I was still basking in the warmth of my success of having completed my M. D in Internal Medicine. I had returned home after 3 years; I was sure that I would take up medical oncology at some point of time in the future, but was not ready for it immediately. As I had crossed an important milestone of completing my post-graduation. I had plans to start a family and have a child. I had reluctantly appeared for the entrance examination for the D. M. Medical Oncology course at the Tata Memorial Hospital (TMH), Mumbai, as I felt that my preparation was not sufficient. Little did I expect that I would be called for an interview a few days later and also get through. I was one among the 14 selected candidates, and the news came as a big, pleasant surprise.
After long discussions with my family and weighing the pros and cons of taking up a 3-year-long specialty training at this juncture, I decided to grab the opportunity and join this prestigious institute. I had accepted that I will not be able to have a child for the next 3 years. Many career-oriented women are constantly plagued by the fear that their biological clocks are ticking away, refusing to wait even for a second. Planning kids among this academia can be quite challenging, but admission to TMH was a golden opportunity that I did not want to miss.
Just as I was about to embark on my journey to Mumbai, I discovered that I was pregnant. Now, I was in a fix. Two very important things in my life were happening at the same time – I felt it was just too much for me to handle. Managing a heavy workload in TMH and taking care of my health and pregnancy would not be easy, and that too without my family being around. I did not have any acquaintances in Mumbai. My mind was in total turmoil. What length of maternity leave would I be sanctioned? What if I were to develop some complications postpartum, prolonging my recovery? And then what would I do after the baby is born and I finish my maternity break? Should I leave the baby back at home with my parents or bring him to Mumbai? With at least a thousand such questions on my mind for which I had no answers, I went to Mumbai to give the joining report. The only thing that I was sure of at that time was my faith in God and the strong support from my family which was reassuring. I knew that no matter what happened, whether I continued the course or left it, they would stand by me.
I walked into the outpatient consulting room of the head of the department (HOD) of medical oncology. I got my first taste of TMH at that moment. The OPD was thronged with patients– all children. It was the pediatric oncology department. All the residents in the OPD were too busy to even glance elsewhere for a moment. They examined one kid after another, hastily scribbling in their files and calling the next kid in. If the pediatric oncology OPD was this busy, I could imagine that the adult oncology OPD would be no less. I suddenly felt very nervous to go up to my HOD and speak to him about my issue. All the professors here are highly professional, and I felt that my plight would sound insignificant to them. I was under the impression that they would ask me to go back home and continue with my family life. I stood there and wondered how these professors must have managed to balance their careers and personal lives. After a few moments of hesitation, I finally mustered up the strength to walk up to my HOD and explain my predicament. I told him that the child was more important to me than the training, and if he thought it would be very difficult to manage both, I will have no option but to leave the course and take it up later, maybe the following year. To my utter surprise, he was very receptive and more than supportive. He told me that he was speaking to me as a friend and a colleague and not as a superior. He encouraged me to take up the admission instead of giving it up. He assured me that he would grant me any length of maternity break depending on the need, and I should be prepared to extend my D. M. residency term for that duration. He promised that everyone would be supportive throughout and asked me not to worry. After talking to him, I felt as if a huge load had been lifted off my chest. With great enthusiasm, I completed all the formalities and started working.
As I had expected, residency in TMH was very tough. A huge number of patients had to be attended to each day, OPDs sometimes running up to 9 PM, followed by loads of work in the ward, continuous turnover of patients requiring the preparation of a number of admission notes and discharge summaries each day, night calls, casualty duties, etc. On most of the days, the ward work used to extend past midnight. I used to be so exhausted by the end of the day that I would just collapse on the bed. There were so many people who supported me like angels and I will be ever indebted to them for their help. One of my female professors was very understanding and used to enquire about my health from time to time. She would bring me fruits, muesli, and other goodies from home every week. She also fixed me up with a senior gynecologist from the maternity hospital very close to TMH, thus easing my antenatal visits. My gynecologist's clinic was very busy with crowds of patients waiting outside, but I would invariably get priority entry. She used to warmly smile and say, “I know, dear, that you leave a busy OPD and come to keep up this appointment. How can I make you wait?”
Just 15 days into the residency, my first antenatal scan showed the absence of fetal cardiac activity, but it was too early to tell. The presence of a subchorionic bleed on the scan was worrisome as it was suspicious of a missed abortion, but the gynecologist said it could also be an implantation bleed. She said she would have to repeat a scan 2 weeks later to confirm whether the pregnancy was viable. She asked me to be on strict bed rest and not to exert myself at all for the next 2 weeks; she started me on beta-human chorionic gonadotropin injections and progesterone supplements. I did not have my family with me. I was scared and emotionally distraught. I then spoke to the head of the unit in which I was posted and requested him for 2 weeks leave so that I could rest. He immediately sanctioned my leave and wished me well. I could not go home as I was advised not to fly. I was confined to the hostel and passed the time reading a lot of books and meditating, trying to divert my mind from the fearful thought that I might have miscarried. I used to break down sometimes, silently crying into my pillow at night as I didn't want to bother anyone else around me. I always put on a brave face in front of my family and never expressed the intense emotions churning inside me as it would make them more anxious that I was all alone and that they could not be with me during such testing times. I was relieved 2 weeks later when the repeat scan showed a live fetus. I rejoiced and rejoined work with more confidence than before that I could handle the three tough years of residency that lay ahead of me because by then, I had got the hang of the system and I had started enjoying the work and oncology.
I had the usual problems of the first trimester, like nausea and vomiting, which luckily were mild, I must say. Smells emerging from our cafeteria used to be the strongest triggers making it very difficult for me to get through a meal completely. I could eat only little amounts each time, despite a good appetite and then within an hour's time, I would have hunger pangs again. My professors and colleagues were kind enough to relieve me from the OPD for a small snack every other hour and would affectionately chide me if I went late for food. I certainly missed being at home at such times and being pampered by my mother and having homemade food, but the environment all around me was so friendly that it eased my yearning for home. I could attend all my antenatal checkups without any hassle thanks to my dear colleagues and seniors who did my share of the work in my absence and my professors who would readily allow me to go.
The nurses in the ward that I was posted in were also very caring. They regularly enquired about my health and helped me with the ward work in whatever small ways they could. They would offer me tea when I stayed till late in the ward. One of the senior sisters was nothing less than a mother to me. She belonged to the same state as I, and would bring me homemade food. Gradually, the nausea subsided, and I was able to eat better.
The waiting area in the OPD complex is a constant pandemonium of patients and their relatives so densely crowded that walking in that area would mean practically swimming through a sea of people. I was frightened that someone might accidentally jab me or push me, and so I would hug my tummy and wade through the crowd sideways shoulder first.
We have a bone marrow operation theater (BMOT) where all the bone marrow biopsies, diagnostic lumbar punctures and intrathecal chemotherapies are performed. We are posted in the BMOT according to a roster. When assigned to the BMOT, one needs to be there from 8 AM to 5 PM performing all these procedures, which involves standing the whole day. My department was considerate enough to exempt me from the BMOT duties during this period as it would be more strenuous for me. Even during the emergency casualty duties, my seniors posted with me used to ensure that I ate well on time and rested adequately at night.
I was delighted at the quickening of the baby, and from that day, I never felt lonely even for a moment because I knew my baby was always with me – whether I was running a busy OPD, finishing my ward work, or doing a casualty duty – he was with me. It dawned upon me how beautiful it feels to have life growing inside one's self. I used to keep chatting with the baby telling him little stories and singing to him.
In what felt like the blink of an eye, I had already finished my first posting of 4 months. By then, I was into the 5th month of my pregnancy and I was finding it increasingly difficult to sit for long hours in the OPD as my back would hurt and I had to use the washroom frequently. Hence, I decided that it was time for me to take maternity leave and go home; I got immediate approval from my HOD and the dean. I probably would have hung on for a little longer if my family was staying with me in Mumbai, but I could not push myself any further and to this day I do not regret my decision.
I delivered a healthy baby boy 4 months after I left TMH. I resumed my course when my child was 7 months old. I left him at home with my parents who took excellent care of him. I successfully completed my residency 3 years later and came back home to be with my son again. I will be ever grateful to my beloved parents for shouldering the huge responsibility of raising such a small baby. My mother managed her bank job, household work, and my boy all very efficiently, and never did she complain of things getting difficult for her. She handled everything with the utmost dedication and love.
The first time I went home to see my son was about 1 month after I resumed my training in TMH. He was 8 months old then. I expected my child to refuse to come to me because I assumed that by then, he would be thinking of my mother as his mother and would see me as a stranger. I cannot forget that expression of pure glee on his face when he saw me after a month. He just jumped onto me from my father's arms. He fixed his gaze on my face for the next 5 min, refusing to look elsewhere, oblivious to my parents calling his name, his face showing a mixture of happiness and surprise. I'm sure that if he could talk, he would have said, “Hey mom, where have you been all these days, I missed you.” And then, he clung on to me and refused to let go for a long time. I had not cried when I left him at home a month prior, but on that day, tears rolled down my face. My eyes still turn moist when I recall that beautiful scene. One of my medicine professors used to say that the emotional umbilical cord persists throughout the life.
Today, sometimes, when I look back at my child's photographs when he was 6 or 7 months old, all cute and chubby, I cannot fathom how I had the strength to leave him at home. However strangely on that day, I did not leave home with a heavy heart that I was parting from my child. Rather, I was bold and eager, filled with a sense of duty to join back in TMH and finish my residency in medical oncology, which is my passion. Part of this strength was derived from the fact that I didn't have to worry about my son as I knew that he would be cared for very well by my parents. There were many occasions when I missed my boy, especially during my pediatric oncology posting. Any child of his age would remind me of him and sometimes I felt miserable for missing all his milestones– his first steps, his first words– but the far sight of the bigger picture in the future always consoled me. My parents would regularly send me his pictures and video clips that kept me happy. They brought him to Mumbai on a few occasions for short visits and I visited home once in a while.
This chapter in my life has made me realize that sometimes certain things may seem just impossible at the outset– like how having a child and pursuing medical oncology simultaneously seemed impossible to me. However, doors eventually open, difficulties ease, and as it is often said, there is always light at the end of the tunnel. All that it takes to see that light is a combination of patience, persistence, a strong will, and certainly very strong support from friends, colleagues, superiors, and family which I was blessed to have and that made my tough journey through motherhood during medical oncology training very beautiful and memorable.
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Conflicts of interest
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