From the May 12, 2023 issue of the Transformational Times - Mother's Day
Reflections on Mother’s Day: You Become
Adrienne Klement, MD
-Ruth Bader Ginsburg
It was a hot July in Durham, North Carolina. I had just finished fellowship and was starting my new role as an Attending in a large academic hospital when I had my first daughter. I planned for six weeks of maternity leave, thinking this would be “enough,” while my husband was on his Trauma rotation as a chief resident in Orthopedic Surgery. I went into labor on a Saturday night, and we decided that he would finish his call shift and work through the night, while I “slept” after my epidural was in place. Emma patiently waited for him to finish his 28-hour call shift. She even gave him a few hours of rest—on the bench by the window—before her arrival. (Ask any resident—we could sleep anywhere). The first few days of parenting were joyous and blissful. Then my husband went back to work, often leaving before 5:00 AM and getting home well after 8:00 PM. Naively, I decided because I would be home with Emma, that he would plan his busiest rotations for July and August. Why would I need any help?
It turned out, the weeks that followed were the lowest, loneliest, and most exhausting I would experience in my life.
I remember asking myself daily: what am I doing wrong to not feel the joy of being a new mother? I quickly minimized my worries and normalized the challenges new parenting entailed. Then two years later, our second daughter was born. You think I would have learned from my experience with Emma to insist on more support...that more support would be paramount to my well-being, and even more so, to the well-being of my first-born child.
Hailey was born in May on a Wednesday in downtown Philadelphia, where my husband was doing his fellowship and I was working as a Hospice Medical Director at the University of Pennsylvania. The day was significant because not only did my husband get two weekdays off, but also that whole following weekend, too. Now, it seems problematic to say, that this felt undeserved, but it did at the time.
Just before Hailey arrived, we had bought a house in Wisconsin to be closer to his family and our best career opportunities. After delivery, in the context of many sleepless nights and the blurs of nail-biting pain from a bleeding nipple, we decided that I should move there first with the girls while he stayed back to finish his fellowship through July. If I could do it myself the first time, why not the second? And wouldn’t a house be better than a small apartment in downtown Philadelphia? Nonetheless, once in Wisconsin, while my mother-in-law was able to help at times, I felt more alone and inadequate than ever.
Then I recalled a text my aunt had sent to me a while back after Emma was born. She wrote, “this too, shall pass.”
My feelings of overwhelming exhaustion and defeat, of being unqualified and inadequate were validated.
In Medicine, we learn from communication training that without validating emotions, there is often little progress in moving a conversation forward. Recalling that simple message was a turning point for me. From that moment on, a weight was lifted, a burden unloaded. I had a total paradigm shift in how I perceived myself as a mother. The conversation in my head changed from “I can’t do this,” to “I can’t do this alone” to “I am really good at this.”
Sadly, we live in a society of contractual relationships, in which asking for help without the ability to reciprocate often feels shameful. Asking for help often requires humility, the ability to receive grace, and some level of trust. While I still wish my own mother could have helped me in those postpartum periods, she died when I was a teenager. I can now look back to those times with gratitude and regard for the much-needed growth I experienced without her. I can now fully appreciate, and am so profoundly grateful for how she sacrificed for me, and for the fierce woman she was. I have become this woman, too.
While some miss the extra time with their newborns—I know I finally did after our third daughter Lucy was born—I felt more energized than ever to return to work. I learned to really invest in relationships both inside and outside the workplace. I have met some girlfriends who are truly exemplary in their parenting, and whom I would never hesitate to ask for help. I have found that reading in bed every night with my girls creates a special space for some deep questions about the universe. My favorite questions so far from my now four-year-old Hailey: “Why did your mom get sick and die, and why couldn’t you help her get better?” and “Can I be a ballerina without doing ballet?” and “If that clock was painted on that house, why did its arms move on the next page?” She noted recently in a school activity that “snuggling with mom” is her favorite activity. This gave me yet another shift in mindset. We learn that sleep is essential for the best cognitive performance.
After almost seven years now, all three of my girls are finally sleeping through the night. At first, getting up to help them fall back asleep was a major stressful event for me. How was I going to do my best thinking and advising while listening to student and resident presentations early the next morning? But the “snuggling with mom” answer, for which I am so grateful for her 4K teacher, allowed me to truly embrace the fatigue and change my perspective. These nighttime interruptions have become a source of rich solitude and joy and serve as a reminder to take care of myself, too, and ask for help.
In my journey as a working mother, I have learned that “work-life balance” is just a loaded and vague buzz phrase.
There are many ways to interpret “work-life balance.” To me, this term puts too much pressure on achieving perfect “balance” with equal emphasis on “work” and “non-work” or “life” experiences. It all cannot happen in a single day. I realize that some days will have different challenges, or unexpected stressors, in which damage control becomes the theme, while others will be filled with deeply meaningful experiences in which I thrive. Hiding in the pantry eating Oreos is just as acceptable of a day in the home, as being celebrated as employee of the year at work.
Now, with three young girls, and as after-school activities abound, a new tactic I have learned is to time-block my schedule in order to bring my most authentic self to work. As the reader knows, Medicine can command our attention, even when not physically present at the bedside or in the clinical exam room. Recently, I was asked as a consultant to assist with a family meeting that was outside of my usual hours when I am physically present in the hospital. I knew the family and residents well, so I decided to call in from home to help. As I was offering my advice on the care plan over speaker phone, a little voice shouted from the bathroom, “Mom can you help me wipe my butt please?!” The patient, his family, and the care team had a good laugh, and care was able to be moved forward in a most goal-concordant and efficient way. I felt honored to be part of that important aspect of care whilst helping my daughter with proper hygiene.
I have come to understand that each part of my life, work and family, provides me with both energy for and respite from the other, and each gives me a sense of real purpose.
In time-blocking my schedule, I find scheduling early morning chart reviews is as important as blocking time for exercise, reading, and moments with my family and friends. And, it is perfectly acceptable to give myself permission that these time investments are not always in perfect “balance.”
Inspired by a Grand Rounds by one of my great mentors who referenced the book, The Velveteen Rabbit, By Margery Williams Bianco, I bought this book and read it to my girls. The story really struck me, especially her words:
“'Real isn’t how you are made,’ said the Skin Horse. ‘It’s a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real.’‘Does it hurt?’ asked the Rabbit.
‘Sometimes,’ said the Skin Horse, for he was always truthful. ‘When you are Real you don’t mind being hurt.’
‘Does it happen all at once, like being wound up,’ he asked, ‘or bit by bit?’
‘It doesn’t happen all at once,’ said the Skin Horse. ‘You become. It takes a long time. That’s why it doesn’t happen often to people who break easily, or have sharp edges, or who have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby. But these things don’t matter at all, because once you are Real you can’t be ugly, except to people who don’t understand.'”
On this Mother’s Day, the advice I would have given to my younger self is this: “This too, shall pass” and “You don’t need to have it all, all at once.” Respect the process and allow yourself to enjoy the journey alongside others. Unconditionally, and with a deep understanding of the journey, I hope to become a source of help for others, and most of all, for my girls one day.
Adrienne Klement is an Assistant Professor in the Division of Geriatric and Palliative Medicine. She works at the Milwaukee VAMC for both Medicine and Palliative Care teams and was awarded ‘Employee of the Year’ in 2021. Dr. Klement is a graduate of the Kern Institute Kinetic 3 Teaching Academy and exceptionally dedicated to teaching communication skills to residents in training.
