Work-Life Balance of a Hem/Onc Fellow

Nitya Narayan, MD
Published: Thursday, May 14, 2015
“Dr Narayan, aren’t you dating anyone yet? Maybe you work too much!” smiled Mrs Butler as she relaxed in her chair. Those tired lines around her eyes were gone. There we were in Exam Room 22, Nina’s room. I lovingly touched her soft, stubbly, baby-duck-like hair. This family had just lived through the worst 9 months of their lives, and now here sat their daughter, flushed cheeks and a cheerful smile on her face. Her recent test results revealed a perfect complete blood count and what one pathologist had described as “a beautiful marrow.” She was an acute myeloid leukemia survivor. “It’s growing,” she said self-consciously as she pulled her wig back on. I knew she wanted her hair back in time for high school graduation. That somehow seemed way more important to me than going on a date. I squeezed her hand. Nina is braver than I am.

As most of my colleagues discuss where to host their kids’ birthday parties or what to cook for their in-laws, I am mentally (or sometimes literally) scrolling through the list of guys on my dating profile, trying to decide who is worth getting dressed up for. I am a member of the cohort of 30-something single Indian women who were not lucky enough to snag the right guy during med school, and perhaps am not genetically engineered to be good at dating and studying simultaneously.

I am subsequently generally the oldest of my single friends and the “singlest” of my same-age friends. Culturally I am a spinster, a has-been, a “well-at-least-she’ssmart” per my grandmother, who is genuinely perplexed by the notion that tall, handsome, Hindu, vegetarian, Brahman professional men aren’t a dime a dozen.

Socially I apparently do not know how “lucky” I am to be alone, according to the fellow with marital problems, or the one who had to stop her whole career and relocate in support of her spouse. And so, counting my blessings, I throw myself into my work and the gym. Most days I leave both places feeling thankful and happy, and admittedly a little wistful for the day I can go home to cook for my husband or play with my own kids.

My days of fellowship generally end with signing clinic notes, preparing lectures for residents, or sending one last e-mail to the Institutional Review Board, pleading for approval of my research project. Many of my evenings entail putting on expensive makeup and uncomfortable shoes to go on yet another date, with a quick prayer before I run out the door. I push the elevator down button and tell myself with determination, “Maybe this will be the right guy,” as I fight to not think about the day’s events. Omar ’s leukemia relapsed again, leaving him very few options…little Corey’s brain tumor is gone, and now he can hold a sippy cup... Mara died last night after a long fight with a bleeding disorder… but Heidi, who honestly nobody thought would beat her cancer, started college today! The emotional ups and downs of the day are exhausting—which frankly makes it that much more difficult to listen to a guy state all his likes and dislikes over the appetizer. I get the familiar rant as he lets it be known he will not ever move from his current job, home, or city, so marrying him means “dealing with it,” all while he sprays a mouthful of crumbs in my face between words. Did I really pause my Netflix for this?

These days it seems there is another degree of screening involved. This is no longer only about this person getting along with my family and sharing my values. Can this person handle my career? Will he listen to me cry when a toddler with a brain tumor dies, one who let me hold her special dolly only 2 weeks earlier? Will he help me remember I did the best I could?

I think back to residency to the guy who was perfect on paper, who I thought had serious potential. I remember calling him over a tiny infant who had been beaten so badly she had 2 black eyes, only to have him say to me, “Your stories are kind of depressing—I really don’t want to hear this.” While I could hardly blame him, that was a game changer.

Remembering the advice of one of my favorite mentors during residency about “work-life balance,” I had always convinced myself I had that part in the bag. I worked my 80+ hours a week, went to the gym religiously, leaving just enough time for family and friends, and occasionally even slept a full 8 hours. I was balanced! I was happy. I had, after all, survived a major hurricane at my Caribbean medical school, a computer shutting down during the medical boards, and having “black cloud” status all 3 years of residency at a busy children’s hospital. I am tough, I often thought. I can survive anything. But my pediatric hematology-oncology fellowship has been the true litmus test of those statements.

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