Author + information
- Michael Lee Jr., MD, JD∗ ()
- ↵∗Address for correspondence:
Dr. Michael Lee, Jr., Division of Emergency Medicine, Boston Children’s Hospital, 300 Longwood Avenue, BCH3066, Boston, Massachusetts 02115.
During the second year of my pediatrics residency, the cardiology fellow kept asking me for parenting advice, and for the life of me I could not figure out why. He had a child, and I was unmarried with no children. My program did not teach much on parenting, and he was board-certified in pediatrics himself. Confused, I tried giving him some child development tips. “No,” he finally told me, “I’m asking for your advice as the child.” I finally remembered: I had told him that my father was a cardiologist. “Your dad must have been in fellowship when you were little,” he said. “Did you feel like you came second?”
Dad was a fellow, and he worked more than 100 h a week. As a toddler, I would fall asleep waiting up late under the piano cover, hoping to jump out and surprise him. Once, after several days had passed with my father returning home after our bedtime, my brother felt obliged to introduce himself: “Hi Daddy, I’m Andrew. Do you remember me?”
It is a topic of anxiety for physicians, as I imagine it is for other busy professionals. Knowing how I grew up, people do ask for my advice as they struggle with long hours away from their families, trying to build careers or finish their training even as their children are growing up without them. It tears at my colleagues to be needed in 2 places at once.
I tell them a few things. It is true, I say, that there may be times when your children will have to come second behind the hospital, and nothing can truly make up for the absence of a parent. But, if you prioritize your family whenever you can, so that they are not third behind a hobby, or fourth behind an external pursuit, then your children will still know that they are loved and valued. The pediatrician in me reminds my colleagues that children only know what they see—their family is their normal—and anyway, children have enough empathy to know, at some level, that sick patients need their doctors.
Mostly, though, I tell them about my father.
I never imagined that other families ate dinners together, since ours did not. I did know that Dad would listen patiently to what I had learned at school that day after he got home at 10:00 pm. I figured everybody’s father got paged in the middle of the night, receiving grainy electrocardiograms via fax while their children played with calipers. He often had to drive back to work at 3:00 in the morning, but I knew that he would be back home at 6:00 am making me a ham and cheese omelet, if I had a test at school.
Mom still shakes her head, marveling at him. “He would get home at 2:00 am after 3 straight days at the hospital. He wouldn’t sleep, he wouldn’t eat—the first thing he would do is get on the floor to play with you.” I do remember those horsey rides, and the funny voices, and our own version of Simon Says, where Dad played Igor from an old Frankenstein movie. “He wouldn’t even shower,” Mom smiles. With hindsight, I remember the smell and realize that Dad stank. But even now, the pungent memory does not conjure up images of sick patients or long nights. It is the smell of my father returning home.
In retrospect, Dad must have been exhausted. Driving my brother and me to school, he would sleep briefly at red lights, asking us to wake him up when the light changed. Andrew and I did not think it was alienating—we thought it was fun, racing to be the first one to call out the change. When he was telling us bedtime stories, we made it our goal to keep him up long enough until he was “talking silly,” losing all coherence. I do not remember his days-long absences, but I do remember playing back the recordings of his delirious mumbling and thinking we had the funniest Dad in the world. I trained in a softer environment with the benefit of new work-hour rules, and I am exhausted after a 28-h shift. Showering us with attention after 48 or 72 h…well, Dad must have been superhuman. I wonder often whether I will be able to live up to his example, his energy and dedication, when the time comes for me to be a parent.
Of course, he did not do it alone. He was lucky to have the support and understanding of my mother, herself a pharmacist and the daughter of a physician. He interrupted their third date to call an ambulance for a drunk on the street, and then waited to ensure the gentleman was loaded up safely. My mother complained only that her own father would have escorted the patient all the way to the hospital. When I proved to be too high maintenance for an au pair or day care, she stepped away from her career to look after the 2 of us full time.
But Dad also made us a priority, stripping out anything that took him away from us unnecessarily. He could not reduce his time at the hospital, but he held off on the other pursuits he loved—bicycling, research, and community outreach—until we were old enough that we would not miss him quite so much. Later, he did take bicycle trips around San Francisco Bay, published some studies, and served as president of our community’s American Heart Association Board. Even then, though, he sometimes wondered whether the American Heart Association was taking too much time away from us. “Dad,” I told him recently, “I was 20 years old at college, 3,000 miles away.”
“I know,” he replied, “but still.”
Of course, he did not just belong to us. Whenever I meet his patients, invariably they tell me how devoted he is: that he takes time to listen, to learn what is important to them, and to explain things to them simply but clearly. They tell me that they can tell he cares, and that they love him. I nod knowingly. “Yup,” I say. “That’s my dad.”
“Did you feel you came second?” the fellow had asked me.
“Yes,” I said, “but I knew it was for good reason. I didn’t notice the time he spent away from us. What I knew was that when he was home, he was ours. And that was what mattered.”
- Michael A. Lee, MD ()
RESPONSE: Sharing the Vision With Your Children
Over the years, I have had a number of younger colleagues ask me how they can hope to raise “good” children while spending upwards of 80 h per week building their nascent careers and taking care of their many patients. I see their angst, their guilt, the pressures, and sometimes the feelings of hopelessness, knowing that they cannot give their children the time, love, and attention that they wish they could. These issues weigh on senior cardiologists as well: raising teenagers is no easier than toddlers.
Reading my son’s childhood stories brought up mixed emotions: pride that our 2 sons have chosen the noble profession of medicine; sadness and remorse that I was not able to spend more time with them while they were young; and relief that they seem to remember the times I was there more than the times that I was not. Although children may need the love and attention of their parents, the joy they bring to the parents is infinitely more precious. It was indeed much more of my loss.
The questions humble me. I do not consider myself a perfect father, nor a parenting expert. I spent 7 years doing 3 fellowships. I was rarely able to have dinner with my children and missed most of their games and recitals. Nor could I make it up to them with expensive toys or fancy vacations, which might have been a blessing in disguise. They actually enjoyed my silly games and stories and never missed not having the latest gadgets.
It is an honor and a privilege to be a cardiologist. Our knowledge, tools, and techniques save lives and alleviate suffering. However, although our spouses and children share in our sacrifices, they rarely get to join in the reward of saving lives.
While my younger son, Andrew, showed an interest in medicine early on, Michael Jr. was adamant that he did not want to be a physician. The personal cost was simply too high. Despite my passion for cardiology, I realized that children are, and grow up to be, their own individuals. Our task is to protect, nurture, and guide them, and ultimately give them the freedom to choose their own fields of interest and pathways in life. As noble as our profession is, we know well that a life in medicine is not for everyone.
Although I tried to allow my children to share about their days with me as much as possible in our limited time together, I did find that sharing about my work with my children would cause their eyes to light up. Understanding why they had to share their father with other people helped them to develop empathy and altruism, and to appreciate that there are others in the world who need to be cared for as well.
Revealing our values, passions, and vision to our families allows them to peer into our lives and see the beauty and humanity of medicine. That is the most precious legacy I could give to my children.
- 2017 American College of Cardiology Foundation