I've got a thread on doctor moms that's been sitting in my drafts folder. I think after another strong coffee I'll pull it out.

My mom was a great mom. She started her residency when I started kindergarten, then died shortly after becoming an attending. Prepare the tissues. https://twitter.com/JJcolemanMD/status/1335395337175896066

1/ Alright here we go - A thread on doctor mommies.

As a 30-something junior doctor w/a keen interest in surgery, I get a lot of unsolicited advice about being a mother-doctor... most often by people who are not mother-doctors (interpret that as you will).

But this thread isn't

2/ about that. It's about my perspective as the child of a mother-doctor & how it shaped my view of what a "good" mom is.

[Spoiler alert to all mother-doctors reading this: your kids are going to be JUST FINE]

My mom graduated from the University of Baghdad Medical School at

3/ the peak of the Iran-Iraq war.

Doctors were forbidden from leaving. My dad spent tens of thousands of dollars bribing airport officials & creating fake passports/visas to get her out after her brother was assassinated. She spent the night in a bathroom stall in Prague before

4/ making it safely to Canada.

Facing obstacles to reciprocity in Canada, she completed all the Steps on consecutive days & started her residency at Mayo Clinic when I started kindergarten. The catch - we were in Nebraska & she was in Arizona. For months, my dad was a single dad

5/ When she came home for Thanksgiving, she decided not to go back.

Over the next 4 yrs, she completed an IM internship & neurology residency at UNMC. This was before work hour restrictions. She spent every other night at the hospital during her PGY2. We were lucky if we saw

6/ her in the morning before we left for school.

She never showed up to her assigned "volunteer" shifts serving lunch at school. We were the last kids to be picked up from after-school day care every single day. Sometimes if we didn't have any leftovers, my dad would take us to

7/ the casinos for the buffets.

Sometimes we missed school events bc mom was too tired to drive. Once mom dropped me off at a soccer game & went to park, but never showed up to the field. My coach was going to take me home until we got to the parking lot & found her asleep in

8/ in the driver's seat of her car. Seatbelt still on. Keys still in the ignition.

It wasn't easy.

She was judged by the other moms.

BUT

I never thought she was a bad mom. As far as I was concerned, she was saving lives. I wore her white coat to my 1st grade career day.

9/ She graduated from her residency & suddenly we could see the light at the end of the tunnel.

Little did we know that light was an oncoming train.

Cancer.

She died at age 41. I was 13.

10/ She didn't do any of the things traditionally associated with being a "good" mom. She didn't bake. She didn't decorate. She didn't participate in school activities.

She dropped us off at school so infrequently that I took a picture of her on my disposable camera when she did

11/ None of that really mattered to me.

As far as I was concerned, she was still the best mom. I was the smartest kid in the grade & my mom was the smartest mom in the grade.

When kids would ask where my mom was, the answer was the same: she's at the hospital saving lives.

12/ That's not to say that the system is optimized for mother-doctors. It wasn't then, it still isn't now.

The system needs an overhaul. It still requires doctors to choose between their families & their careers. It promises time once you're done - but it can't guarantee time.

13/ Between 2000 & 2014, 324 individuals (220 men, 104 women) died while in residency. The leading cause of death was neoplastic disease, followed by suicide, accidents, & other diseases. For men the leading cause was suicide & for women, malignancies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483979/

14/ This doesn't even touch on the number of medical students & attendings affected - we lose 400 doctors per year to suicide - but it's a clear indictment of a system that is so unhealthy it's literally killing its own.

Is it possible to be a "good" mom AND a "good" doctor?

15/ Well, as @JJcolemanMD pointed out - that depends on your definition of "good."

I never thought my mom wasn't a great mom. By my definition.

Other people probably did. By their definition.

But honestly, who TF cares what they thought?

I'm still here.

Now I'm a doctor.

16/ Posthumously, she received the Teacher of the Year award from her residents.

So clearly she was a great doctor AND a great mom.

Residency programs need to acknowledge that the way they treat their trainees affects not only their trainees, but the ppl who depend on them.

17/ The one thing I will say to any program director out there.

If you're choosing between metrics & the well being of your trainee - choose your trainee.

Metrics don't have kids.