THE GOOD, THE BAD & THE UGLY OF LIFE ON-CALL

Don’t know about you but I am CONSTANTLY in awe of all medical professional: sacrificing so much of themselves to help others. Add to the fact that many are doing that whilst raising kids is even more remarkable. Here Dr Victoria Wakefield shares the good, the bad and the ugly of life ‘on-call’.

• Being a West African immigrant child growing up with a single working mother, not working was never an option for me. 

• As a Nigerian immigrant the choices of jobs my parents told me I had to choose from were limited to, doctor, teacher, lawyer or engineer.

• Many immigrant families encourage their children to have a profession, because it’s seen as the best way to guarantee independence and financial security for their offspring in the future.

• Thankfully medicine won my heart, so the choice was easy.

• Paediatrics was the speciality I chose.

• For 3 years I was a paediatrician without a child, and I loved my job, as hard and as long as the hours were.

• I loved it.

• I looked after and helped save the lives of what most people consider their most precious asset: their children.

• Then I had my first child; a son.  And suddenly I got what all the fuss was about.

• He was an extension of me, he was my literal beating heart, any pain he felt I felt a million times over.

• I was suddenly in a position where I truly had a foot in both worlds. 

• Being an On-call Mummy is multi-dimensional and comes with the good, the bad and the ugly.

• THE GOOD:

• Working within the NHS, taking a year for maternity leave was very straightforward.

• I timed my pregnancy so that when I returned, I would be returning on the next run of my career ladder, coming back as a register (2^ND from the top).

• Believe it or not 1 month of my maternity leave counted towards my training, (that is a nod to how having your own child aids your development as a paediatrician).

• I had realistic expectations of what having an infant meant.

• Ranging from how hard breastfeeding can be in the first few weeks, to the fact that babies don’t really sleep when you want them to or the reality that babies cry for a whole bunch of reasons.

• Not every cry meant something was wrong or I was doing something wrong.

• I spent my first 3 years of training childless but exposed to thousands of infants and learning what normal was. There is a popular paediatric teaching topic called “The crying infant”

• So, when my son went through his colic weeks, I knew there was nothing medically wrong with him. Having that knowledge gave me incredible peace of mind and saved unnecessary trips to my GP or A&E at 2am.

• True shared parenting can happen from early on. I was returning to work when my son was just under 1. Therefore, had to make sure my husband was able to feed, bath and put the baby to bed without me.

• My son was 6 weeks old when I first went out, breast pump in handbag, and left him with his dad and a supply of breast milk in the fridge.

• I won’t lie some of that was my strong desire to get some of my old life back and being able to go out, without a baby hanging off me was really important and felt bloody amazing, apart from the engorged boobs.  I am not saying this is a standard that you should be aiming for, but I feel sharing the care for our children as equally as possible is a good thing and has benefited my family.

• Previous experiences of seeing both female and male doctors and nurses look after babies and children who aren’t, that are not even their own in loving, caring and adequate ways, made me feel that much more confident about leaving my 6-week-old baby in the hands of my husband who was after all his dad.

• I have always been the sort of mother that did not buy into the idea that ‘only a mother can look after a baby’. I have spent many a night shift, feeding, burping and changing the nappies of other people’s babies, with tender loving care, before I even had my own. So, I felt giving myself a few hours off now and then would cause my baby no harm.

• I initially went back to work at 60% of full time (the NHS allow you to return anything between 60-100% no questions asked). 

• I chose to return to work part-time as I didn’t feel I it would be fair to my young children or my poor ever understanding husband for me to go back full time. I would have just never seen them.

• A full-time  paediatricians doctor’s week can easily be a 52-60-hours long, and often horribly unsocial hours too.

• I felt strongly that I wanted to play a big part of the first 5 years of my children’s lives. ‘The personality years’, I call them. These are the years we make our little people’s personalities and I wanted to have some say in that. For the better or the worse.

• What makes my setup different from most is the balance of ‘shift work’. Believe it or not, there are a few pros to shift work and being a literal “On- Call Mummy”. 

• I get random days off in the week when the kids are at school or nursery, where I can take myself off to watch a movie, go to a gallery or just sit in bed in my pants all day.

• If I am really good, I’ll even do some batch cooking and pop a store of food in the freezer, to make meal times a bit easier when I am not there.

• The other pro is the fact that I get to miss some a lot of the mundane family chores. Daily cleaning (I always told my husband I became a doctor, so I didn’t have to clean the house), the boring morning ritual, stressful meal times, stressful bath times etc.

• Of course, I still have to do some of them, but I know I do far less than most mums so, therefore, I think I find them slightly less stressful.

• I often listen to my husband moan about how another meal he made was left uneaten by our 3-year-old and how this drives him mad. I then swoop in a handful of times a week and she is a dream for me. (Smug face) 

• I’ll be very honest, I LOVE my family, BUT I find some of every day family life pretty dull and unexciting at times.

• I have the attention span of most of my 5-year old patients, so on occasion I do prefer the adrenaline rush that comes with treating a sick child in A&E or the drama of running a busy paediatric ward.

• I am useful; the other main perk to being an On-call Mummy is how useful I am to people. I am on speed dial to all of my friends with kids. It’s great to feel so needed and valued.

• It’s the main reason I started my On-call Mummy first aid classes. I wanted to share some of this knowledge with the masses. Save people from needless trips to GP’s or hospitals.

• The final main benefit to being an On-call Mummy is, that being exposed to such a huge number of kids and parents in my studies and in practical training, means I have been lucky enough to see things that work and don’t work. 

• I have learnt that there are a host of good positive ways to bring up your kids and that there are behaviours/actions that are likely to cause them both short and or long-term damage. This can range from how we feed them to how we speak to them and everything in between.

• THE BAD:

• I was petrified of labour.  As a result during my pregnancy I had to watch countless You Tube videos of normal labours as I had just spent 3 years of my working life only seeing labours that had gone wrong or seeing the results of labours that had gone wrong. So, I had to wash my brain clean of all that birth trauma. I had to perform my own cognitive behaviours therapy and allow myself to believe I could and would be able to have a natural atraumatic birth.

• The shifts can mean some days I leave before my kids wake up and get home long after they have gone to bed, so I can easily go for 48hrs without seeing them awake, as annoying as they can sometimes be, that does suck.

• The other main drawback is when I do nights, I just don’t get that much sleep in between shifts anymore. On average I get 4 hours of sleep interrupted by needing a wee at least once. (We release a hormone called ADH at night that stops us making as much urine, so we don’t wake up; we have much lower levels in the day, meaning I wake in the day to wee).

• So over three days of night shifts, I’ll be lucky to get 12 hours of uninterrupted sleep. 

• How do I cope? Vats of coffee and Haribo at work and I think having gone through the early months of no sleep as a new mother has helped me cope with sleep deprivation. Pre kids, I slept for 8-10 hours easy between night shifts.

• What this lack of sleep does to the bags under my eyes and my long-term health, don’t ask!

• My sweet husband tries his best to maximise my sleep in between shifts. I constantly hear him shushing the kids “be quiet, mummy is trying to sleep!” To rephrase that famous “behind every man…” quote; in my case, ‘Behind every woman that wants it all, is a great partner.’

• Without him, the bad parts of my job would make my career incompatible with having a family.

• My career progression has slowed. If I had chosen not to have children, I would have finished my training already and been a consultant by now.

• The other side of that coin though is the huge benefits having children has given me and my career as a paediatrician. Simply put, it adds so much more weight to the advice I give parents, which increases their trust in me. Being a parent myself has really helped to underline how important what I do is, this has made me raise my game. I treat every child the way I would want mine to be treated, meaning I would move every mountain possible if I believe it will benefit the well-being of a child whose care I am charged with.

• THE UGLY:

• I didn’t really enjoy my pregnancies.

• I spent the first 30 weeks worried I would lose the baby. I have spent a lot of my training working with extremely premature babies, babies born at 24 weeks weighing the same as a bag of sugar. I had seen first-hand the unbelievable stress and anxiety caused by having extremely premature babies, furthermore being witness to families whose babies had been born still. I therefore spent a large part of my pregnancy protecting myself and not allowing myself to truly believe I was having baby until I was holding that baby in my arms. 

• By the end of my maternity leave year I had sort of had enough of it.

• Am I allowed to say that out loud? I felt my brain was saturated with mother and baby groups and the chats about poo and sleep training. 

• I craved being able to have a poo with a locked door and not cleaning a cereal caked high- chair, I felt. I needed something else too. I still wonder if some of my need for more was the fact, I felt I was just OK at this new domestic role. Us high achievers don’t like feeling like we are just OK at anything we do.  

• However, going back to the front line of the NHS after a year off and having major baby brain literally filled me with dread. I cried on most days in the month before I went back. I was scared I had forgotten everything. I was worried I had forgotten how to be doctor. 

• I had left for maternity leave as a very capable junior doctor that nurses and fellow doctors where happy to see on shift to now the fear of returning as the doctor that had forgotten the most basic aspects of her job.

• I was also worried about my son being looked after by strangers at nursery. Would they know what he wanted when he cried, would they be kind to him, would they give him enough cuddles?

• Thankfully we found an amazing nursey on my hospital site, so drop offs and pick ups where easy.

• My non-medic husband was a god send, mainly because he was not a medic and because he is self-employed and works from home. This meant when I was doing late shifts or nights, he had the flexibility to be able to rearrange his work day to allow for picking up the kids etc.

• I currently work 80% and have done so for the last 4 years. I work on average 4 days a week combined with doing 80% of my late shifts and 80% of nights compared to full time. 

• Practically speaking it basically means I have Fridays off and do 1-2 less night and weekend shifts than the full time doctors over a 6 month period.

• Mummy guilt; Fridays are my mummy days. These are the days I try to make up for the endless mummy guilt I get.

• This day (if I am not on nights) allows me to be the closest I can to a “perfect mum”. I try and do nothing work related on my Fridays.

• Sick day rules, are how we manage work when one of the kids is sick and can’t attend school or nursery. Such conversations can cause arguments at times. Thankfully this problem has come up on very few occasions. In short, we have to decide on the day who would be missed least at work that day. 

• For my husband, who works mainly at home and on his own, it depends if he has a deadline or a big job on. For me, it depends on what shift I am doing and how much the service will be disrupted if I don’t go in. If it’s going to be a few days off school or nursery then we take it in turns.

• To live this sort of work life balance with kids, no-one’s job can be more important than the other, even if one earns more.

• That being said my husband knows more people rely on me being on shift than do on him being able to work in his studio, in general. 

• Also I say this with slight hesitation, looking over my shoulder that, he knows that my job is both physically and mentally more demanding than his, which reflects how we manage our family life. 

• I remember the first time I saw a very sick, dying or dead child that for some reason reminded me of my son. I took myself off to the toilet and had a good cry. It was hard to not see my kids lying there and hard not to put myself in the position of those poor parents.

• 7 years into being a mother and a paediatrician this is still the hardest, ugliest part of my job. Having to see the unbearable pain caused to parents after the loss of a child.  There are never any words. I will not end my On-call Mummy list with the low point above, because I feel this topic brings me back nicely to why I chose paediatrics in the first place, many moons ago.  

• When things I do go right and I save a life. I keep a family from that unspeakable pain of the loss of a child.  When I take an active part in giving a child the rest of their life, the bad and ugly bits of my job don’t even come close to that feeling. That’s why I am an On-call Mummy. 

• I look at my children and feel I can say, I see happy, healthy, well balanced kids and my choice to continue to work in a demanding unconventional job does not seem to have affected them in a negative way so far.

• My hope is in fact, the opposite. I hope I have shown them that there are no gender specific roles within a family, that people are multi-layered and to function as a family, one needs compromise. If you want anything good in this life, you need to work hard and sacrifice.

• I hope I have taught them that as important as they are to ME, in this WORLD they are not its centre. That their happiness is no more important that anyone else’s, including their parents…apart from when it comes to giving them my last bit of crispy bacon, I was saving for last.

• I love them unconditionally and would do anything and everything for them if needed, like giving up my much-loved job. However, I don’t feel this translates into me choosing to do a job that does not fulfil me, just so I can be there for every meal or bedtime. I chose them a father that can do that when I can’t.

• Would I want my kids to do my job? Yes for so many reasons, being a doctor is the best job in the world. Of course, there are draw backs, and sacrifices to be made, but anything worthwhile has the same complications. 

• I may not earn the most money out of my friends but as I lay my head on my pillow each night, I have job security, plus job satisfaction. What parent would not want that combination for their kids?

• I have seen so many different types of children, many different types of parents and so many types of parenting styles that very little phases me in my mothering life to date (I know I still have plenty of time for this to come!).

• I know what a child is, odd thing to say right? Of course all children are different in certain ways, but actually they are similar in so many. There are certain constants in them that I have learnt in my training. Having an understanding of this has proved to be invaluable to raising my own little people.