Motherhood, medicine, memoir

Michelle Au is an anesthesiologist, wife, mother of two, and a longtime blogger. She's collected her thoughts on her journey into medicine and motherhood (so far) in the hilarious, honest, and touching memoir This Won't Hurt a Bit.

Opening with an excruciating moment as a third-year medical student and taking us through the ups and downs of residency and the birth of her first son, This Won't Hurt a Bit (Grand Central Publishing, $24.99) is a breezy if irreverent account of the shaping of a doctor. But what sets it apart from most medical memoirs is Dr. Au's focus on building a life outside of the hospital walls.

Dr. Au, who has been writing her delightful blog The Underwear Drawer since October 2000, took some time out of her hectic schedule recently to share her thoughts on the book—and about finding the balance between her precious time with family and her commitment to her patients.

Mom MD: Let’s start at the beginning. Do you think you would have been drawn to a career in medicine if your parents were not both MDs? What prompted you to pursue a medical career?

Dr. Au: The fact that my parents were both doctors definitely made an early impression on me, though I honestly can’t say that I understood very well what exactly it was that they did at work, only that they worked long hours and seemed to enjoy their careers. Probably not until I was a bit older—meaning early teens—did I really understand what it really meant to be a doctor, and the long, sometimes winding path people traveled to achieve that.

I think I’ve always known that I would be a doctor, and I’d like to think that even if my parents weren’t both doctors themselves, I would have found that path eventually. I am Chinese, after all, and all Chinese kids are supposed to become doctors, right? (Just kidding. Kind of.) But seriously, I think that what people choose to do with their lives should be at the interface of what they enjoy doing and what they can do well—for me, medicine strikes that perfect balance.

Mom MD: Throughout the book, you show your self-doubt and worries—that you are not a superhero. Were you writing with the young medical student in mind? Or for your fellow mother physicians?

Dr. Au: What I always say about medicine is that the act of becoming a doctor is simply putting ordinary people into extraordinary situations and trusting that they have the knowledge and character to do the right thing. But the emphasis is on the fact that, despite the occasional idolization of doctors both within and outside of our own ranks, doctors are just ordinary people, and never is this more evident than watching young doctors trying to find their way.

The thing that med students and residents need to understand and remember is that the path is difficult, but that it’s difficult for everyone. Everyone has been there, everyone has struggled, everyone has been afraid at times. And that’s part of what the book is about—sharing that commonality of experience, and opening up about the fallibility intrinsic in the practice of medicine. If being open about my own experiences, including my self-doubt and worry, is helpful to young medical students, then I’ve accomplished one of my goals in writing the book.

As for speaking to the experience of the young physician who chooses parenthood early on in her career, it’s simply an experience that I’ve never seen discussed widely or openly at all, though it’s a choice that young female physicians are increasingly making. It’s obvious that the face of medicine is changing, and I’m proud to be one of the first physician authors to write about this particular aspect of modern medicine.

MomMD: Humor seems to be a good part of your approach to life. Can you talk about finding and using humor in the often humorless world of professional medicine? And in your home life as well?

Dr. Au: People often talk about humor as a defense mechanism, and I think humor absolutely serves that purpose for me sometimes, especially in emotionally charged situation like the ones we face in the hospital. If you’re laughing about something, at least you’re not crying about it, I guess! The thing is, despite what people might think, the hospital environment is actually ripe for humor, as long as you let yourself see it. I think, for example, that the show Scrubs is a much more accurate depiction of hospital life than, say, Grey’s Anatomy, which is essentially only tangentially related to medicine. What you really have in the hospital is essentially a circus of the ridiculous, and I mean that mostly in the sense of the situations we find ourselves mired in. You have to laugh sometimes—how can you not? Working in the hospital is so intense as it is, if you didn’t have a way to defuse some of that emotional energy, you’d burn out fast.

My husband and I get along well because we have a similar sense of humor, and as such, I like to think that our kids have a good sense of humor too. Of course, my boys are five and two years old, so their humor is largely fart-based, but I have high hopes that their comic sensibilities will become more, um, nuanced over time.

MomMDThis Won’t Hurt a Bit is about choices—those we make as students, as residents, as partners, and parents. You are honest in showing your decision to change residency from pediatrics to anesthesiology, to leave a fellowship and join your husband in Atlanta. Can you talk about the choices you’ve made and how difficult they were at the time?

Dr. Au: If there’s one thing I’ve learned in my medical career, it’s that the right choices are usually not the easy ones. I decided fairly early on in the course of my Pediatrics residency that I probably would be better suited for a different field of medicine, and after my second year of training, I switched to a residency in anesthesia. That was not an easy—it was absolutely the right decision for me in retrospect, but at the time, I felt like a quitter, or that I was letting my fellow residents down by not putting on a happy face and sticking it out. Making big choices requires a leap of faith and a strong support system, because as adults and as doctors in particular we know that no outcomes are assured. But in many ways, my training in medicine enabled me to make some of those more difficult choices. There are times in life, like when taking care of patients, that the right thing to do is often the most arduous and time-intensive, but you know you need to do it anyway.

Another more difficult choice I made during residency was the decision to have a baby early on in my training. No one will argue that having children, regardless of what you do outside the home, complicates your life, and many other people expressed serious reservations about my choice even well after my son was born. Let me emphasize that fact that it was other people that had these reservations—Joe and I, as nervous as we were for taking on the monumental task of parenting during a period of our professional lives which could roughly be compared to boot camp—never seriously questioned our decision to start our family when we did. And let me not lie to you, it was difficult, for all the reasons you might expect. But it was what we wanted, and it was, and is, the most worthwhile thing we’ve ever done.  Again, the right choices are not usually the easy ones.

MomMD: Looking back at your experiences, what one piece of advice would you pass along to young medical students? And to Mom MDs?

Dr. Au: I received an excellent piece of advice from one of my senior residents during my intern year—I included it in my book, and quote it often. He told me, “You’re not supposed to know everything yet. If you did, what would be the point of residency?”

I think that medical students and young doctors in general tend to be very hard on themselves, because it’s in their nature to do everything well, and to do everything right, preferably the first time. But that’s just not the nature of training in medicine. You will make mistakes. It’s part of the process. Strive to do your best, always, because the obligation you have towards patients makes the stakes that much higher, but don’t beat yourself up when you inevitably do things wrong. I wrote a whole book filled with mistakes I made as a medical student and as a resident, and I did that because I wanted to show people: this is what it’s like. Fallibility is built into the process. Doctors, like everyone else, are human beings too.

As for the other Mom MDs out there, I’m in no position to give advice, since even now, as an attending with two kids, I’m still trying to learn the ropes. But I think the best thing we can tell each other is, “You’re doing fine.” And we are. Plus, we have the two best jobs in the world, so really, what could be better than that?

Buy the book:

Click here to get a copy of Michelle Au's This Won't Hurt a Bit (And Other White Lies): My Education in Medicine and Motherhood

Check out MomMD's recommended books for summer reading.

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