It was around 5 o’clock in the afternoon and my husband, Sam, and I were lounging on the bed of our hotel room in Venice, Italy. My shoes were off my tired feet, and I was propped up on a stack of pillows with my legs stretched out in front of me. We were both on our phones, taking advantage of the hotel’s WIFI. We were exhausted from wandering the maze-like passageways of this pedestrian city with our two children for the past several hours and were taking a break before heading out to dinner.
While Sam caught up on sports news of the day and Facebook happenings, I scrolled through my work email, which I knew would continue to fill my inbox throughout my evening, as I was in a time zone 6 hours ahead. I deleted various emails, filed others, and replied to those I could deal with quickly. I left some to deal with when I was back in the United States. After spending 15 minutes or so on email, I opened the Haiku app to access my institution’s electronic health record, Epic. The messages my patients send me through the electronic portal come directly to me, and I was able to quickly answer some patient questions. I forwarded a few to my nurse to handle.
Closing up the Haiku app, I opened Facebook and saw a post pop up in one of the women physician groups I belong to. The author of the post asked the group for opinions on checking work email while on vacation. I typed out my answer: “I am currently sitting in a hotel room in Venice, Italy, after getting back from a day out exploring with my husband and kids. I’ve just spent about 15 minutes catching up on work email. I may do another 15 minutes before bed. This is pretty typical for me.”
I remembered this event as I opened the Haiku app while waiting to board a Delta flight home from DC, where I’d been for an ASCO committee meeting. This got me thinking about how I manage my work and my non-work life, a term we frequently refer to as “work-life balance,” on a daily basis and also while traveling for work and for fun.
As the years have gone by, my home life has evolved in tandem with my work life, and my work-life strategy has also evolved with the needs of both my family and my work. I had my daughter during my second year of residency, and my son was born during my second year of fellowship training. They are now 15 and 12 and finishing up 9th grade and 6th grade, respectively. My daughter is a theater kid and plays tennis, and my son is involved with student government, his school’s STEM club, and band. This means lots of after-school theater rehearsals, drama and band performances, tennis practices, and club meetings. While my children have gotten older and grown more involved with before- and after-school activities, my career has become more complex. I’ve been promoted from assistant to associate professor, I’ve taken a leadership role in my institution’s cancer center, and in this last year, I’ve become more involved in administration of my division. I continue to maintain an active oncology practice, caring for women with gynecologic cancers. Over the years, the way I have integrated my home and my work life has morphed, with a shifting of emphasis to best meet my family’s current needs and desires, as well as my own.
Perspectives differ on how to maintain work-life balance, and this includes how to handle work while vacationing. Some physicians function best by turning work completely off while they vacation—no emails, no phone calls, no checking the EMR. Others, like me, work just a little while on vacation. There are probably those who take plenty of work with them while traveling (though I suspect that this group is in the minority). It’s really no different from the way some physicians are able to leave work completely behind when they go home at the end of the day, others constantly bring work home, and yet others only bring work home occasionally. None of these are necessarily the right way to handle the integration of work and a busy home life. None of these are the wrong way, either.
The concept of work-life balance is a mirage, and I think the expectations this phrase sets up are problematic and one of the major triggers of guilt felt by many women physicians I’ve spoken with. It suggests a separation of work from home, with perhaps equal attention on each, but not at the same time. This is nearly unachievable. I propose a change in the terminology, eliminating “work-life balance” in favor of the work-life pendulum.
In whatever setting I’m in, whether my office at work, my living room, or a hotel room in Italy, I experience a shifting of priorities to match the moment and setting. My family, my academic and administrative work, and my patients all take top priority in my life. In that hotel room in Venice, after spending quality time with my family all day, I felt comfortable letting the pendulum shift toward work, taking a few minutes to prioritize work email and answering messages about and from patients. In those 15-20 minutes, I took care of what I needed to, and in doing so, lessened my own anxiety about the volume of work I’d return to after my vacation. In my office at work on the day I received the call that my grandmother was in the emergency room, the pendulum swung strongly toward family. My grandmother immediately became priority number one.
For each of us, the work-life pendulum always swings, sometimes with just a slight shift in one direction or the other, and sometimes it sways more forcefully. How you manage your pendulum may be very different from how I manage mine, and that’s as it should be. Neither of us are wrong; we are both just managing as best as we can.
We may not always be in control of the direction of the pendulum’s oscillations, but when we are, it’s okay to give it a firm nudge. That evening in Venice, after spending those few minutes on work email and patient messages, I put my phone away and swung the pendulum back toward life and my family. After all, we had another delicious Italian dinner to get ready for.
Photo: Dr. Markham and her family in Venice. Photo courtesy of Dr. Markham.