Bismarck Odei considers the competing push and pull between parenthood and medicine, and how this dilemma has echoed down the generations in his family
I raced across my backyard, a soccer ball in front of me and my determined and indefatigable daughters in tow. After what felt like hours to my tired legs, my side stitch finally set in from all the running. In submission, I lay down on the grass, and was immediately attacked by a group of young “bandits,” their cheerful screams punctuated by uncontrollable laughter.
One of the most unexpected discoveries of fatherhood is that the delights of children can be experienced vicariously and so completely. Yet in our household of six daughters, my pager haunts me on occasion, and the paucity of time I have with my children is a subject of frequent reflection. As I juggle the priorities I have as a physician and a father, my reveries sometimes take me to a place where I wonder if I can rise to the full measure of the father these girls will need: a father who can be completely present without the mental tugs from work during a ballet recital, a father who will be engaged during the imminent and likely ominous teenage years, and one who will be reliably available as a confidant when these biracial girls mature into women and need help navigating a world that may be foreign to them—and to me too.
My experience is not unique. In a recent survey of almost 9000 US physicians, 80% expressed feeling at full capacity or overextended, with a similar number feeling burnt out.1 The prevalence of these scenarios may be partly attributable to the perception that medicine is a calling, which leaves physicians with an inherent expectation that other priorities in our life will have to come second.2 Perhaps we have been conditioned through our necessarily arduous training to equate extreme sacrifice of time with nobility—and so, quietly and assuredly, the cycle persists long after residency.
Part of the reason for my current worries is that I, too, grew up in a household with a physician father. My father, with his altruism and a solid dose of unchecked optimism, opened a small private practice to serve his local community in Ghana. At times, desperate hands would pound on our front door in the deep of the night in search of care. My father served his community tirelessly and often at no charge to his patients, until his practice eventually became financially insolvent. The toll of sharing a father with medicine is a social contract that often disproportionately favors the community. When my father died when I was 11, somehow, I felt that I had lost him twice—once when he practiced medicine, and then again when he passed away. I reasoned then that medicine would never be an acceptable option for my future family goals.
Yet when the distinct call to medicine eventually came, its unique resonance with my heart was unrelenting. So, in the summer heat of Los Angeles, and with my wife and children in attendance, I swore to uphold the Hippocratic oath that entreated me to accept my “special obligations to all fellow human beings, those sound of mind and body as well as the infirm.”3 In that moment of dual allegiance to both family and the frail, I became keenly aware that navigating these two competing worlds would require all of me. I finally understood my father’s dilemma of limited time, but I was hopeful that as part of a newer generation, I could bring more resourcefulness to this old quandary.
As a Black physician, I also feel an abiding responsibility to the Black community; my professional success will be their victory, and my failures their own. As Black physician fathers, the need to succeed at home is paramount as father absence has historically been a spectre that haunts the Black community. Almost half of Black children in the United States live with a single mother.4 In contrast, only 13% of White children and 7% of Asian children experience a similar scenario. Generally, father absence has been associated with negative effects on growing children,5 6 which is one of the many factors that contribute to early onset racial disadvantages within the Black community in the United States. While a father’s taxing work schedule may not qualify as father absence, often the lines can become blurred.
In my journey through medicine, I have not always found the desired balance between home and work. Some physicians have found solace by searching for “quality time” over “quantity of time,” while others long for more of both. This push and pull between parenthood and profession is often well described by women working in medicine, but rarer to hear among male physicians. I often wonder if as a fraternity of fathers (and mothers) in medicine, it has now become incumbent upon us to demand more of the healthcare system, or if we should continue to resign ourselves to a state of imbalanced priorities as our status quo. Are the taxing schedules we encounter solely a product of undersupply of physicians, or is it driven by an inordinate prioritization of corporate profits? Change never occurs without a demand on the system. As Newton’s first law has taught us: “every object will remain at rest or in uniform motion . . . unless compelled to change its state by the action of an external force.”7 Do we care enough to be that external force in this equation?
Bismarck Odei is a radiation oncologist at the Ohio State University James Cancer Center. He is a native of Ghana, and received his Baccalaureate degree in Chemical Engineering at Brigham Young University-Provo, and his medical degree at University of California-Los Angeles (UCLA). Twitter @BismarckOdeiMD
Competing interests: none declared.
References:
1. 2018 Survey of America’s Physicians: Practice Patterns and Perspectives. The Physicians Foundation. 2018.
https://physiciansfoundation.org/wp-content/uploads/2018/09/physicians-survey-results-final-2018.pdf
2. Hartzband P, Groopman J. Physician burnout, interrupted. N Engl J Med 2020;382:2485–7. doi:10.1056/NEJMp2003149
3. Tyson P. The Hippocratic oath today. Pbs.org. Mar 2001. https://www.pbs.org/wgbh/nova/article/hippocratic-oath-today
4. Livingston G. About one-third of U.S. children are living with an unmarried parent. Pew Research Center. Apr 2018. https://www.pewresearch.org/fact-tank/2018/04/27/about-one-third-of-u-s-children-are-living-with-an-unmarried-parent/
5. Dubowitz H, Black MM, Kerr MA, et al. Fathers and child neglect. Arch Pediatr Adolesc Med 2000;154:135–41. doi:10.1001/archpedi.154.2.135.
6. Pruett MK, Pruett KD. Fathers, divorce, and their children. Child Adolesc Psychiatr Clin N Am 1998;7:389–407, viii.
7. Murphy P. Newton’s laws of motion. In: Applied Mathematics. Elsevier 1982. 66–83.