(Originally posted on JanetteDeFelice.com 10/14/2016)

Discrimination and Motherhood

I have never before felt discriminated against before I became a mother. I was always encouraged to follow my passions, my dreams, always excelled in school. I never felt the need to take a home economics course, as I was going to be a career woman. Never did I think that institutionalized sexism would hold me back.

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Excited about pursuing a career in medicine.

I became a mother later in life, not getting pregnant until age 35. I had pursued every dream, every passion, as I had been encouraged to do up until that point. I did, however, start to feel my biological clock start ticking around age 30. And, when I finally met and settled down with Mr. Right, we started trying to get pregnant. Nothing happened.

Not knowing whether or not we would be successful with a pregnancy, I decided to move on with my life while we continued to try to have a family. After the untimely and unexpected death of my mother, I was propelled to follow another dream of mine. To attend medical school. (I say “attend medical school” instead of “become a physician” because I guess I didn’t really know what the day-to-day life of a doctor was at that time, let alone residency – the required low-paying position that leads to licensure and board certification.) I had already taken all the required pre-medical courses and decided I would take the MCAT (Medical College Admissions Test) and see how I did. Well, I scored pretty well. So I decided to apply to medical school and got in.

Part of me knew, however, that if my husband and I were successful in our quest to start a family, my career would probably suffer. But what was I to do? Not pursue an interesting and challenging career? Not pursue having a child? Both noble pursuits indeed. In the end, I figured it would all work itself out. And I entered medical school in the fall of 2008.

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Late night on-call studying.
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Scrubs and socks.

Medical school was hard, as anticipated, but nothing I couldn’t handle. So I decided to throw some fertility treatments into the mix. As anyone in the know knows, juggling a relationship with a significant other while in med school is quite a challenge. Try being the perfect wife, the perfect student, and the perfect female procreating specimen. Well, lest you say it cannot be done, I am here to tell you that it can.

The first couple of quarters, I earned all A’s and B’s (well, one A and the rest B’s), and served both as a student representative to the Educational Affairs Committee and as a news editor for the student newspaper.

By the end of first year, after one abandoned IUI (intrauterine insemination) cycle in which my follicles were overstimulated and one IVF (in vitro fertilization) cycle, I became pregnant. And not just pregnant, but pregnant with twins. The first time I saw two little specks on the ultrasound at 6 weeks, I knew my career would be in jeopardy. And I kind of freaked out.

I was supposed to participate in a summer research project regarding medical education, but was not able to because of my unbearable morning (all-day, all-night) sickness. I had wanted to participate in research about medical education because I, as an experienced adjunct professor in the humanities and child of a grade school teacher and college professor, saw many flaws in the way I and my colleagues were being educated. There had to be a better way than just memorizing astounding amounts of information, regurgitating with a number 2 pencil on a scantron, and repeating.

And the method of feeding all that information to the students? An instructor would stand in the front of the lecture hall reading a pre-prepared PowerPoint presentation word-for-word. There was no actual “teaching.” No wonder I continued to do just fine even after I stopped attending class to travel to the city for fertility treatments.

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Studying in the hospital–neurology notes at my knee. (NOTE: According to my OB/GYN clerkship supervisor, none of my experience with my high-risk twin pregnancy counted toward having any knowledge of OB/GYN.)

“And Who’s Going to Take Care of these Babies?”

At the point that I backed out of the summer research project, I was still telling people that I had a “medical issue.” I was a bit frightened about coming out and telling others, the dean of students included, that not only was I pregnant, but I was having twins. The day finally came when summer break ended, second year started, and I started looking like I had been eating a few too many potato chips.

I made an appointment to discuss some “personal issues” with the dean of students. She was a female who had previously given a presentation to the students about what it was like to be a woman in medicine, about her difficulties getting pregnant, about a spontaneous abortion experience that altered her career decisions, how she had an adopted a now college-aged daughter, and how she lived in a different state than her husband so they could both pursue their careers. I figured this meeting wouldn’t be too uncomfortable.

I think my attitude really said it all about how I was influenced to feel as a pregnant woman in medical school. I went into the meeting apologizing. (For what? Who apologizes about willingly and successfully starting a much-longed-for family?) I told her I was pregnant, and she took that in stride. But when I told her I was having twins, she asked me, in a condescending tone, “And who’s going to take care of these babies?”

I was somewhat taken aback and totally offended. I was a married 35-year-old woman. I replied, “My husband and I are.” Um, ok. This does not bode well for my career.

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Day after emergency C-section to deliver 32-week twins.

“Doesn’t your job offer parental leave for new fathers?”

I remember naively asking my husband, “Doesn’t your job offer parental leave for new fathers?” as I was studying for medical school exams while caring for newborn premature twins. The answer was a big no. This was so astounding to me. I painfully came to the conclusion that just because I was a woman, I was the one who was supposed to sacrifice my career. Ouch! Never had I expected such discrimination in the land of opportunity. I refused to let this phase me, however, and continued straight through school and hospital rotations until a year later when I just physically could not continue, due to stress-related back pain and severe lack of sleep.

After a 6-month leave of absence, I returned to hospital rotations, and received glowing recommendations from my superiors. I graduated soon after and was offered two different resident physician positions outside the residency matching system.

For many reasons, I turned them both down.

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Mama and son.

“Mama, why are you a little bit mad?”

My kids are very tuned in to my facial expressions these days. “I’m not mad. I’m just thinking.” I’m thinking about how I worked very hard to get through medical school and I feel like I’m precisely nowhere. Well, that’s not exactly true. I get to spend time teaching and guiding my school-age children. I get to have on the planet the people that I wanted to put on the planet, instead of having them raised by someone outside of my family with a completely different value system. That’s something.

Before seeking a residency, I got advice from many physicians (mostly male). “Your kids will be fine,” they would tell me. But I don’t want my kids to be fine. I want them to thrive. I want them to feel safe, like someone’s there that has their backs no matter what. So this is the sacrifice I made. I guess it wasn’t such a difficult choice when the only two options were to devote my life to being an underpaid resident physician, working both day and night hours, missing out on contributing myself to the early lives of my children, or to devote my life to two little human beings who, I often pictured to be floundered in the world without their dad (working a lot) or their mom (working even more).

My husband has now advanced at his job and I feel happy to give him the support that he gave me during medical school. I have even begun to feel proud at times and to reframe the traditional marriage model as a partnership.

Still, the field of medicine calls to me. And I have a call for the field of medicine in return. At this point however, because of the timing in my life, I think that ship has sailed for me.

But there are other women out there who want to pursue medicine AND motherhood. This male-centric model of medical education has got to be pushed aside to keep up with the times. (It’s important, when understanding where the male-centric model of residency comes from, to explain that medical residents were traditionally young, single men who actually lived in the hospital.) Times are changing, more varied and diverse groups of people are aching to join the field, aching to help people. If we had more flexible, extended residencies that allowed people to tend to both their work and family lives, we wouldn’t have a shortage of doctors. Instead of keeping the barriers up and keeping the non-traditional, highly educated women out of the field, they should be welcomed and accommodated for.

I now hold an M.D. (medical doctor) degree, and I’m apparently qualified to do absolutely nothing. Leaving medical school owing many hundreds of thousands in student debt, the only job I could get (outside of residency) was teaching clinical skills at the medical school from which I graduated. The pay was about $16,000 a year. Quality childcare for the twins was about $19,000 a year. Thinking that one opportunity might lead to another, I put my children in preschool and just paid the difference. Given the amount of education and debt, after almost a year, I decided it didn’t make sense.

I am currently a work-at-home mom.

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