No balance without boundaries for physicians

My first experience with finding balance came when I was fresh out of residency. Having just joined a private obstetrics practice, I was so excited to finally make money and enjoy a lot more free time than in the prior four years. It did not take long to realize that I had significantly overestimated the amount of free time I was going to have. I had scheduled a tennis lesson for Friday evening, which gave me plenty of time to finish office hours, sign out and get there on time.

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But things don’t always go as planned. My office ran way over, and the last patient was more complicated than I had originally thought, so I ended up racing to my lesson and still got there half an hour late. Maybe the week had been worse than normal, or maybe I just got caught up in the moment, but when I actually got onto the court, all I could do was sit down on the bench and cry. Cry over the complete lack of control I had over my own schedule and essentially my life.

It wasn’t supposed to be like that after residency. I had paid my dues. My tennis instructor listened patiently, then looked at me and said, “The problem is, your life has no boundaries, and if you have no boundaries you can’t possibly have balance.”

I thought about his words long after leaving my defunct tennis lesson-turned-therapy session, and realized that he was exactly right. So much so, that it has been one of the most profound pieces of insight I have ever received. 

 Now you may ask why I found such a seemingly simple piece of advice to be so profound. Because that one answer, wasn’t just one answer. It led to a cascade of many other answers that helped me reevaluate and rebalance my life at that time, and many other times throughout my career and life when balance escaped me.

So what was it about boundaries that was so important to finding balance? The most important thing I figured out wasn’t about establishing boundaries. It was the realization that sometimes in our profession there just weren’t any boundaries between work and home. One often bled into the other.

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The nature of the job dictated that no matter how hard I tried, there were days that office hours would run late, and others when dates or events would be cut short or ruined by an emergency. Coming to grips with, and accepting that was monumental for me because I had fought against that so hard. But the reality was, that was part of being a good, caring doctor. It was part of the job; a job I loved, and indeed had signed up for.  

Once I accepted that, it was up to me to create the boundaries I wanted and needed for balance. How much time off and me-time did I need to rest and rejuvenate? What did that ‘R-and-R’ look like, and was my schedule and the hours I worked conducive to that? Nobody could answer those questions but me. 

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It was also up to me to make those changes, and sometimes that required asking hard questions and making tough decisions that led to a more balanced life. In the beginning of my career, that meant going off on my own so I could make my own hours and work four days a week. Later in my career, it meant changing jobs to spend more time with my newborn son, then adding back more regular hours when he started school. 

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It was also about figuring out how much time off I wanted versus how much money I wanted to make. And if I gave up some time off and made more money would it fit in with my model of balance? That was one of those hard questions for me that also changed as my family and personal needs changed. 

Those experiences led me to one of the biggest keys to balance: It was an evolving phenomenon. As my life changed, my needs and my idea of balance also changed. I continually reevaluated my choices to make sure they still worked for me and kept me balanced.

When I was single, my time off and me-time looked very different than when I had a family. My me-time went from lots of tennis and beach vacations to mommy-and-son time, family outings closer to home and reading romance novels. They were very different, but each gave me the balance I was looking for at that time in my life.

All  of this led me to the realization that when I found boundaries and balance, I also found what all this was really about: being happy. I was so happy when I became a doctor. It was my life-long dream, and for a long time that sustained me. Between the hours, lack of sleep and realization that with every decision patients’ lives were in my hands, it has also been very stressful. So boundaries and balance allowed me to find happiness not just in my job, but in the other part of my life that I had neglected: my personal life.

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And that is what I wish for all of you. To find that complete happiness we all deserve. We have worked so hard and given so much that we deserve to give back to ourselves. If not, we are in serious danger of resenting that which we love, which could lead to someday walking away from this amazing gift that we have all been given. So find your boundaries and don’t give up until you have created the life that you want and the balance and happiness you deserve.