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ER Goddess

ER Goddess

The EP's Reality during the Holidays

Simons, Sandra Scott MD

doi: 10.1097/01.EEM.0000604564.05100.1c
    physicians, holidays, shifts
    physicians, holidays, shifts:
    physicians, holidays, shifts

    To my sons,

    I'm sorry for all the Thanksgivings and Christmases I spend in the ED. Being away from you on days we're supposed to spend together weighs on me more heavily than you know. My hope every year is that you won't feel like you're not important to me when I must pay the burdensome penance of my career choice and report to work on a holiday.

    You've never known a time when I didn't have to be in the hospital on special days. With a son born on New Year's Eve, even my very first day of motherhood was a holiday that I was supposed to work. I'd been scheduled as the senior resident in the trauma bay overnight. Night shifts are hard enough without lugging around a full-term baby in your belly, not to mention the two lead aprons I'd taken to wearing after too many careless techs shot unannounced x-rays just feet away on the other side of a flimsy trauma bay curtain.

    When my OB decided to induce me for pre-eclampsia on Dec. 31, I thought it was a small victory to be spared the dreaded overnight shift in the trauma bay on New Year's Eve. But giving birth on New Year's Eve meant that as long as I work in emergency medicine, I have to work on either my son's birthday or other holidays in exchange. It's a no-win parenting situation and an epic failure in foresight on my part.

    Unfortunately, I set out on a path of personal sacrifice to become a doctor, which I believed was the paragon of personal success before you were even born. If I had known then how much it would hurt to spend Thanksgiving and Christmas away from the two people for whom I'm most grateful, I might never have become a doctor. Now, trapped by student loan debts and bills, I'm unable to stop. That's adulthood. Between you and me, it sucks sometimes. Yet “good” physicians don't complain.

    We learn in med school to wall off our desires and emotions for the sake of professionalism. I've been trained to suppress my urge to cry when I lose a patient, my disdain for time spent chained to a keyboard instead of talking with patients, and my frustration at the sheer volume of non-medical tasks expected of me. We doctors think that we are supposed to hear about and fix everyone else's pain, not talk about our own.

    Because I'm a professional suppressor of emotions, I worry that I might not be able to show you what's in my heart. It would be intolerable to me for you not to understand that you are what matters most, so this holiday season I'm putting it in writing. I know my articles are boring to you now and no normal teenage boy would willingly put down his iPhone or Xbox to read anything in a medical publication, but I have faith that one day these words will make their way in front of you. When they do, please know that my love for you shapes my every thought and act, and your love for me is the best thing in my life.

    I've seen interviews in which people who have suffered horrific life trauma were asked how they manage to keep going. Their response was, “My kids.” I understand. Medicine takes a lot out of a person, and many days I just want to wrap up in my covers like a burrito and hide from the world. On these days, getting you fed and off to school is my reason for getting out of bed in the morning. Then when every ounce of me is screaming to spend the rest of the day curled up on the couch, my desire to take care of you helps me find motivation to get things done. A hug from you or even just a smile is the best incentive in the world.

    I will love you always, regardless of whether you meet my sometimes too-high expectations. Physicians are overachievers and expect a lot of themselves. Sometimes this tendency spills over into parenting, so please know that my love is not contingent on your success. I will love you more when you fail fiercely than I love you when you triumph because that's when you need me.

    Spending Thanksgiving and Christmas taking care of someone else's family doesn't mean I care for you any less. Don't presume I go to work and stop thinking of you. No matter how chaotic the ED, there is somehow always time in a mother's mind to worry about what her sons are doing at that moment. You're forever with me in a way that feels like each of my brain cells has a microscopic maternal magnet pulling my thoughts in your direction. This maternal orientation makes me a better doctor because in the ED I constantly think, “If this patient were my child, what would I want for him?”

    Like all the other feelings we physicians button up under our white coats, parental love can seem muted by the demands of the job, but trust me, it's always there. Knowing I have two sons to go home to is what keeps me going through the maelstrom of medicine and what mends my heart each time it breaks over a tragedy at work. No matter how much my world seems to be coming undone, I know if I keep my focus on who and what matter, I will find my way. You two boys are who and what matter, so even when I'm not there this Thanksgiving and Christmas, you'll be in my heart. I hope your imperfect but one-and-only mother will always be in yours.



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    Dr. Simonsis a full-time night emergency physician in Richmond, VA, and a mother of two. Follow her on Twitter@ERGoddessMD, and read her past columns at

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