Editor’s Note: This is a gut-wrenching story about memories and feelings surrounding a profound personal loss.
“My husband and I carefully planned the timing of our first pregnancy.” I was a third-year orthopaedic resident in a very small program. When I became pregnant per our plan, the ultrasound showed that I was carrying twins. We were delighted. Although there had been women who passed through the teaching program ahead of me, none of them were co-residents when I was there. I liked the men I was training with but did not feel comfortable sharing the news of my pregnancy with them.
Toward the end of my first trimester, I began to bleed. My obstetrician-gynecologist called my husband and me into the office for an ultrasound. There were no detectable heart sounds, I was miscarrying. I was scheduled for a “night call shift” immediately after the appointment; I went ahead and did my job. I told no one about what I was experiencing. It took several days before the miscarriage completed itself. To this day, none of my colleagues knew what happened.
I am now in practice. As I think about all that we sacrifice during orthopaedic training and our practice lives, I carry seeds of resentment and harbor some negative feelings about my experiences. I especially resent that the residency program culture did not provide a safe place for me to speak about this profound event happening in my life. I was mourning a loss and was afraid to speak about it to my colleagues. Thankfully, my husband, family and friends provided a strong support network.
The product of this experience is that I have erected “boundaries” separating my professional and personal lives. I now treat my work as a “job,” and it is not my sole life’s focus. This causes me a sense of shame when I see my male counterparts reaching out for every experience they can to make themselves better at their work. I also feel this way when I attend professional courses. The instructors appear to have a “never ending cup to pour from.” I sometimes feel as though I am not doing the work to become the best surgeon I can be.
As a former cross-country runner, I remember well the quote from the late Steve Prefontaine: “To give anything less than your best, is to sacrifice the gift.” I have attempted to live my life that way. I am a life-long perfectionist. I stand on the shoulders of women in orthopaedics who came before me. Am I letting them down?
I don’t think of myself as an orthopaedic surgeon first and a human second as do many of the male surgeons I know. I have one colleague who continues to come into the office every day despite being retired. The profession is so much a part of him that he can’t give it up. During this timeframe, he honored me by asking that I perform his total knee arthroplasty. This is the greatest honor I have ever received from another surgeon. I am eternally grateful.
Looking back, do I feel that the stress, the missed meals, dehydration and exposure to work-related environmental hazards led to my miscarriage? No, I do understand that it is highly unlikely. Yet, I persist in feeling anger, resentment and distain about the many sacrifices I was forced to make. I feared that asking for time off while I was miscarrying would limit the time I might be allowed after giving birth in the future. I also did not want to show signs of weakness.
How did my pregnancy loss make me feel personally? I was the “protector” of the twins. I provided the barrier to the outside world. They were with me all the time. My job was to keep them safe. In some ways, I feel I failed them.
I am happy to say that I now have two healthy young children, a son and a daughter. Some of my boundaries have been erected to honor them. They have already survived my work during the COVID pandemic. I aim to be present in their lives.
After my personal and professional experiences to date, what have I learned?
- Pregnancy should not have a professional stigma. Complications can occur and it is in no way a sign of weakness. A healthy training program or workplace culture should allow discussion of these important life’s events without negative repercussions.
- Women communicate differently than men. They build networks by connecting, by showing their vulnerabilities and admitting when they are not perfect. These networks can help suppress the pervasive “Imposter Syndrome.”
- Women should lean into each other to experience the power of connection. This can help enhance leadership skills while earning a “seat at the table.”
- There is a special truthfulness and sincerity in all-women orthopaedic forums when discussing difficult cases and complications. We learn from each other and do not necessarily show a “one-upmanship” during educational discussions. These opportunities lead to professional growth, enhance our range of skills and are invaluable.
- I derive great satisfaction when serving as an “access point” for high school or even college students who are interested in some sort of medical career. If one does not have a family member involved in a medical field, these students have a very limited ability to get in to observe what medical and allied health professionals do. Institutions now limit student visitation to a day or less; not enough time to see if the profession is one they might truly wish to pursue. I try to bend the rules so I can provide them with a more immersive experience. I also participate in the Perry Initiative and find it gratifying.
- Just having the conversation that this narrative was taken from has eased a bit of the resentment and shame I still carry regarding the circumstances around my miscarriage. Revealing painful professional experiences in a supportive setting can be a cleansing experience. Find a place where you can do it.