Time Macho: I’m Part of the Problem

It was a concept intimately familiar to me long before anyone gave it a name. From my earliest days in college, I felt surrounded by people who packed their days with meetings, activities, sports practices or competitions; classes, study groups, and research; for whom every moment had been spoken for and each day didn’t so much end as spill over into the next. The standard was clear: to do any differently was to be lazy, unmotivated, and destined for failure.

During medical school, the feeling only intensified. Free time was a prize to vocally lust after but also a guilt-inciting purgatory to be avoided at all costs. After all, we could never learn all there was to know about medicine, so how could we ever stop trying?

When I read Anne-Marie Slaughter’s description of “time macho” – the idea that “somehow you’re better and tougher and stronger if you work harder and longer”[1] – during my last year of school, it gave me a tangible practice toward which to direct my frustration and a paradigm away from which to direct my own behavior. Throughout my training, I tried to assign some priority to sleep and to the people and things outside of medicine that nourish my soul. And until recently I thought that I had done an adequate job of it, and of encouraging the same in my colleagues.

Last month a speaker at my hospital’s Grand Rounds presented data highlighting the importance of sleep – how many benefits it brings and how much physical and emotional damage a deficit of it can unleash. When she presented the recommendations for sleep durations according to age, she asked how many people in the audience had young children who were getting the appropriate amount of sleep. Less than half raised their hands. What about teenagers, she continued. Again, less than half.

What about all of you, she finally asked. How many people in the audience regularly slept for the recommended seven to nine hours each night?

Only a smattering of hands popped up across the auditorium. My own hand stayed down, despite the fact that I have been sleeping eight to nine hours per night over the past few months. I felt embarrassed, guilty for allowing myself such an extravagant amount of rest when colleagues all around me were working so hard. Never mind that I had entered my year as Chief Resident, with my work hours nearly halved and allowing much more time for rest, and that I was exhausted from preparing for the pediatrics boards while caring for my toddler son and navigating the first trimester of my second pregnancy. It still felt somehow shameful to be a physician getting so much sleep.

Most of the day passed before I realized that my reaction – my embarrassment, my instinctive need to offer justification for taking care of my own basic needs – only contribute to and perpetuate the culture of time macho that pervades medicine and so much of our society. The speaker could just as easily have asked how many of us value ourselves, our health, our well-being? And while that might have garnered a few more raised hands, it would by no means have been met with universal commitment, even in a room full of healthcare providers.

As with any effort toward culture change, the first steps involve shifts in the beliefs and behavior of individuals. So this is me urging myself and my colleagues to stop judging ourselves based on how many hours we’ve worked, the depth of our exhaustion, how thoroughly we’ve driven ourselves into the ground. To direct at least a little bit of care that we provide toward ourselves.

This is me raising my hand.


[1] Dell’Antonia, KJ. “Talking About Why Women Can’t Have It All.” New York Times, 21 June 2012. Web. 15 Nov. 2015.

Tools for Survival

My poetry book, “Tools for Survival,” is available for pre-sale!! If you are thinking of buying a copy, please do it now because the number sold during this period will determine the actual press run. Thanks for your support!

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My first book of poetry!

I’m thrilled to announce that Finishing Line Press will be publishing a chapbook of my poetry entitled Tools for Survival in early 2015.  Prepublication sales will take place from November 25 – January 23.  Stay tuned for information as the date gets closer!

Tools for Survival cover.jpg


The Big Ask

Sometimes you recognize it as you are making it.  Other times you only realize later, long after the answer and its effects have rippled outward through your life, just how much rested on – and sprang from – that question.  Will you help me with this?  Do you know anyone who does xyz?  What do you think of this idea?

Several years ago I read an article that gave this phenomenon a name, to which I pay homage in this title. You can read it here, and I highly recommend that you do; it makes you want to jump up and shout your big, scary, but potentially life-altering question from the rooftops.

Which is, on a smaller scale, exactly what I intend to do here.

When I was a little girl, I wanted to be a writer. I became a doctor who loves to write, and now my goal is to make a career of both in the tradition of my idols Danielle Ofri, Atul Gawande, Pauline Chen. In fact, I wrote a collection of essays during medical school. Several have been published on their own, but I am hopeful that I might be able to publish them together as a book.

So here it is: I’m looking for an agent. Or a publisher. Someone to take stock of what I have written and help me toward the next step, or to guide me in reworking what I’ve done so far. And I will appreciate any thoughts/recommendations/general advice that anyone has to offer.

This ask might not end up being the big one. But maybe it will lead me somewhere. And at the very least, it’s good practice for the next one.

Should the star of my life star in my writing?

Lately my husband has been sending me a lot of articles discussing the use – or careful avoidance of – the Internet and social media by parents for the sharing of photos of their children. Most of the articles are written by people who have made a conscious decision to minimize their children’s exposure to the online public, some simply by limiting the number of pictures they post and by strengthening their privacy settings, others by establishing password-access-only sites to share pictures with close friends and family, and, in one case, by registering a URL, email address, and Facebook account in the child’s name, to be handed owe to him or her at such time as the parents deem appropriate.  I have not yet come across any articles encouraging the opposite, go-ahead-and-share-away philosophy, which I suppose makes sense since that approach seems to be the norm.

I will admit that I share photos of my son on Facebook.  There was the initial birth announcement featuring a shot from the delivery room. I keep an album of the photos we take each month, him propped in the same chair with his stuffed elephant nearby for comparison. Is he in my profile image?  Yes.  Other than that, I don’t post very often, but does it really make a difference given that I’m posting at all? In terms of preserving his privacy and waiting until he is of an age to give consent, or at least assent, to the sharing of his identity and image, is it an all or nothing phenomenon?

This really brings up a bigger question for me – what about my writing? How does one manage privacy concerns when writing about one’s family? My husband figures frequently in my work, and although I never delve into deep dark family secrets or share anything overly private, he is always my first reader and I give him full veto power over any piece that involves him. (He has yet to exercise that power.)

But now there is my son. One simple solution would be to not write about him until he is older and can grant permission, but he is such a huge part of my life, and already has such a great influence on all of the things that I process through my writing – my work as a pediatrics resident, the balance between career responsibilities and family life, and of course the joys and challenges of motherhood – that avoiding mention of him feels impossible and counterproductive.

Protecting our subjects’ privacy, especially when those subjects are patients, is a topic that features frequently at conferences in the medical humanities. The general consensus seems to be that the writer should try to gain the subject’s permission and, barring that, alter any information that might make the individual identifiable to someone who knows him or her.

Thus far, I have taken a similar approach in writing about my baby. I never use his first name, and handily his last name is different from my own.  Nothing that I share pertains to his appearance, health, or any other aspect of his life thus far that he could conceivably in the future wish to keep private. The question looms as to whether he will be upset one day that I have written about him at all. That’s something that I can’t predict. I can only hope that he will understand how essential the act of writing is to his mother’s well being and that he will know that I have made every decision with the intent to protect him.

How do other writers feel about including their children in their writing? Do you avoid it, embrace it, or strive for some middle ground?