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Friday Jul 25, 2014

Oh, Baby! What Happens When a Family Physician's Family Expands?

“She bought us a minivan, ladies and gentlemen. That is the biggest goober-mobile you could ever own in your life. There is no way to be cool in a minivan." - Comedian Bill Engvall

Close to a month from now, my wife and I will welcome our second daughter into the world.

And our third.

There's a lot to do to get ready for the arrival of twins. Fortunately, my daughter, Rosella, helped put together this baby bed.


Overnight, our family of three will become a family of five. I’ve assembled a second baby bed. We bought a dual stroller and two new car seats. I bought a vertical deep freeze for storing milk. We’ve even moved our 20-month-old into her new room, complete with a big-girl bed and a fresh coat of under-the-sea paint.

We also bought a minivan. It’s cool. I promise.

On the surface, we are as ready as we’ll ever be. Below the surface, I’m still dealing with the implications of having three daughters younger than 3 years old. Don’t misunderstand. I’m not complaining. I’ve been blessed beyond measure, not only with the children, but also with my wife, my job and our family.

From a work/life perspective, the changes for me will be subtle. I’m blessed with a job that affords me nights and weekends essentially clear of clinical duties. My employer has been supportive, and during the immediate postpartum period, I’ll likely have a locum tenens physician covering my daily clinic. I know many physicians aren’t as fortunate, so I plan to make good use of my time off, acclimating to the changes that come with multiples.

My wife, a clinical Pharm.D., works 36 hours a week, including every other weekend. We live comfortably, even with our student loan payments, so it was an easy decision to scale back her hours in exchange for more time at home.

The implications to which I referred fall more in the realm of the psychological. How do we navigate rearing a 2-year-old while welcoming and investing deeply in two newborns? How do I avoid favoritism? What if I feed one twin twice and the other one goes hungry? Is the full-featured minivan really cool, or am I just lying to myself?

Some good questions, some irrational, but all running through my mind as I go about my daily clinic schedule. My work hasn’t suffered appreciably, and I certainly don't want it to. I know that I will survive, just like many other physicians before me. I depend on the support and advice I’ve gleaned from physician friends and colleagues who have navigated these waters successfully (or not), and who have seen fit to share their wisdom. I hope to be able to share my own wisdom with others in the future. Right now, though, I don’t feel wise. Maybe ask me again in six months.

As an intern, I joked with my wife that I was preparing for the sleep deprivation associated with a newborn. When our first daughter was born, I was proven right in some ways and woefully wrong in others. There are few experiences akin to parenthood. Pets are great, and they can be like children in some ways, but they will never be more than a companion who can’t speak. Patients can sometimes seem to be like children, no matter how strongly we try to avoid the paternalistic model of medicine, but they go home eventually.

Children carry all the promise that is part of becoming entirely autonomous human beings, with their own thoughts and feelings but no ability to provide for themselves or survive for any length of time apart from an adult. Others have spoken and written volumes about the responsibility and the process of child-rearing, so I won’t belabor the point. Suffice it to say, being a parent -- that is, helping to shape a human life that is entirely dependent on you for EVERYTHING -- can be significantly more stressful than being a doctor, because in this case, the person will be under your care for years, not just days or weeks. But being a family doctor has prepared me in one very big way to handle parenthood: No matter what happens, I can deal with it with skill and grace, and when doubts arise, I can refer to someone with a higher skill level than my own.

For others who have experienced being a new physician and welcoming multiple babies into your family, how did you meet the needs of your practice while also finding time to be a good partner and parent? Are there any insights or warnings you'd care to share? Sound off in the comments below or on Twitter to @DrTolbert.

Gerry Tolbert, M.D., is a board-certified family physician who practices in northern Kentucky. A lifelong technophile, his interests include the intersection of medicine and technology. You can follow him on Twitter @DrTolbert.

Posted at 09:27AM Jul 25, 2014 by Gerry Tolbert, M.D.

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