Many physicians and other professionals seek that elusive work-life balance. That is not surprising, since a high-power career and family responsibilities can generate the perfect storm to suck you into an imbalanced lifestyle. Part of why many of us get ensnared is because we have a strong sense of duty. Further, dedication to both career and family before all else are reinforced by the cultures around us. With limited bandwidth, something has to give. It is often self-care that gets pushed aside and eventually that can unravel the whole thing. Some find balance when forced – others don’t get a second chance. So, it is important to be proactive and assertive.
There are different ways to approach work-life imbalance.
Some decide to go part-time to free up time. Others buy time by outsourcing tasks. Personally, I have had a hard time doing either of those. I did cut-back to full-time a few years ago. However, it took me longer to get there than it probably should have and was facilitated by finding other responsibilities to draw me away from my medical career.
Fulfilling what I perceive as my commitments has been ingrained in me since a young age. So, the answer for me has been to find externally-accountable self-care time. A responsibility to compete with my other responsibilities. That could have the potential to simply add another rock to the bucket I carry – unless it is leveraged to my other roles. It is also easier to say “No” to extra work when it is because you have already said “Yes” to something else that people are depending on you for.
For me, that external force has been karate and its benefits have extended to our entire family. I am sharing my story, not in hopes that you’ll take up martial arts – although that would be awesome! Rather, my intent is to cause you to reflect on whether you have been sucked into the vortex of work-life imbalance and need to find your own “karate”.
Career and home fronts can collide to create the perfect storm.
Medicine is very alluring.
Intellectually, medicine is stimulating. It is emotionally and spiritually rewarding to help people who are generally in need and grateful. You’ve worked hard to become a doctor, and socially, that comes with a degree of recognition for your achievements. When you speak, people usually listen. Further, it is intrinsically satisfying to ply hard-won skills. Extrinsically, you even get paid well to do this.
Medicine also has unlimited potential .
Due to medicine’s attractions, it is easy to be drawn into doing more and more of it. It even feels natural. After years of putting in the prerequisite hours of study and work to start practice – the momentum is already built up and it feels normal.
Patient-need is not usually a limiting factor. You can work as much as you want. Except, possibly in areas where limited infrastructure (like OR time) limits you. Even medicine isn’t fully pandemic proof. Still, when there are limits in one area, there are usually other opportunities elsewhere.
So, a medical career has unlimited potential for growth. However, it also has unlimited potential to consume the rest of your life.
Maintaining a household and raising kids is also hard work.
Responsibilities on the home front can look different for different people. For example, you could substitute helping friends, parents, or other relatives for “raising kids”. I have also not met many couples where each member of the partnership didn’t feel that they made an out-sized contribution to the household without fully realizing all of the things that the other person does. My wife and I actually made a scoring system early on that included a time and “grossness multiplier” for tasks to ensure transparency and equity. The specific contributions have shifted around over the years, but neither of us spends much time sitting around.
The work and rewards of parenting also change with time, but it is a constant. Some revel in the early-parenthood stage. However, for me, playing repetitive games like peek-a-boo… not appealing. No big thank-yous for cleaning up poop-nadoes either. Even when infants develop into toddlers, it isn’t all unicorns and rainbows. Often kids listen and then try to do what they want anyway. Now that they are teenagers, the poop-nadoes have resolved, but the listening part is even more complicated. I wouldn’t change any of it, and we are fortunate to have enjoyable kids. But, there is a lot of input required and it isn’t on your schedule.
The storm formed by these colliding weather systems.
For some, the immediate input-reward balance favours spending more time working and less time at home. I have seen this happen with many friends and colleagues over the years. You can even feel a little self-righteous about it. Medical martyrdom is a strong part of medical culture. So is being a good provider for your family part of our broader culture. Practicing medicine brings home the bacon. You are doing your duty.
I fell into that line of reasoning to a degree and worked a lot when my kids were really little. However, I also had a strong sense of duty towards my family, who needed my time and attention also. I did not want to be the workaholic absentee dad nor the husband who comes home and puts his feet up to watch TV. That stereotype was usually vilified in the movies and sit-coms that I grew up watching. I think many physician parents (male and female) struggle with the pressure to give to their career and do double duty at home. Unfortunately, that dual pressure, coupled with finite amounts of time and energy, meant that something else needed to give.
Exhaustion exhausted both my time and my self-discipline.
For me, the response was to over-eat and under-exercise. I had gained a significant amount of weight. That would ultimately be fatal, if left unchecked. My family strongly manifests the “efficient-energy-storage-famine-survival-phenotype”. Great for a post-apocalyptical scenario. However, in normal times, combatting that tendency requires extra effort and self-discipline because it doesn’t come naturally.
I was also getting burnt out. Both at work and at home. Medicine and parenting both require huge amounts of energy, time, patience, empathy, and problem-solving. Trying to do both well meant that I would oscillate between falling short on one end or the other. I either felt like I was slipping as a doctor or failing as a parent/husband in rapidly alternating cycles. Not a good place to be.
Duty: The problem and the solution
I am really good at accountability.
Fulfilling my perceived duty was a core value in my upbringing. To counter-balance the duties pulling me away from diet and exercise, I needed another competing accountability. Karate provided that for me. Part of the commitment was to attend at least two classes per week. Our senseis keep count, and call you out on it if you are behind. I needed some external accountability with immediate feedback to look after my health.
Even more influential in holding me accountable were my kids.
When I joined my kids to practice karate, they were five and seven years old. I insisted that they meet their obligations. Therefore, I also needed to show leadership by example. Kids have a strong innate sense of justice (particularly injustice inflicted upon themselves). If I expected them to do their exercises and practice like they were supposed to, then I would get an earful if I did not.
We kept each other accountable during those inevitable times where one of us felt like slacking off.
Families that kick together, stick together.
Karate is a great mix of fun and exercise.
Our school has a good mix of exercise, self-defense techniques, sparring, and traditional karate. All of that involves a degree of control and explosive movements. While I have always liked the results of high-intensity cardio, I have never enjoyed the feeling of impending doom that often accompanies it. Somehow, it is much more enjoyable when you are hitting stuff.
It is also tough. That is good.
There are some techniques that are hard to master. You fail at them many times before finally succeeding. Sometimes you feel like collapsing during a tough training session or belt test. Challenge, and sometimes failure, is a part of life. It is important to experience that to build and doing that together with the family support helps to build resilience.
Sharing fun and physical activity is great. Facing challenges, even better.
However, supporting each other through the challenges has really brought us closer together. Those who train for and perform in high-pressure situations like resuscitation, rescue, or combat know that the way you perform under pressure is determined by how you trained for it. You revert to your basic training as your reflex response. All relationships will face pressures, and karate has helped us train to default to supporting each other when the going gets tough.
We now have an extended karate family.
As I alluded to above, with work and home-life dominating ones time, it narrows your social circle. You see your work-family/friends frequently at work, and your family at home. Sure, you can meet other parents at kids activities which is helpful. However, the focus there is usually on what is going on with the kids.
Karate also provided me with a couple of nights per week where I could interact with other adults doing an adult-focused activity. My karate friends come from various backgrounds. Even the occasional doctor that I encounter in class doesn’t drift into conversations about medicine while we are there. Some of my classmates are parents of kids in the school and others are not. We don’t really talk kids much. The focus is on a combination of learning and having some fun together.
We even adopted a new member into our family. Bob. Great for getting out your Covid-lockdown frustrations. He also doubles as security. He lurks in a doorway of our basement to scare off would-be burglars.
Be Part of a Broader Community
Our karate family doesn’t just beat each other up. We also enmesh into a larger community. That extends both within martial arts, but also out into the community in which we live. We participate in various fund-raisers. March in parades. Travel to conferences/competitions together. Have social events.
You can do many of these things as part of a medical community. However, developing a sense of purpose and contribution completely outside of medicine is very important. Firstly, you probably won’t practice medicine until you die. You need to develop other ties. Secondly, building social capital both within your community and through doing it as a family is very synergistic. It is important role-modelling for your kids, who may well want nothing to do with a career in medicine.
A Black Belt: Important for more than holding your pants up.
One of the good aspects of karate, and most organized sports-training programmes, is that there is a natural progression with escalating challenges. That allows for continual growth in skills, fitness, and enmeshing into the community.
The peak of our challenge so far has been our black belt testing. That was a six-month major daily commitment to exercise, training, and a healthy diet. There are also a number of self-improvement or empathy training exercises along the way. It culminated in a 2 hour long high-intensity test, followed by another six months of demonstrating ongoing commitment. I have done many difficult things, but this was tough. Not only in intensity, but duration.
Fortunately, I also had the opportunity to do this in conjunction with my children. I did my 1st Dan while my daughter did her junior black belt and just recently was able to do my 2nd Dan while my son did his. Sharing such a challenge together has definitely strengthened our bonds.
This type of major rite of passage is also a concrete milestone. When faced with difficult times in the future, my kids can look back at how hard their black belt test was and that they did it anyway. Hopefully, they will also remember that while they have to do the work, they aren’t truly alone in their challenges. They have family and friends to lean on.
This type of easy-to-recall-challenge-milestone is important in building resilience. Both for kids and adults.
Do you need some karate in your life?
We all hear about the importance of work-life balance. However, it can be very difficult to achieve for those of us who are strongly pulled by accountability and duty to others. I think this is a common trait amongst physicians and many professionals.
Starting a career in medicine and starting a family are two major commitments that often strike at the same time. They can be all-consuming. That consumption can include your own personal health. Karate helped me to escape that path. It also helped to strengthen our family synergistically.
Karate isn’t for everyone. However, there are plenty of activities and organizations with similar characteristics.
The helpful characteristics of karate are what I think is vital:
- External accountability to exercise
- Shared experiences that both challenged me and my family together. Not just as a spectator. As an active participant.
- Building a social network and community outside of medicine
- Having separate adult-time that wasn’t focused on parenting
- Progressive challenges
- Concrete milestones