Latest / Coffee Playdate Podcast with Dr. Olga Deengar / Mother’s Day Special Ep 27: Balancing Medicine & Motherhood – Real Talk with Dr. Zeel Shah
Transcript
- Dr. Olga Deengar: Welcome to the Coffee Playdate podcast. I'm Dr. Olga Deengar and I have a very special guest joining me today, Dr. Zeel Shah. Welcome. Zeel Shah MD: Hi Dr. Olga Deengar: So because it's Mother's Day, I'm excited to bring you a very special episode. We've gotten together here to talk about what it entails to be a mom in medicine. So in this episode, we're going to talk about what are some of the challenges of balancing work and home life. We'll give you some practical strategies that we've put in place to create more balance as busy physician moms. And we'll also answer some commonly asked questions and share our perspectives. ⁓ more importantly, we're going to have a ton of fun. Zeel Shah MD: is so exciting. I'm looking forward to it. Dr. Olga Deengar: So let's get started with just some brief introductions. ⁓ Dr. Shah, would you like to introduce yourself? Zeel Shah MD: Yeah, hello, my name is Dr. Zeel Shah I am the hospitalist medical director at a small rural community hospital in Greenville, North Carolina. I have one daughter who's now 13 months. I don't even know how the time just flew by. I had her like this past year, which was my first year as being like an attending. I am a full-time hospitalist in addition to managing my administrative duties. And it's been quite the journey. Dr. Olga Deengar: I love that. So the perspective of a full-time hospitalist and a new time mom, I mean, you're going to have a lot to share with our audience today. I'm excited to ⁓ your thoughts. Just brief intro about myself. I'm a locum hospitalist in Ontario, Canada. ⁓ I three boys who are six, three, and one years old. ⁓ I my first son in my second year of internal medicine residency at the peak of COVID. Zeel Shah MD: is going to be a little bit a setback. Dr. Olga Deengar: Then my second son was born when I was a full-time hospitalist at a rural community hospital in Connecticut. And then my third son was born when I was a locum hospitalist, when I've made that transition. So it's, I've got all these different kids from all different stages of my career. that's the perspective that I'm going to bring into our conversation today. So our first question here ⁓ what does a typical day actually look like when you're on service? Like from the moment that you wake up. until your kids or your daughter is asleep. Zeel Shah MD: I'm just gonna give you backdrop of like our typical structure because hospitalists function differently across the board. at our hospital, hospitalist shift runs for seven days straight. We start on Tuesday and go until Monday. The shift starts at 7 a.m. where we take over, sign out from the night doctor, and then we finish at 7 p.m. where we give over our patients to the night team. So that's the general structure of my job on service. So let's say a typical seven-day stretch is extremely hectic. I'll be honest, I'm very fortunate that I have like an incredible partner because otherwise it would be very, very difficult. Prior, truly the seven day shift starts prior to that. So the week that I'm off, let's say the day or two before that, so it would be Sunday or Monday, ⁓ preparing and meal prepping because ⁓ the week on, it can be extremely hectic. So say now it's Tuesday. So my day typically starts, I set my alarm for five, I tend to get out of bed at 5.30. ⁓ Usually I've done 10 minutes of meditation, I've been trying to incorporate working out and it's been a little difficult because some late Aria had been waking up in the middle of the night, but she's been better about it. So I'm trying to get back on track with doing morning workouts, but I'll be honest, most of the time that's not what happens. So I typically wake up and get out of bed. It's five 30, start getting ready, go downstairs and then I'll prep her bottles. make my and typically the lunch is in a section of ⁓ the fridge that has already been placed there the night before. So I pull and go pack my lunch, get my coffee, and Out the Door by let's say 620 630. I have like about a 40 minute commute where I listen to an audiobook of some form. Typically in the morning commutes, I like to listen to more of like a developmental audiobook. And right now I was listening to the Let Them Theory, which has been very good so far. I'm driving, think beautiful rural road, going to the hospital, listening my audio book, drinking coffee, trying to wake up. I get to the hospital. thereby like usually like 7, 7:10 And generally our census is about, 20 to 25. So for those of you don't know, that's quite a lot. So typically I would be reviewing all the charts and seeing what happened overnight. How are their electrolytes doing? Make any serious adjustments, We have a multidisciplinary meeting at 8.30. after that, we typically round on my patients. what that means is I'll start out. We have an open ICU. We manage patients with vents pressors and all of those fun things. ⁓ And so I usually start off the ICU, ⁓ see all my patients that are managed on drips and ventilators. See, is a patient teed up to extubate? So that's typically, we start off with them and then I start going to the different other floors. We are a 150 bed hospital, so it's not very large. So I go down in that sequence. I'm done seeing all my patients, I typically will manage the documentation. So what the plan is, I'm consulting ⁓ that we need on board. it's basically facilitating all of those different items. But there's a lot of tasks switching because nurses are messaging you, Case management's messaging you, ⁓ Fairly chaotic in the best way possible. in midst of that, you have admissions because we don't have a dedicated admitter. ⁓ And so in the midst of all of this lovely chaos, have the emergency department contacting you because. There's a patient that needs to be evaluated for admission. You assess, you do the chart review, go see the patient, determine is this patient appropriate for this hospital? And now that I've taken on a more administrative role, on top of my full-time role. I typically have meetings interspersed in the afternoon with ⁓ other leadership. So it could be the hospital leadership, could be nursing leadership and then usually by 7 PM I'm done. I drive home about 40 minutes, get home, immediately go shower to get all the germs off of me and give my daughter a big old hug and we sit down as a family to have dinner and like I get home around 8, 8 15 and then we'll have dinner and then maybe I'll play with her for like the 15, 20 minutes and then it's time for bed for her and so me and my husband go up and we do her bath and her bedtime routine, read her a book, put her to sleep and by that time I am exhausted because it is probably like nine, nine thirty. And at that point I go get ready for bed and I have also passed out. Sometimes I'm not fortunate enough to do that because, I couldn't get through certain documentation or I had some meeting work to prep for. So after I put her to bed, like I would go back down and finish up some work. And usually I'm in bed by like, 1030, realistically, and then we do it all over again. Dr. Olga Deengar: a full day. mean, there's so much going on and there are a lot of things on your plate, especially with your new role the hospital. How do you balance it all? ⁓ Zeel Shah MD: ⁓ it's, I'm learning and I'm still learning. ⁓ so it's definitely been a lot of transition because I've, graduated from residency back 2024. So ⁓ there a, as I know, as I'm sure you can attest to, there's a huge transition from being a resident to being attending. So once I got the hang of that, Like I essentially had a baby and I was away from maternity leave. had to make a lot of adjustments because then I came back as a mom and an attending. And that is a different balance because, ⁓ imagine in case, the midst of all this chaos, I also have to schedule a pumping time. ⁓ So the way I balance things has constantly had to evolve. During the week off, balance is very difficult. think that work-life balance is more like work-life integration. So the way that I make things more feasible during the day is that I always ⁓ make sure that I... my daughter during the day ⁓ that resets me and like de-stresses me On the days that I meditate in the ⁓ on the days that I work out in morning, I find that I have far more energy and more mental focus. So I'm making more of an effort to incorporate that. But in terms of balance, I think that's how it typically goes on the weeks that I'm working. Truly not much of a balance during those weeks, unfortunately, and that's the reality, that balance is not always achievable depending on when. But if I look at things let's say for the month, I would say I have balance because then I have seven days where I'm not doing anything at all when it comes to work. through these different roles, I've had to be very protective of that time. So I achieve balance by knowing that, know what, I took on the role, I made it very clear to everybody that meetings will be scheduled during my on week as much as possible. ⁓ Prior to having Aria I would pick up shifts and precept in the outpatient clinic during that time off, or I would pick up shifts in the wound clinic to work on that, but I've had to learn how to say no, and I've learned that I've had to scale I felt that I wasn't getting enough time with my daughter and my family, and it just wasn't aligned with goals. So I think I've had to make a very deliberate and strict boundary on the time on my week off So that's how I found balance is just, being very strict with my boundaries. ⁓ Dr. Olga Deengar: Yeah, no, I love that you are honoring the season of your life. And right now your daughter needs you when you're off, when you're at home. So she wants you to be present with her. She doesn't want a mom who's like thinking about all of the things that are going on in hospital and you're not fully there with her. And that's also something I've had to do as well is how do you separate that work and life? ⁓ Zeel Shah MD: Mm-hmm. Mm-hmm. so hard. Dr. Olga Deengar: hard, like you, have to just mentally prepare yourself when you step in through that door. You have to be the mom. You're no longer the hospitalist. You got turn everything off. Stop checking the patient's charts Stop bringing documentation home you can leave that at work. ⁓ So that have helped me are some ⁓ Zeel Shah MD: ⁓ Yes. Dr. Olga Deengar: breath work, in the driveway, when I park my car just before I'm about to go inside after a long day of work, ⁓ I take in four deep breaths for four seconds, one breath second, and I just pause for five seconds and then exhale for six seconds. You wanna make sure that the exhale ⁓ is a lot so you can really kinda turn everything off ⁓ and remind yourself, now I gotta switch over. This is my cue. ⁓ And also I like to use affirmations, positive affirmations, just reminding myself who I am, what I'm here to do. So I would say, I would repeat something like this to myself. I'd say, I'm present with my patients and have a lot of respect for my patients. I want to take good care of them, ⁓ this is my time to be present with my kids. And right now is exactly where I need to be. So just repeating that kind of a mantra in your mind. helps you step into your new role as a mom being at home. Zeel Shah MD: What a good way, I should incorporate that. that's a very good way to like switch because also sit in the driveway or like in the garage for a couple minutes and usually like it's wrapping up a phone call like with my family or whatever the case may be. But I also need that time to switch gears. And I think that was one of the hardest things that I had to learn was that switch. Like, okay, the doctor is taking a back seat the mom is taking a front seat and then we switch. so I think that part is certainly something that I'm still ⁓ working through I do find myself like after I put her to bed and then like, ⁓ I should go to bed. But then I'm like, let me just quickly look what happened to that patient there. ⁓ Even though literally could wait until I see them in the morning. ⁓ But I that's also just part of being a doctor, especially if it's your calling. Dr. Olga Deengar: friend. Zeel Shah MD: Your patients never truly leave you, but you have to learn how to turn down the volume sometimes and then switch channels and then switch back. Dr. Olga Deengar: Exactly, yeah. So our second question here that we get asked is, what's the hardest part about being a mom and a hospitalist that people outside of medicine don't see? So we already touched a little bit about separating that work and home life. there any other tips or tricks ⁓ you can think of or what's the hardest part for you? Zeel Shah MD: I think I really struggle when we've had a lot of codes and I've lost patients and I haven't had time during the day to process that grief because, it's hard, especially when you're in a code. ⁓ you're running it and you'll lose a patient that you were working really hard to save. It really hits hard and just by the work that we do, you don't have time to process it. And that's unfortunately the reality. ⁓ You don't have to process during the work week because you have 20 other patients that you have to see ⁓ and they also you. So you have given everything at work. Some days more than others and it's really difficult to not be depleted and come home when kind of just want a little bit just sit in the grief or like Process it but you don't have time to do that because you come home ⁓ there's your children that haven't seen you all day and they want their mommy, but you're also just little drained and I think That is the hardest part The stakes are very high. I think for me, what worked was practicing gratitude. sit in the car and I just am so appreciative of the other day of life that I have and seeing my daughter in her naivety, ⁓ enjoying and like having such a ⁓ with the world around her. I try see things through her eyes and I think it makes it a lot better. because you're dealing with such a dichotomy of life where you're dealing with death and then you go and you're getting to cherish the living and the young who are just to experience this world ⁓ Intentionally forcing myself to mindfully put myself in her eyes has really helped me stay grounded It doesn't always help, obviously, because sometimes the grief is too much, but it does help on most days. Dr. Olga Deengar: Yeah, and it's true. mean, we face these life and death situations and the patients that go through that, unfortunately, those are the hardest ones. They're the most memorable cases that we have. And I think one other thing that really helps, at least for me, is being in a dual physician family, I'm able to talk to my partner, my husband, about the thing that just happened in the hospital and how we tried to save the patient, but it didn't work or whatever. the situation may be and just having him listen, it doesn't have to say anything, but just having him listen and be there for me as someone to just talk to, it really is a huge help and it helps me kind of offload all of those emotions that are associated with what just happened. Zeel Shah MD: Yeah. Yeah, that's just incredible having that support because sometimes like you don't have to explain the grief or you don't have to explain what you're feeling because your partner feels it too. ⁓ And there's a true unspoken understanding because if you haven't been in that situation, it's so difficult to truly grasp the gravity of what you're feeling. ⁓ So that's I think and I'll provide perspective of someone who doesn't have a partner in medicine and that in its own way can be helpful too because he helps provide, I get so zoned and focused on medicine and what I'm doing, I forget that there is a world outside of there and so having a partner that's supportive to me who's not in medicine also can be helpful because they see that there is other things going on in the world and expand your horizons. So Yeah, having a supportive partner makes a huge difference, certainly for sure. Dr. Olga Deengar: Yeah. The next question is, how do you handle guilt that comes with missing things at home, like the sick days or the bedtime routines because of a long shift? Zeel Shah MD: I recently dealt with that. So I went to a leadership retreat for three days and it was the first time I was away from my daughter for so long, like, because it was several hours away. And think you just have to keep reminding yourself because I haven't fully, I would love your thoughts on how navigate that because I think I still deal with a lot of mom guilt I'm a first time mom and think, I haven't been doing it for that long. You know, it's only been 13 months. So I'm still trying to figure it out. You're a veteran. So I would love your thoughts on how you navigate it. For me, I just try to remind myself that, because I have a daughter, I'm being an example for her that, you can, as women, you can show up in the world the way that you want to. Sometimes telling myself doesn't always work. So my husband has to remind me that she's watching me, she's watching the things that I do, and she's gonna be empowered to do similar things. Like I grew up with a working mom and I was always proud of her. Like, oh my gosh, look at my mom doing X, Y, Z. So reflecting back on my own thoughts as a daughter makes me feel a little bit better now that I'm a mom that's also working. But I don't know, that guilt doesn't really go away. I haven't really gotten to that phase of motherhood yet, so how do you manage it? Dr. Olga Deengar: It takes practice. It's not an easy thing to overcome. And even still to this day, it's something that keeps creeping up in a while. But I think learning about life coaching and the cognitive behavioral therapy you have to make sure that you have to be aware of the thoughts that you're having around a particular circumstance. So ⁓ if my kid sick at home and I have to be at work. And of course, he's being taken care of by this caregiver. I have reframe my thinking. So instead of saying, I'm such a bad mom, I can't believe that I'm at work and I'm not home with my kid. ⁓ I have to that thought to say instead. I'm a good mom. My kid is safe. He's going to get better. He's in great hands and I'm really proud of him. ⁓ and that changes the feelings that have around ⁓ that same thought. So instead of guilty now, I feel hopeful. that he is going to recover quickly from whatever little cold that he has. And your thoughts translate into your feelings. Those feelings translate into your actions, which ultimately become your results. So once you shift that perspective, you're able to get through your day, be present there for your patients because they need you when you're at the hospital. And then come back, not feeling the same guilt when you step into the house and check in. on how your kid is doing. And it takes a lot of training, because first you have to recognize that there's a problem with your thoughts. You're like, okay, now I need to change the way I'm thinking. ⁓ takes a lot of practice. Zeel Shah MD: It definitely does. I'm still figuring it out. It's still hard. Dr. Olga Deengar: Thank It is, yeah. And if you have more kids, it'll become a little bit easier with practice there too. Zeel Shah MD: I really had to audit my life and then see what aspects were not in alignment and were not worth time away from her. I still struggle with it still, but I think it's something, like you said, a work in progress. Dr. Olga Deengar: But you're doing an amazing job and the fact that you are focused on showing her what's possible, like the leadership that women can step into in the healthcare world. I mean, that's huge. Like coming from also my mom was a working mom the majority of my life. And it's a different feel than when she transitioned to being a stay at home mom, because I didn't see that ⁓ drive her. And I kind of, I kind of wanted that. And that's something that. drove me to become even more determined, even more motivated to do the things that I wanted to accomplish in my career. So it's cool to have kind of both perspectives, but just kind of figure out what you want to teach your kids and what legacy you want to leave behind. Zeel Shah MD: Yeah, I agree. Yeah. And I think that's what you nailed it. It's what legacy do you want to leave behind? What do you want them to get out of it? ⁓ think that was a big thing for me because at my hospital, I work in a very male dominated team. So majority of our group are men, and that has its own unique challenges now that I am their leader, basically, and I think that it's a important skill to teach women and other girls that are growing up, like how to have the self-confidence and just be a representative of the fact that, hey, well, my mom did it. I'm sure it's fine. Like it's not that big of a deal. Everyone can do it. And it's just, I think it leads for a more equal society, ⁓ Dr. Olga Deengar: so next one is what kind support like partner, family, hospital culture actually mattered and where are the that you're still feeling? So Zeel what kind of supports you have in place? I know you've mentioned your partner ⁓ as a huge support. What about the hospital? Do you feel like the workplace culture has been supportive? Zeel Shah MD: Yes, I think that we have a very supportive workplace. Like the previous medical director who now got promoted, he fostered a very supportive culture, which I hope to continue on. All the women in my workplace, well, like including like, I'm including APPs, they have been logistically enabled to schedule in pumping because it's one thing to say, we support you as a mom, but it's entirely a different one to make space for you to be able to do that. So in this chaotic day, it's really difficult to necessarily schedule time in to take time away and pump. ⁓ But I'm by an incredibly supportive group of people that help me facilitate that. If something comes up, it's like, worry about it. You can leave to care of your daughter. And we do this. We carry that same mentality and we empower everyone to do that. but ⁓ we support each other ⁓ in that way. Like if we had a team member whose child was sick, we would find coverage. It's fine. Like be with kid. I think I'm very in that way. ⁓ I'm 100 % don't think that this is common absolutely everywhere across the board. Dr. Olga Deengar: True. And I'm really lucky in this way as well. But one of the other hospitals where I used to work, they actually didn't have a lactation room and I was pumping. I still had like my two month old, I needed to pump. And so it's like, what do you do? Well, you have to pivot. ⁓ I had wireless pump that I had to buy, ⁓ And ⁓ just because a workplace doesn't a for you to do that doesn't mean you just have to stop. So you find ways, you always have to course adjust ⁓ and figure out what works best for ⁓ And with workplace culture, I think it's important to find a good supportive environment, especially if you have a supportive boss, ⁓ because they will help you get shifts if there's nobody that can care for your kid when he's sick at home. and you have to take the day to take care of them. The ones that don't do that, I would stay away from working at those type of facilities because in the long run, these things add up and it's just going to not be a good place for you to work. Zeel Shah MD: 100%. I would definitely agree with that. I think if a workplace can't support someone on such a basic human necessity, they very likely don't value you as a person and ⁓ you be very easily replaced, You are important, but you're not the thing that keeps the hospital open. So ⁓ workplace that doesn't acknowledge that ⁓ and, ⁓ make you feel like you are a valued member by supporting you in practical ways is probably not the best place for personal and career growth anyways. They're not going to very likely uplift you to achieve your professional desires either. Dr. Olga Deengar: Absolutely agree with that. Yep. And then in terms of having supports at home, one thing I want to say is we're very lucky that in Toronto we have four grandparents who are more than happy to do the pickups and drop-offs for the daycare and take care of the kids But when we were living in Connecticut, we didn't have any family support. We didn't know anyone there. ⁓ And so had to create a system that would be sustainable for our family. We hired a housekeeper slash nanny. Zeel Shah MD: Yeah. Dr. Olga Deengar: that would help us out a days a week for about three or four hours each time. And that includes taking care of ⁓ chores, like laundry, cleaning, all the things that we didn't like to do. We with it to the housekeeper and it's been so invaluable. mean, ⁓ you think it in this way, you're like, well, I can do this. I can just mop the floors and vacuum. It's not a big deal, ⁓ but it's about knowing how to it. It's about putting in a sustainable system in place so that someone else who's really good at those things can take care of that in a much shorter amount of time than you can. And you get that time freedom back to really enjoy spending that time with your family, being present with your partner, with your kids. I mean, that does not have a price tag. Zeel Shah MD: No, I completely agree. It really does take a village, honestly. And sometimes you have to create that village because just like you mentioned in like your situation in Connecticut, that's kind of our situation here is that we don't have any family nearby. I'm really lucky that my husband is self-employed. We have like some businesses and then he manages that. So he's in charge of his time. And I think that has allowed us to have at least one parent home with Aria. ⁓ And even though he's working on own stuff, knowing that he's at home, makes a huge difference because ⁓ we have a nanny and ⁓ she comes a couple of times ⁓ a week, we're very fortunate to be able to be in a position where can have help we can hire help that we don't unfortunately have around us. So I think that really helps support both of us in our because we have that flexibility. Dr. Olga Deengar: Yeah. And I want to wrap up here with one last question. What would you tell a female resident or an early career physician who wants to have kids but is scared of how it's going to affect her career? Zeel Shah MD: I would say go for it. Honestly, and the reason I say that, if you think that you're mentally ready and you're in place where you think that you can have kids, just go for it. I think that a lot of times, and myself included, ⁓ we the mistake of being like, I'm gonna finish this and then I'll have kids. And we spend our entire careers ⁓ putting off ⁓ life and... ⁓ Children and all that kind of stuff because we're so focused on medicine and we feel that we have to put everything forward To medicine and I think at this point I'm talking to the younger version of myself because I wish ⁓ had really encapsulated that Like I went through infertility and I went through IVF And because I end up having kids at a age. There was no ⁓ Reason that was found about the infertility, the doctors couldn't figure out what was causing it, but it was there. And I feel like there is some component of the fact that I was chasing my medical career and my dreams, I did not even think about kids. didn't prioritize that, but I always knew I wanted kids. but it was not something that I focused on. And I think that it is important ⁓ and there's nothing wrong with prioritizing that aspect of your life. And because I think that having kids is definitely not a career breaker, it certainly doesn't have to prevent you from further. Like I feel like if I could do it, anybody could do it. if I was able to, come back from maternity leave and secure promotion to be the head of a group, anybody can do it. you just have to make sure that you're in the right place. Having kids is not a career breaker, but what is a career breaker is not having a supportive partner and being employed by the wrong company. Because if you are employed by the wrong company, they will view that as, they would judge you for having that and feel that you are perhaps not as committed to your job because you have other priorities, but that means that that place is not the right place for you. So those are two most important things, supportive partner and supportive culture. And if you don't have two of those two for two, probably need to reevaluate some choices. Dr. Olga Deengar: couldn't agree more. think that is the key to success and the key to being a working mom, especially as a physician. And I think a lot of times we forget that we make choices in our lives so we can actually design our lives the way we want to live them. We don't have to go with a full time job that gives us great benefits and a great salary. can step back Zeel Shah MD: Yeah. Dr. Olga Deengar: from that, we can switch to being a locum hospitalist, for instance, and then switch back being full time later on in life. We are the narrators of our own stories. And the most important thing to remember is that you can curate your own life and you can design your life to live on your own terms. And even though it scary or hard or something that doesn't feel comfortable, can always step away from your full-time job and pivot. Zeel Shah MD: Mm-hmm. Dr. Olga Deengar: if that's not the right season of life for you. mean, right now in my season of life, I have very young, ⁓ boys who are six, three and one. ⁓ I don't want to hire a nanny to take care of them for 14 hours a day while do, 7 on 7 off 12 hour shifts at the hospital. ⁓ So now this what for our family, ⁓ but you have to out what works for you. Zeel Shah MD: Yeah, absolutely. And it's so different for everybody. You really have to step back and figure out what works for you. the important aspect of that is what are your goals and what are your values? And then you have to ⁓ try design your life in alignment with those. And it's so scary to do it because sometimes ⁓ it against the grain and it goes against what you've been raised and what you're used to. But I think that's where the bravery comes in and taking a leap of faith and again, having a good partner, and that's not to say for all my single ladies or single men out there that you have to have a partner. You don't. You can do it on your own. It's absolutely fine. But if you're going to have a partner, you might as well make sure they're a supportive one. because that could derail you more than anything else. Dr. Olga Deengar: It sounds like you're DAMA-ing your life. You're staying driven. You're staying aligned with your core values. You're building that momentum and taking action the right place. So really happy for you. Zeel Shah MD: Yes. thank you for introducing me to that method. I'm DAMA-ing my way through life. Dr. Olga Deengar: So just to wrap up here, thank you so much, Zeel, for joining me this special Mother's Day episode. And I know you've given a ton of value to our listeners today by sharing your stories and perspectives. And I'm so grateful to have you as my very good friend. Zeel Shah MD: Thank you. It was such a pleasure. Thanks for inviting me. This was so much fun. It's always such a privilege to be on your podcast and one of the OG members of the DAMA Club. It's incredible. It's just, you know, I always learned so much from you. Dr. Olga Deengar: Thank you.