Balancing Work and Life

“For me, the number one factor is work-life balance.”

I have grown to hate the discussions about work-life balance. When I hear students and trainees discuss it, I can feel my shoulders tense. My reaction is unfair. It has taken me years to understand that there is no such thing as work-life balance. It is all one life. To succeed in medicine, you must not work to live but live to work. Your work must bring you as much joy and reward as vacations and friends and family -- just different sorts of joy and reward.

I love this piece by Noah Hoonhout as he so perfectly articulates the process of adapting to a life in medicine.

Adam Cifu

A couple of nods and murmurs of solidarity around the lunch table indicated my classmate had struck on an agreeable point. He had articulated a feeling many of us were wrestling with, but perhaps felt some guilt to admit.

This was, in other ways, an odd interjection to a conversation about what specialties my assorted medical school peers were keen on. From a group of second years, one might expect comments of idealism in the burgeoning of our careers—the earnest desire for long-term relationships, or passion for intellectually challenging cases, or a deep satisfaction in working with one’s hands. Instead, many of us young medical students, though eager to leave the classroom for real practice, have a fair bit of apprehension toward the clinical training looming ahead. What is ahead calls a rougher cynicism through our waning enthusiasm.

Scenes like this are not uncommon. Lunch conversations evolve from a break from medicine to an indictment of it. I voice my frustrations (usually in the form of a complaint) seeking some catharsis; I receive murmurs and nods (you always find solidarity, that’s just good manners), and yet I am still unsatisfied, except that my grievances are that much more at the forefront of my mind.

Every generation in medicine finds its own causes to rally behind and practicalities to obsess over. So too does each generation seem to form its own unique brand of cynicism. The response of my peers and I comes when we look with a wary eye at the looming “Medical System.” An amorphous conglomerate of hospital work, health insurance, electronic medical records, and all the other healthcare black holes medical students hear of but in truth know nothing about. This conglomerate will end up dominating our work hours.

If we can’t fix the system, we can at least balance it by diluting its potency with more leisure found in life outside the hospital. I sympathize with this instinct of self-preservation and often find it in myself. This growing attitude is an indictment of the establishment and a challenge to us medical students. There is nothing wrong with calling out masochism and broken structures, though one cannot help but wonder whether, in our efforts to find balance, we stretch our concerns into our priorities.

The reality of work-life balance in medicine is that it’s often no balance at all. The more we tip the scales toward “Life,” the more we make “Work” the villain, the one thing getting in the way of the leisure and lifestyle we pine for. An internal battle wages between our work as

physicians-in-training and our “real” life of nights out and holidays. Medicine morphs from the privileged and sacrificial profession to a means of social prestige, financial well-being, and vaguely interesting work.

This sentiment among trainees ultimately limits the potential of our unfolding careers and creates a myopic view of what medicine ought to be. This constricted perspective does not bring peace or a simpler path through the rigors of training. In favor of carving out more personal time, we close ourselves off to the profound and thorough patient care that often first characterized our desire to become physicians. And when our brief moments of recess end and the work looms large again, do we dive back in well-rested, or begrudgingly pull up the next question bank or patient chart?

We can talk about systemic change and work for it, too. But is there a point at which frustration with a difficult system alters our disposition toward patient care or the very nature of our professional work? Medical training will always be a challenge requiring longer hours and more emotional weight than most careers, but what drew so many of us to it was the deep meaning found uniquely in that work. When our eye is firmly set on the lifestyle outside of medicine, should we be surprised if we grow to resent the career that gets in the way?

Noah Hoonhout is a third-year medical student at the New York Institute of Technology College of Osteopathic Medicine in Old Westbury, NY. He is interested in critical care medicine.