Happy Monday, everyone! And Happy February!

So excited it’s February! I thought January would never end!

 

I’m especially excited to talk about today, February 3rd, because it is a day that is pretty near to my heart: National Women Physicians Day. We celebrate today because, as I’m sure many of you know, it is the birthday of the first female doctor in the United States, Elizabeth Blackwell.

Even though this story might be familiar to all of my physicians reading, it’s a story worth telling again and again. Elizabeth Blackwell was, in every sense of the word, a boss. Born in England but raised in the US, her family highly valued education for boys and girls alike, so Elizabeth was extremely comfortable in academic settings. She was inspired to pursue medicine when a dying friend confided in her that managing her illness would have been a better and completely different experience if there were “lady doctors” present. It was in that moment that Elizabeth decided to go to medical school. 

But women were not encouraged to be doctors in the 19th century. In fact, they were often discouraged. Strict gender norms were in place that firmly espoused that women should remain in the domestic sector while men went to work and earned money for the family. Despite these challenges, Elizabeth applied to dozens of medical schools, only to be rejected by all of them, except for one. However, Geneva College, the school that did offer her acceptance, offered it as a practical joke and did not realize that Elizabeth was indeed serious about attending medical school. When she showed up on the first day, she was so resolute that they had no choice but to actually enroll her as a student. 

Even though she now had her foot in the door, it was still an uphill battle. As the only female, Elizabeth often faced blatant discrimination from her teachers and fellow students, but she kept showing up and kept doing the work, always keeping track of her final goal. Her diligence and resolution earned her respect from her peers when she graduated in 1849 as the #1 student in her class.

The adversity didn’t stop there. It was nearly impossible for her to get hired as a female doctor (and there were no legal courses of action to take against discrimination), and when she was hired, she often was relegated to the maternity ward when she really wanted to be a surgeon. Despite this, she still contributed to the medical community. One of her most helpful observations to the field was paying attention to hygiene, realizing that epidemics spread because of the lack of hand washing by male doctors (so gross!), and went on to establish the U.S. Sanitary Commission. Throughout her life, she continued to teach and heal, founded a clinic for the poorest of New York’s citizens and trained nurses during the Civil War. She opened a medical school for women as well, paving the way for future doctors like you and me to practice medicine. Blackwell continued to teach and practice medicine into the 1900’s until her death.*

Because of her resolution to become a doctor, she showed other women that it is possible to thrive in the medical field. Studies revealed that women physicians are the growing majority in the United States healthcare sector. Like Elizabeth, women still provide missing and unique perspectives from the field that can better diagnose and treat our patients. 

When I think about the story of Elizabeth Blackwell, in some ways I feel like she and I are similar; the first in our families to go to medical school, charting a course that was completely new and foreign, coming right up to the face of adversity, getting knocked down, and having to get back up and keep going. I was not only the first physician in my family, but I also am a first-generation American, and Serbian was my first language growing up in this country – so navigating the path to become a medical doctor was especially challenging and I had to be very resourceful, like Blackwell. She truly is an inspiration and I am so grateful for her and her dedication that led the way for us today.

 

 

Even though Elizabeth overcame the challenges of her day does not mean that new challenges do not exist for us. A big challenge for us now is having to manage the freedom to be a mother and a doctor at the same time. It is challenging because traditionally women are seen as the primary caretakers of their children. From growing the baby in the womb to giving life outside of it, from multiple nightly feedings, to raising the child, as well as the emotional and physical toll that takes on a mother’s body and emotions. I am well versed in this experience as I got pregnant, had a baby, and went back to work 5 weeks postpartum! It was a bit of a crazy move, I agree. I had to adjust to all the amazing and wonderful things that happen to my body and my emotions after I brought life into the world, but I was still expected to work at the same capacity before having my kid. And I am not a special case. This is just how it unfortunately goes. Female doctors are still expected to perform at the same level after they’ve had the baby, leading to exhaustion and burnout, depression, and at its worst, suicide.

Other challenges for women, depending on the work environment, can include experiencing sexism, harassment, bullying, and severe pay gaps. It’s scary, just plain gross, and detrimental to the emotional health and camaraderie of the hospital or medical team overall. And it’s dangerous! Having physicians who are constantly functioning at the end of their rope does not instill confidence in their patients and can often cause deadly mistakes. Studies have been done that have linked higher mortality rates of patients to doctors that are emotionally exhausted. This is not a good look for anyone.

Does any of this sound familiar? Am I the only one that has gone through challenging situations in medical school and beyond? I can’t be the only one that senses the difference between the treatment of male and female doctors, working beyond my capacity post-baby, and being just plain exhausted on so many levels. 

This is the truth: We can have it all, but we physically cannot do it all without completely running ourselves into the ground. We were not meant to physically do it all. There is no way we can raise a baby or babies, take care of a household, and excel at a demanding career without a little bit of backup. It is okay to ask for help. Whether it’s asking your husband to step up with the laundry or groceries or hiring someone to keep your house clean. It can even be as simple as creating some boundaries and utilizing the power of the word “No.” It’s okay to say no to things that you do or don’t want to do outside of work or home. It might be hard, but it’s worth it. It’s okay to reprioritize your life during the busiest and craziest season and adjust them as time moves on. 

This reminds me of an article that I read that encouraged women in healthcare to find balance in their lives. It was pretty helpful to me and I hope that it will be helpful to you as you move through your physician journey. Here are some of the things I have learned: 

It is a bit of heart work, but I want you to think back to the why. Like really think about it. Spend some time journaling or talking it out if you want. Why are you on this journey? What motivated you to be in medical school or residency to begin with? What is your purpose in this? Like Elizabeth Blackwell, she saw a need for women doctors that inspired her through all her setbacks. When you reflect on the reason that you are doing this, things just kind of seem to fall into place. When I think about why I do this, I know it’s for three things: to keep people healthy, to give them self-confidence that they might not have, and for my family. Even on the hard days, when it seems like there is nothing but studying to do and I just want to quit, I look at the picture of my son on my phone and I remember the Why. And then I refocus and keep moving toward my goal. That’s not to say that it immediately makes it easier. It’s still rough to get up and go to work and then study and then come home and take care of my house and my family. But it puts it in perspective. And it allows me to keep going. 

It also helps me prioritize my days and weeks and months. In this season with a brand new baby, he’s my first priority. It’s all baby, all the time. Whether it’s feeding, playing, sleep training, my baby’s development comes first. My life is geared around that now. Second to that, it’s studying for my boards this summer. It’s clearing my schedule, staying up late, waking up early, and making sure that I know everything that will be on the test. And as of right now, that’s pretty much it. I can make time for friends or some fun things that I would like to do, but the priorities really lie with my family and my job now. And I can’t feel bad about it. I have chosen these things and I need to see them through at my very best. Everything else is prioritized under them. 

That’s not to say that my life will be all babies and all studying forever. The rhythm of my life will change after the test and as my kiddo grows up and spends time in preschool. After that I will have more time for the things that have been lower on my priority list. At that point, I can look at my life and the time that exists and put different things in it, like different hobbies that I was considering trying, or just some more time to rest and hang out with my husband. It’s constantly revisiting the important things in my life and seeing if they need more or less attention and adjusting accordingly. Some times will be harder than others. 

A final thing that helps me handle the work life balance is time management. Even though sometimes it feels as though we don’t have enough hours in the day, we have 24 hours. We have to take a good look at our priorities, know how much time they will take, and plan accordingly. If I know that studying will take me 20 hours a week, that’s 20 less hours I have for taking care of the house. It might be worth it for me to hire someone, or to relegate a couple hours during the weekend to get the laundry done or do my meal prepping. Paying attention to how long something takes and disciplining yourself to focus on those things can help improve your time management. 

These steps have been essential for me to create a work life balance that prevents me from burning out. Sometimes it goes to plan, and other times it totally blows up in my face. But it’s a goal that I work towards as I navigate this season. I want to make sure that the doctors that come behind me feel empowered to be the best doctors that they can. To be seen in their struggles, encouraged when things get hard, and having resources provided for them that I didn’t have to make it easier for them to balance the very full life that they have chosen. Elevating women is something that I am particularly passionate about and I believe will make the biggest difference and strengthen the physicians to come. If you need encouragement, want to chat about that female physician life, or just say hi, shoot me an email, a DM, or leave me a comment here! I would love to come alongside you on this journey. 

Looking professional is something I’ve prioritized in my practice. I love my white coat from Medelita – get one for yourself here!  You can also use the code DRNIKOLETAW20 for 20% off anything else on the Medelita website if you’re looking to stock up!

What has your journey been like as a woman in medicine? Share with me and use the hashtag #ThisFemPhysicianCan.

Xoxo, 

Dr. Nikoleta

 

 

 

 

*The information regarding Elizabeth Blackwell was found at these following articles: 

Women’s History

Harvard

Biography – Elizabeth Blackwell

Sources for other articles:

Young female doctors are at high risk for burnout and “self-care” is not the answer

How Burnout is Dangerous for Patients 

Work Life Balance for Physicians  

The healthcare future is female