Create Clarity. Build Confidence. Take Control.

Jane Doe, MD–My Mid-Life Medical Sabbatical

 Chapter 9–Life Happens to Everyone.  Paying Forward to Pay Back.

By Jane Doe, MD

pay it forwardI have what I hope to be a budding friendship with two of my peers for the coming year.  These are the only ones of the fifteen of us with whom I have been afforded the opportunity of more than casual conversation.  Both are women.  One is just finishing residency and the other has been in practice for a few years and is now returning to complete the training postponed by family pressures.  I like them.  This week I am thinking about the circumstance of one of the two, Dr. D, as I feel resonance of her current situation with my past.

Dr. D is out of residency a few years and is now coming to the fellowship training she postponed to remain near her physician husband who was still in residency.  A few months before beginning, she found herself unexpectedly pregnant.  Congratulations, it’s twins.

When I was towards the end of my PGY-2 year I found myself unexpectedly pregnant.  I had a singleton gestation but a problem pregnancy with nausea severe enough to cause significant weight loss, a two month long medical leave and a preterm delivery resulting in my absence long before the planned date.  The practical concerns, guilt, joy and determination that occupied my mind twenty-five years ago occupy Dr. D’s mind now.   Guilt is the emotion that requires examination.

When we are out of the clinical rotation due to pregnancy and childbirth we feel guilt because we will cause at least some dislocation for our colleagues in terms of increased call to be taken, altered vacation schedules, later days and decreased flexibility to trade assignments.  We also know that we will not be able to “payback “ each inconvenienced colleague in a period as short as a year or perhaps even two.  In the near term we focus on the demands of motherhood.  In the longer term, at least for me, the sense of unmet obligations returns to haunt.  I have thought about this for a long time.  If I cannot “payback” I will “pay forward”.  I will be one of those who, without displaying resentment, gives extra time and effort to fill in the gap left by the necessarily decreased presence of the new mother and thereby repay my debt.

I try to take this approach with anyone with serious illness, injury or family crisis.  These situations arise for almost all of us but many of our colleagues are more resentful of the group inconvenience caused by pregnancy and childbirth. There are both voiced and unvoiced reasons for this:  because it is voluntary, because it is caused by carelessness, because it is only women who become pregnant.  I too have these thoughts rise unbidden.  I cannot change the assumptions and judgments of others.  I can only show and when the opportunity arises, say, how I think we should approach these absences:  “Life happens to us all and sometime soon some one else will need increased consideration.  Maybe you.”


Jane Doe, MD is pursuing another year of fellowship training after having spent 20 years in a successful practice.  These are her thoughts and observations from an unusual “gap” year. 


Sign up for our Newsletter