kids if you aren't going to raise them yourself.

To answer sluox's question, I admire stay-at-home dads (as well as stay-at-home moms) for putting their children first before themselves. I admire them more than I admire two-career parents who choose to put their young children in daycare so that they can both continue to work full-tilt. (I'm assuming they can afford to have one parent stay home.) That's my personal conviction, and I realize that I'm probably out of step with many in the younger generations.

 

[Kraazy]

To answer sluox's question, I admire stay-at-home dads (as well as stay-at-home moms) for putting their children first before themselves. I admire them more than I admire two-career parents who choose to put their young children in daycare so that they can both continue to work full-tilt. (I'm assuming they can afford to have one parent stay home.) That's my personal conviction, and I realize that I'm probably out of step with many in the younger generations.

I don't know if there is truly a moral difference between these choices. I think people make the decision mostly based on what will bring them more personal satisfaction, whether that means staying home with the behbehs, working all the time, or trying to strike a balance. All of these choices involve sacrifice and hard work. The choices are also influence by people's own experience in childhood. Both my parents worked when I was a kid, and I turned out OK, I think...

 

[Maxprime]

I don't know if there is truly a moral difference between these choices. I think people make the decision mostly based on what will bring them more personal satisfaction, whether that means staying home with the behbehs, working all the time, or trying to strike a balance.

+1. People do whatever makes them happy. If someone volunteers, they generally do it because it makes them feel good. If someone stays at home to take care of their kids, they generally do it because it makes them feel better than sitting in lab and feeling guilty all day.

We all make choices and try to maximize a balance of short term and long term happiness - but those preferences will vary by individual.

 

[MedRower]

We all make choices and try to maximize a balance of short term and long term happiness - but those preferences will vary by individual.

So, this type of normative theory of human rationality, while it is the basis for classical economics, is now widely known to be patently absurd. Experiments today are showing that humans act irrationally (but predictably so), and hence do not always act in their best interests. I have a soft spot for people like Dan Gilbert who have done some neat studies on this, but I suppose the field is really being led by people like Eldar Shafir and Dan Ariely - although it all started with Kahneman and Tversky (for which a Nobel was awarded in 2002).

So, basically what I am trying to say is that, no, we don't always choose what makes us happiest. Unfortunately, I'm not yet sure how to apply this to the work/life balance (but I'm positive it is possible).

 

[Maxprime]

So, this type of normative theory of human rationality, while it is the basis for classical economics, is now widely known to be patently absurd. Experiments today are showing that humans act irrationally (but predictably so), and hence do not always act in their best interests. I have a soft spot for people like Dan Gilbert who have done some neat studies on this, but I suppose the field is really being led by people like Eldar Shafir and Dan Ariely - although it all started with Kahneman and Tversky (for which a Nobel was awarded in 2002).

So, basically what I am trying to say is that, no, we don't always choose what makes us happiest. Unfortunately, I'm not yet sure how to apply this to the work/life balance (but I'm positive it is possible).

Without getting into some absurd argument about the importance of pareto efficiency in a work/life balance, I agree (as every sane individual does) that humans don't always act rationally. I even went as far as to write "generally" in front of the behaviors I stated (I have tough reviewers ). But this deviation from rational behavior doesn't necessarily mean that humans never act rationally. If it were true, we would be left without the wonderful gift of malpractice cases.

 

[MedRower]

I even went as far as to write "generally" in front of the behaviors I stated (I have tough reviewers ).

Ah, good call. I actually missed that. I wasn't actually trying to start an argument. I actually agree with the general sentiment that whatever we do, it's impossible not to define it as "selfish."

I guess my point was that we often don't know what is going to make us happy. We often make choices that will make us less happy in the future (i.e. some of Gilbert's work). So, I have very little faith in my own ability to reason about a work/life balance. I suppose an alternative is to look for role models, which people have been posting here, which is great.

 

[mercaptovizadeh]

Everyone is jumping all over sluox, but he does have a point--we can't have everything, because we are each a mortal man or woman, and there are only so many hours in a day and days in our lives. That being said, mercapto also has a point--each of us must answer the question of what our greatest priority and value in life is. I would agree that if you have children, they (hopefully) are the most valuable and important thing in your life. So, if you desire to have a family, and if your family is (understandably) the most important thing to you, then you and your spouse will have to sacrifice certain other things to give your children the attention they deserve. In other words, you will not be able to put the kind of time and energy into your career that a person who does not plan to ever have children can put into theirs.

I don't think there is anything wrong with either choice (i.e., choosing to have a family and being less career-oriented versus choosing to devote oneself to one's career and not have children). What I do think is tragic is when people go off maternity/paternity leave and their 3-month-old infants are being raised in day care centers by people who are being paid minimum wage and (probably?) view caring for those children as just a job. I realize that some people are not able to afford to stay home with their kids, and if that's the case, you do what you've got to do. But that doesn't make putting young children in daycare an ideal solution that everyone should emulate. I don't think it matters that much which parent chooses to cut back on their career (or maybe both decide to do it to some extent), but I confess that I don't understand the point of having kids if you aren't going to raise them yourself.

To answer sluox's question, I admire stay-at-home dads (as well as stay-at-home moms) for putting their children first before themselves. I admire them more than I admire two-career parents who choose to put their young children in daycare so that they can both continue to work full-tilt. (I'm assuming they can afford to have one parent stay home.) That's my personal conviction, and I realize that I'm probably out of step with many in the younger generations.

Thanks Q, for this less harsh analysis. Of course sluox does have a point - we can't have it all. I was just reacting to his almost disdainful treatment of people who value family over career. The fact is, we were told a lie by the previous generation: you CAN'T have it all. You cannot have several children, develop strong lifelong bonds with them and be an integral part of their lives, AND dedicate yourself fully to a career. Because to dedicate oneself first to one's children precludes doing the same with one's career, and vice versa.

Now, for the daycare point, I absolutely agree. As a Christian, I am well aware of the centrality of the father and mother in the development of the child. It is the responsibility of the father and mother - not the school, Sunday school, community, daycare center, babysitter, or anyone else - to raise the child into a well-disciplined, moral, contributing member of society. But even someone who rejects religion and goes only by human history and mammalian biology must be under the impression that the mother's (and father's, in many cases) role in development of the young lies not merely in supplying food, water, shelter, and other biological necessities - but also in the emotional connection. How can a daycare worker ,who has no emotional connection to a baby, provide what the mother or father can give? It's impossible. The only situation where I can understand the child being entrusted in the care of another in the early years (and this is certainly not ideal), is if it is in the care of a close relative who has an obvious emotional interest in the child, e.g. an aunt or uncle, grandparent, etc.

My mentor several years ago is a clinician and a researcher (not MD/PhD), but he turned down working crazy clinical hours to make more money, or spending all free time in the lab. He does his clinical duties (it's a large academic medical center), delegates the lab work to his techs, students, post-docs, and spends as much time as possible with his two children - he coaches his daughter's soccer team, did some science demonstrations at his son's school, taken his family several times a year on vacations to Italy, Japan, Hawaii, etc. His wife is also a doctor who has chosen to work part time and be at home by the time the kids get back from school. Have they made sacrifices? Yes, e.g. they don't own their own home (very expensive area), they rent, and they can't send their kids to private school, but I think they've made the right choice.

 

[decal]

As a Christian, I am well aware of the centrality of the father and mother in the development of the child.

As a Christian, eh.

Edit: Spot on, EpiGirl.

 

[EpiGirl]

Oh, hot-button issues...

I really think everyone could profit from letting go of the one-size-fits all approach to parenting in general. What works well for one parent may not work well for another, and it is easy but unfair to decide that there is one optimal way to do it and that parents who go another way are selfish or incompetent.

Now...really, am I the only person on this forum who was in child care as a child? What do you guys imagine happens there? While I fully agree that child care in this country needs oversight, regulation and political resources behind it, that does not mean that it is impossible for a physician-scientist to find a safe, enriching environment for his or her kid to spend a few hours in during weekdays. I used to work for a Head Start program, for which at least 90% of the children came from families meeting a pretty strict definition of low income. There was an auxiliary child care service that was set up in recognition of the fact that most kids had working parents, and it was phenomenal. I would send my child there any day. If there's one, there are others. Taking care of a child all by yourself, or only with your partner, can lead to burn out that is far worse for your child than spending some extra time away from you. This expectation that parents are supposed to be able to provide everything for their children, economically, emotionally, etc. without help is impossible to live up to and can be very destructive.

It is really hard to know how good a job a parent is doing from the outside; you just don't know what he or she has to work with. The way a person turns out is not necessarily an accurate reflection of how hard his or her parents tried or how good their choices were. We all know wonderful people who came out of homes that were unstable or unloving or unsafe. Well, the opposite can also be true. I know it's hard to accept the idea that you might do everything right and still wind up with a kid with problems, or unhappiness, or who makes bad choices that the world at large blames you for. But that's how it goes in the real world. We should all remember that before we start criticizing other people's life choices.

 

[mercaptovizadeh]

I would send my child there any day. If there's one, there are others. Taking care of a child all by yourself, or only with your partner, can lead to burn out that is far worse for your child than spending some extra time away from you. This expectation that parents are supposed to be able to provide everything for their children, economically, emotionally, etc. without help is impossible to live up to and can be very destructive.

It is really hard to know how good a job a parent is doing from the outside; you just don't know what he or she has to work with. The way a person turns out is not necessarily an accurate reflection of how hard his or her parents tried or how good their choices were. We all know wonderful people who came out of homes that were unstable or unloving or unsafe. Well, the opposite can also be true. I know it's hard to accept the idea that you might do everything right and still wind up with a kid with problems, or unhappiness, or who makes bad choices that the world at large blames you for. But that's how it goes in the real world. We should all remember that before we start criticizing other people's life choices.

Look, if someone wants to be a parent, then they need to take upon themselves the responsibilities of a parent, if they are capable of doing that. I am not talking about someone who has lost his/her spouse or needs to work three jobs to make ends meet; these are difficult circumstances and are certainly not voluntary. I am talking about people who choose to sacrifice their own relationship with their children and even the emotional well-being of their child so as to maximally advance their careers/research.

And day care is not "just a few hours," it frequently stretches from as early as 6 in the morning to 6 in the evening. In a lab I was working in there was a post-doc (living in Vallejo, California) whose 6-month old twins were in day care all day long (i.e. 6 to 7) while he worked in San Francisco and his wife worked in Sacramento. Each worked a full day and each commuted 4-5 hours per day. Can you tell me that this is a healthy situation - 6 month old babies in daycare seeing neither their father nor their mother except for an hour or two in the evening?

On your last paragraph: fully agree, we don't control everything and can't predict how children will turn out. However, there are general trends and we ought to do the best that we can...

 

[mercaptovizadeh]

As a Christian, eh.

Edit: Spot on, EpiGirl.

Precisely so. My faith teaches me that there's something greater than personal success, career advancement, prestige, human respect and human knowledge. God comes first, then comes family and other people, and a distant third is career. You're free to have a different perspective, but rolling your eyes at me isn't really engaging in the argument.

 

[MSTPbound]

Oh, hot-button issues...

I really think everyone could profit from letting go of the one-size-fits all approach to parenting in general. What works well for one parent may not work well for another, and it is easy but unfair to decide that there is one optimal way to do it and that parents who go another way are selfish or incompetent.

Now...really, am I the only person on this forum who was in child care as a child? What do you guys imagine happens there? While I fully agree that child care in this country needs oversight, regulation and political resources behind it, that does not mean that it is impossible for a physician-scientist to find a safe, enriching environment for his or her kid to spend a few hours in during weekdays. I used to work for a Head Start program, for which at least 90% of the children came from families meeting a pretty strict definition of low income. There was an auxiliary child care service that was set up in recognition of the fact that most kids had working parents, and it was phenomenal. I would send my child there any day. If there's one, there are others. Taking care of a child all by yourself, or only with your partner, can lead to burn out that is far worse for your child than spending some extra time away from you. This expectation that parents are supposed to be able to provide everything for their children, economically, emotionally, etc. without help is impossible to live up to and can be very destructive.

It is really hard to know how good a job a parent is doing from the outside; you just don't know what he or she has to work with. The way a person turns out is not necessarily an accurate reflection of how hard his or her parents tried or how good their choices were. We all know wonderful people who came out of homes that were unstable or unloving or unsafe. Well, the opposite can also be true. I know it's hard to accept the idea that you might do everything right and still wind up with a kid with problems, or unhappiness, or who makes bad choices that the world at large blames you for. But that's how it goes in the real world. We should all remember that before we start criticizing other people's life choices.

Word.

 

[delirium81]

As a Christian, I am well aware of the centrality of the father and mother in the development of the child.

I'm sorry, I'm with EpiGirl. I can't let that slide. Because, as an atheist, I think children should be raised by packs of wolves. Preferably hungry wolves.

 

[EpiGirl]

And day care is not "just a few hours," it frequently stretches from as early as 6 in the morning to 6 in the evening. In a lab I was working in there was a post-doc (living in Vallejo, California) whose 6-month old twins were in day care all day long (i.e. 6 to 7) while he worked in San Francisco and his wife worked in Sacramento. Each worked a full day and each commuted 4-5 hours per day. Can you tell me that this is a healthy situation - 6 month old babies in daycare seeing neither their father nor their mother except for an hour or two in the evening?

Mercaptoetc.,

My point is that I can't tell you it's a healthy situation because I don't know this family. And I don't think that on the basis of the fact that you work with this man you can tell me his family is in an unhealthy situation. Maybe it's not the perfect situation, but maybe it's the best that family could work out. And it might not be as bad as you're imagining--I don't think you can assume based on the information you have that those twins are not bouncy, happy babies either of whom will grow up to be Paul Farmer/Desmond Tutu/Mia Hamm. We all make judgments about people--me more than most, probably--so I think I can understand where you're coming from, but I hope you can also acknowledge that you probably don't know the whole story. Whether we're talking about trends or individuals, these are extremely complex issues and I think there's very little to be gained by simplifying.

In any case, while I assert that there is more than one way to raise a healthy child, there are probably some families in situations that we would both agree are unhealthy. Even there, I think there is a very narrow set of circumstances in which I would not still urge you to reserve judgment on parents. We are all just trying to make the best choices we can and time and time again we're reminded of the fact that none of those choices are perfect, and sometimes they are all deeply flawed.

Since we are all going to be doctors, and doctors have an unusual role, I think it is important to keep a dialog going on what our judgment means. It's one thing when we hold a low opinion of a colleague because of a choice with which we disagree, but at some point that opinion is going to apply to one of our patients. My personal feeling is that we're all responsible for looking at ourselves critically on this one, and we don't get to be finished with that process. You don't like people making assumptions about you based on your religion, so you have a head start.

 

[achamess]

Boy, I'm glad I got this topic going. As I suspected, there is a diversity of answers, all of which have their own merits. I am realizing more and more that, with some effort, one can integrate a career into a very active family life. I am with Mercapto in that I believe my family to be my most important commitment in this life. My career will certainly make my life more rewarding and interesting, and it will be a means to attaining the necessary things to raise a family, but at the end of the day, the family still comes first.

I actually think the life of a researcher could well suited to raising a family, if one is flexible and able to adapt (and has an understanding spouse). I see several PIs bring their young or teenage children to the lab and they hang around, do homework, watch movies in the conference room, etc. In this way, if for nothing else, the children can see what their parents do, and perhaps, gain an early admiration and interest in science and their parents' jobs.

Let's keep this conversation going.

 

[malchik]

Interesting discussion. My current thinking as I finish the mstp with several kids now, is that I can't do it. Not in this funding climate, combined with the amount of time I want to be with my family. I think many of you are looking at this wrong, imo parenting is not about how the child turns out. Terrific parents can have kids not turn out so well. And a successful/healthy child does not define a good parent. It is the relationship. It is unlike anything I have experienced, even sacred. I find myself redefining what I want out of life. For me a career in medicine + science while trying to maintain this bond I have with my kids are mutually exclusive. Others can do it, but it takes more energy than I have. I've decided science is a hobby for me. I read journals, go to meetings, and maybe I'll collaborate as an academic clinician, but no RO1's.

 

[QofQuimica]

I am somewhat perplexed at how this thread went from a discussion of general principles (at least from my perspective) to becoming full of warring personal anecdotes and (presumably to epi and some of the rest of you) judgmental.

Epi, I'm not sure if you were mainly responding to mercapto or to me as well. But if it's the latter, nothing that I said should be taken as a "judgment" on individual decisions made by individual parents. We're discussing the ideal solution to a hypothetical question here. (Well, at least I am!) I also would agree that the type/quality of childcare matters, as does the age of the child. What I specifically find objectionable is people putting their young infants in daycare all day, more along the lines of what mercapto is describing. Once the child is school aged like what you described, of course the situation is not equivalent. As in your example, I don't think it's unreasonable to have a school aged child go to daycare for two or three hours from the time when school ends until his/her parents get off work at 5:00. The problem is that a full-tilt physician scientist career is not a 9-5 kind of career. One can choose to make it that kind of career in order to pick up the child from day care by 5 PM every day, but that person will do fewer experiments, put out fewer papers, get tenure later, etc. Such a person is clearly making a sacrifice in his/her career for the child, considering that this person's childless colleagues will be working in the lab or the clinic until much later.

I also don't agree that holding moral views that are at odds with those of your patients or colleagues precludes working with (and for) them. It is neither necessary nor desirable to become amoral when one dons the white coat. Part of being a professional is doing what is best for the patient, even if their choice is not the choice that you would make if you were in their shoes. If a physician felt so strongly about something that s/he simply could not in good conscience help the patient (ex. a physician who is morally opposed to abortion), then it is appropriate to refer that patient to another physician. There is no need to ever have a discussion like the one we're having with one's patients (nor probably with most of one's colleagues either!). The focus should be on helping patients, which requires learning about and understanding their belief systems, not proselytizing them with one's own. Even if I really wanted to "scold" patients who I thought were making bad decisions, the truth is that I have more than enough work to take care of my own moral hygiene. I'm really not looking to get into the business of concerning myself with other people's.

 

[QofQuimica]

One semi-related tangent for the atheists in the thread to consider: finding out about patients' religious and spiritual beliefs is very important to their care, even if you don't share those beliefs. Religious beliefs can affect people's health in interesting and unpredictable ways. We had a patient a few months ago who was getting these new, strange headaches that mysteriously went away on their own after a few weeks. At the time, none of us could figure out what was wrong or what could be causing the headaches, until someone found out that the patient was a devout Catholic. It turned out that the patient had given up a serious coffee habit cold-turkey for Lent, then started drinking coffee again afterward. Once the patient went back to drinking coffee, the headaches went away as mysteriously as they had appeared.

 

[decal]

Precisely so. My faith teaches me that there's something greater than personal success, career advancement, prestige, human respect and human knowledge. God comes first, then comes family and other people, and a distant third is career. You're free to have a different perspective, but rolling your eyes at me isn't really engaging in the argument.

Not attempting to. Didn't see how that was germane, however.

 

[greg12345]

Just skimmed this real briefly. My 2c: it is hard to know what you will feel and what your views will be once you actually go through it yourself. I do not want to dissuade you but you must realize it will be an excruciating sacrifice. Your kids are only young once, and there is a good chance you will miss a huge chunk of their childhood depending on when you have them. Of course people have different opinions over how much time dads should spend with their kids, but I am of the opinion that quality time is no substitute for quantity time, i.e. the more the better. Quite frankly it kills me that I am missing or have missed things in my kids life (birthdays, games, etc.) because of call, etc. Maybe other people are OK with stuff like that but it really eats away at me. Is a career in academic medicine worth missing big chunks of your kids life? Obviously the answer depends on your values and what you treasure most in life. Think about that carefully before you jump into the fire. As for me, I doubt when I am on my deathbed I will be thinking fondly of that Swan I floated in the ICU but rather playing tee-ball w/my son, etc. Who really wishes they spent more time at work when they are dying and looking back on life?

And I am going to pull rank and say until you have kids and are in residency, you DO NOT know what it is like and the magnitude of the sacrifices you will have to make. You have no idea what it feels like to see your little boy's face fall w/disappointment when his dad can't take him out for ice cream on his birthday because he has to "take care of really sick people at the hospital" for 30h straight and won't be around. Sure, it is justified and reasonable and that's how life is, but a kid is a kid and only understands his dad isn't around. Would I have chose this career if I had known what I know now back when I was 21? Maybe not. I guess my best advice is to become either a dentist or a dermatologist.

 

[Decepticon]

realistically, you are asking the wrong question.

Wrong in what respect?

(1) Would you rather have your father be a stay at home dad and be on welfare but be oh so 100% available to you?

Yes, I would.

(2) Did the fact that you didn't see your father much made much of a difference on how much you love him or how much he loves you? In fact, if you actually saw him more, would it have made any difference?

I think so. But I don't know a great deal about child psychology and biological imprinting.

(3) Would you feel guilty if your father quit his job, or took a less prestigious job just because he had kids and needs to take care of the kids more? (I know I would.)

If he wanted to make me guilty, he would have managed to. However, I never felt guilty that my dad chose to work as an home-based independent architect instead of spending the whole day in an office downtown. I wouldn't even have felt guilty if my mom had to stay as home as well. I know I made her feel miserable every morning she went to work. Spoiled kids.

One doesn't have more than 24 hrs a day. If you want to be an outstanding researcher, you won't be able to spend as much time with your family. Being a scientist is not like having a trust fund. It isn't possible to have everything you want.

I have heard a few professors say that. One was a neurologist I was very fond of, but I suspect that the comment was influenced by some crashed-marriage bitterness. People generally bitch and moan. I worked a little in a lab where the professor didn't do much experimenting himself. He had enough liberties to do what he wanted with his time, and if he wanted to do research at home, he could have done so. I haven't really cracked this code, as I am still a student. He told me he had to put in insane amount of work to get enough published in order to become a professor, but once he got tenure...

Sacrifices always have to be made. How good of a researcher do you want to be? It's all up to you in the end.

I understand that, and I don't think you pointing that out is very controversial. I think the heat generated comes from your spin on the original posters question, that you come off as not thinking it is legitimate to worry about family opportunities as a researcher.

 

[EpiGirl]

Epi, I'm not sure if you were mainly responding to mercapto or to me as well.

I guess I was incidentally responding to you on the topic of child care. I actually did mean to defend infant child care as well (Early Head Start etc), but I think the larger point I was trying to get across was not in the specifics of what age groups or how many hours a week are acceptable. Nor do I wish to minimize the difficulty of this decision or the magnitude of sacrifices most parents have to make if they're passionate about their work--for better or worse. What I want to emphasize is that taking a normative approach to time management, and implicitly denying the validity of different approaches to parenting, creates social pressures that make finding the optimal arrangement for any given family that much harder and harder to keep rational. Or to put it a little more emotionally, with all the neglected and abused children in this country I think we all have bigger fish to fry than getting ticked at each other over how many hours we work and how many hours our kids are in child care.

The focus should be on helping patients, which requires learning about and understanding their belief systems, not proselytizing them with one's own.

Here here.

 

[EpiGirl]

One semi-related tangent for the atheists in the thread to consider: finding out about patients' religious and spiritual beliefs is very important to their care, even if you don't share those beliefs. Religious beliefs can affect people's health in interesting and unpredictable ways.

There was an incident in a Northern California health department recently in which a young man turned out to have been instrumental in spreading a reportable STI because several doctors had failed to test him once they found out he was a divinity student. Food for thought.

 

[dl2dp2]

(1) not everything's possible.

(2) children are more resilient than you think. if you have good genes, it's hard to mess it up by sending them to daycare. similarly, you'd be crazy to think that just cause your quit your residency and spend more time with your children he'll be the next Einstein. there's no study demonstrating absolute superiority of either, and it's unfair to fault people for choosing either.

Daycare does not constitute a form of what i would consider "sacrifice".

(3) being a great scientist is very hard. takes a lot of time and energy and CAN SOMETIMES result in divorce, estrangement and loneliness. It's a risk everyone who has the aspiration for has to take.

(4) Balance is possible. You do somewhat lower-level science. Go to lower ranked institutions. Have smaller labs. Don't kid yourself. The quantity and quality is not as good. But it is still fun. It may still be useful (or possibly more so.) Are you okay with this? Most people are. Some aren't.

(5) Some instead choose to take a gamble, work their butt off and still get married and have kids. Send them off to daycare, ignore their wives/husbands, have affairs, etc. Now you tell me how is this much different from any other competitive field where successful people often have miserable personal lives?

(6) Successful people chose to have bad personal lives. People are particularly judgmental about it as if one are morally obligated to choose one over the other. Why can't some people choose work over life? They already paid bitterly for it. If Newton had his two kids and dog and house we'd still be in the dark ages.

(7) I would imagine that I'd rather have my father as a Newton than as some regular old joe, although the answer may be different for Newton's son. But my father may rather be a regular old joe than Newton. Let's just please be realistic and honest about it.

 

[QofQuimica]

I guess I was incidentally responding to you on the topic of child care. I actually did mean to defend infant child care as well (Early Head Start etc)

Well, I can agree to disagree.

What I want to emphasize is that taking a normative approach to time management, and implicitly denying the validity of different approaches to parenting, creates social pressures that make finding the optimal arrangement for any given family that much harder and harder to keep rational. Or to put it a little more emotionally, with all the neglected and abused children in this country I think we all have bigger fish to fry than getting ticked at each other over how many hours we work and how many hours our kids are in child care.

Again, that's a pretty strong emotional attribution for what is to me an abstract philosophical argument. I'm not "ticked" or even annoyed at people who put their infants in daycare any more than I'm "ticked" at people who eat beef even though I don't. Putting an infant in daycare is not a choice that I would make based on my values, and I don't think it's the optimal choice. That's about the extent of my emotional investment; I'm certainly not going to go picket outside of Head Start centers over it.

There was an incident in a Northern California health department recently in which a young man turned out to have been instrumental in spreading a reportable STI because several doctors had failed to test him once they found out he was a divinity student. Food for thought.

Wow, someone must have gotten their rear end reamed for that little oversight. You got a link for that?

One of my more colorful attendings told me once that he knows when patients are lying about sex, drugs, and rock-n-roll b/c their lips are moving.

 

[kassie]

This is a problem in any time-consuming career.

My husband and I are both MD/PhDs, he's an intern and I'm a resident, and we have a 16 month old son. The second he was born, our priorities shifted. We work hard in our residencies but sometimes it had to take a hit for the little guy. But then again, I try and work my butt off when I am at work to make that time I am away from him worth it. But we're lucky, we also have lots of readily available family in addition to a day care we love. We also don't have much of a social life anymore. That's really what was sacrificed if you ask me, but that's fine with me.

But as much as we love our little one, we're having another child any time soon because we're stretched to our limits right now. I would die if I had to see another child grow up learning to cry when my pager goes off (I do home call). So, not until after residency...

 

[grendelsdragon]

Getting back to the original post...

Yes. It is possible to be reasonably accomplished in all the above, but we have to make priorities based upon on own moral compasses. I am a cardiologist (fellowship in a top 5 program), attending cardiologist at a major university hospital, basic scientist (NIH funded and faculty at a well-known medical school) and most importantly a proud father to a rather precocious little child.

First, get used to not getting much sleep. It's hard, but your waking moments are sooo gratifying. Try hard not to bend the child's schedule to yours.

Second, being a physician-scientist is no greater a temptation for being a workaholic than most any other profession.

Third, you have to be responsible and put food on the table. Academics is (usually) not a lucrative profession, and you have to make sure your family is well provided for.

There appears to have been some back and forth about our respective morays, but suffice to say, I ascribe to the overall view that we should be mindful of the plank in our own eye before drawing attention to the speck of dust in another's eye. We have too much to improve in our own lives to be concerned with judging others'.