Insights on Residency Training

Dr. Bergman Lewis is a senior resident in Pediatrics at Seattle Children’s Hospital. By way of introduction, I am finishing my pediatric residency at Seattle Children’s Hospital, have enjoyed being a resident editor of Journal Watch Pediatrics and Adolescent Medicine for the past 3 years, and will write as an interim blogger for the next month or so. Greg left big shoes to fill but I’ll do my best to pave the way for the next resident blogger.

When my daughter, Anya, was a few months old, I remember reading a blog post to my mom that I found when, for the first of many times, I Googled “baby bedtime routine.” One father wrote: “The solution to bedtime is that I crawl in the crib with my baby, then when she is asleep, I crawl out.” My mom and I laughed and rolled our eyes. Fast-forward 1 year and I’m blearily gazing into the crib, patting Anya to sleep, wondering if it would hold my weight. Sleep is only one area in which being a mom has humbled me and challenged the tenets of my pediatric education.

When the time to expand our family coincided with the last year of my residency, my husband and I knew it was not going to be easy. However, I did not foresee all the ways it would shape me as a physician. As a pediatrician-in-training, I knew the “right” advice to offer in each situation, but it turns out that the “right” advice carries little weight in the minute-to-minute nuances of parenting.

We found our stride as a family only when I started accepting that we would have our own unique challenges as well as our own solutions and started doing what worked for us. We hunkered down and my world became very narrow — hospital or home. My husband and I tried to listen to each other and tune out all the “shoulds” that made us feel inadequate. We were blessed to have local family and actually moved in with my mom for the year. The bills piled up and the voice mailbox filled. We co-slept, not for philosophical reasons, but because it felt necessary. I was tired and couldn’t spend the precious time at home with Anya listening to her cry from the other room. Anya stayed up late when I was on the wards and slept all afternoon with me post-call. When I was on nights, we took two daytime naps together. This was not the sleep-nap routine I had outlined for parents in clinic, but Anya’s adaptability gave us long hours together snug in bed, breast-feeding after 30 hours apart. By paying attention to Anya’s cues instead of outside advice, we found our own rhythm and Anya thrived — and my husband and I survived!

Once I became more comfortable in our own ever-changing “routine,” I began to recognize allies within medicine. I felt less isolated as I shared more about our solutions. After attending a Grand Rounds presented by the medical examiner on the dangers of co-sleeping, I sheepishly admitted to my intensive care attending that we spend the majority of time co-sleeping. “So do I,” she responded, “you have to when you’re away so much, right?” The fellow and the pharmacist both chimed in with their own stories of co-sleeping. It felt like we were talking about brewing gin during Prohibition.

My own experience adapting to motherhood while being a resident convinced me that our job as primary care doctors is to lay out the safe — but wide — framework within which patients can find their own path. It is tempting to preach guidelines and be quick with advice but more valuable to tailor our expertise to empower individuals to find their own way. Particularly in light of my experience as a parent, I will strive to have conversations with patient families that are nonjudgmental, honest, and practical.

I salute my fellow resident parents out there. Keep up the good work crafting a home life that is uniquely right for your family. I would love to hear your stories from the trenches.