You Are Okay: Letting Go of Guilt, “Balance,” and Impossible Expectations

You Are Okay: Letting Go of Guilt, “Balance,” and Impossible Expectations

Women in Oncology

May 01, 2017

Editor's note, July 19, 2018: The following post by Dr. Julia Close was recognized with a 2018 APEX Grand Award for publication excellence in the category of Social Media - Best Single Blog Post. 

Dr. Julia CloseBy Julia Close, MD

My first child was due to be born at the end of my first year of hematology/oncology fellowship. I have always been a planner. This was not my plan. I had planned to have my first baby a year prior while I was a chief resident and enjoying bankers’ hours. As I have now come to appreciate, the best things in life often do not go according to plan.

I prepared for life with a baby as I had prepared for most everything else—with endless study. I gleaned that there was a new elusive balance to be reached. This was prior to blogs, Twitter, and Instagram, so I searched the medical literature for editorials written by physician mothers (Perry Klass was a favorite of mine). I attended any available session on work-life balance, taking notes with great diligence.

My son arrived, later than scheduled. I balanced as best I could. I outsourced anything I could afford to outsource. I sought reliable and loving childcare. My husband (also a physician) and I altered our schedules the best we could so that one of us would be available for a daycare emergency.

Ten years and two additional boys later, this arrangement remains the precarious house of cards it was then. I have never minded noise or chaos, so this works for us. Is it “balance”? When I hear that word, I imagine a scale, with two arms perfectly set so that neither dips lower than the other. That’s not what I have. It is more like a seesaw, constantly moving up and down, taking me in the direction that needs me more—and always hoping one side doesn’t slam to the ground as the other side goes flying off into the distance. So far, so good.

In all my studies before my first son, I neglected to take into account the emotional impact of guilt. For many years, I felt that I was not quite good enough, that I had not given enough to either motherhood or to my career. I’m better now—a few years ago I let the guilt go (most of it, anyway). I can put my finger on when it happened.

It was at back-to-school night for my youngest; he was 4 at the time. I was sitting in his junior kindergarten class, precariously balanced on a chair designed for someone much smaller, wondering why, in my rush to get the kids home, fed, and situated with the babysitter, I had neglected to change out of the pencil skirt I had worn to work that day. A room of about 20 parents, mostly women, listened intently as the teacher introduced herself, then the assistant teacher. She introduced the families new to the school. Finally, she introduced the “room moms.” There were seven (seven!), more than twice as many as I had seen in prior classes. This left three moms looking around, myself included—neither shiny and new, nor able to volunteer to take on yet another organizational task, we were the only anonymous faces in the room.

The meeting went on, reviewing the exciting upcoming cognitive advances of my budding 4-year-old and his classmates. The time came for the lead room mom (LRM) to speak. She was sitting next to me, a friendly woman several years my junior. We had chatted pleasantly just prior to the introductions. She fervently discussed the importance of having parents in the classroom whenever possible. To that end, the room moms had decided to have a class party for every holiday and every child’s birthday, with full plans to include additional parties for summer birthdays. At this point, my mind was reeling. This was my third exploit into junior kindergarten—with my older children, I had attended one party a year, and select important events (mostly plays and musicals). There had been class parties for holidays, four or five per year. While I was still digesting this, LRM enthusiastically made an encouraging statement to volunteer at as many parties as possible, and handed to me a clipboard stacked thick with sign-up sheets.

Realizing I could never make a significant contribution to this profusion of class parties, I focused instead on the positive. Before me was a great opportunity: these women had the time to spend providing love and attention to my son and his classmates. I passed the clipboard on, and signed up for nothing. Later, I talked to the room moms in a more honest way than I ever had before—I shared my guilt about missing events, and then let them know their involvement helped me to move on. I let the guilt go.

When I was planning my life before children, I had hoped to have three little girls. I would teach them that girls can do anything, and guide them to successful and fulfilling careers. When my three sons were born, I was not really sure why I was given boys. I have since seen the influence I have on my boys in how they view women, and it makes my heart happy.

While traveling in the car one day, I asked the boys what they wanted to be when they grew up. The oldest was only 4 or 5, so the responses ranged from fireman to police officer. I asked why nobody wanted to be a doctor and the oldest responded, “Mommy, boys can’t be doctors! Only girls can be doctors.” When I asked them what they thought their father did, they all agreed that he worked at Home Depot. As tempted as I was to allow this conviction to continue, I opted to inform them of their dad’s actual profession. I realized that they were surrounded by so many strong women, and the impact this was having on how they viewed the world around them. (Although they now fully admit boys can be doctors, none of them want to be doctors, but they are still young. There is hope.)

I do not mean to imply the guilt is gone, or that I have found some Shangri La in work/life balance. There are still days that I feel the guilt weigh heavy. A few months ago, close friends invited us to spend New Year’s Eve out of town. My husband and I were both working the holidays, making this weekend escape impossible. As my son complained to me about how frustrated he was to spend much of winter break in day camps, rather than home with his family (as I had spent every winter break in my childhood, as my mother was a teacher) or out of town with close friends, my heart broke. He is older now, so I just told him the truth: his father and I made a decision to pursue a career that is rewarding but often inconvenient, long before he was born. While he was not involved in this decision, I know that he suffers the consequences. He ended the conversation in a huff.

Despite all of the challenges, it still feels like the right decision. Last year, a friend of mine suggested I stop by the 4th grade hallway to see what the kids, including my son, had made lately. I did, and here is what I found under the title of “Our Heroes”:

child's drawing of a doctor that says "Best Mom Ever"

I’d say I’m doing okay. And to all the moms out there, or anyone struggling with balance, so are you. Let it go.

Dr. Close is a clinical associate professor at the University of Florida, where she is the program director of the Hematology/Oncology Fellowship Program. In addition to education, she is focused on performance improvement as the assistant chief of medical service in the Gainesville VA Medical Center.


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Sonali M. Smith, MD

May, 02 2017 11:01 PM

Dear Julia--I give you a ton of credit for finding the silver lining. I have definitely been in that room with all the room moms, knowing that I couldn't be there the same way. I usually  left feeling kind of low, but your perspective--that those moms would be there for the kids, is a great way to interpret the situation. In truth, as I look back, the room moms have become some of my closest friends. We build our communities at work, but we also have communities outside of work, and your perspective to see the room moms as on your side is truly inspirational. 


Uma Borate, MD, MS

May, 30 2017 3:48 PM

Dr. Smith and Dr. Close-Thank you for creating this blog and encouraging us all to continue to excel and grow as physicians and mothers.

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