154. Grief, Money, and Time Pressures: Holidays for Women in Medicine

Can we have it perfectly imperfect and enjoy however things roll out, whatever mishaps happen so that you can actually be fully present and connecting with those relationships that are so important to you.

Are you a woman in medicine feeling overwhelmed and disconnected from the personal fulfillment that you desire? You're in the right place. Join doctors Joanne and Erin as they rewrite the rules for women in medicine. Let's begin.

You just had a 10 hour workday. You still have notes to finish and you come home to order gifts and wrap gifts, prepare meals, deal with family members. And you're supposed to also create holiday match. Well, if you are already exhausted just hearing this, you are not alone. So many of us women in medicine have to deal with so much during this holiday season. But what if you believed that it could be different this year? That's what we're going to be talking in this episode. And I'm here with my Amazing Co host, Dr. Erin Hurley. And let's go straight to it, Eric. Erin, tell us what's important. What do we need to know? Also, not just about all this stress, but even the gender differences.

We've talked about this before and I've done a ton of research this week on why things can feel differently, especially around the holidays for men and women. And so as I've shared in other episodes, there's a gender gap, a gender difference in who's doing more of the household chores. And this is not to criticize or mail bash. This is just saying the research shows that on average women are spending about an hour more per day. So add that up over a week, seven hours a week, some studies say even more per day on doing household chores and also taking care of kids. And as Joanne shared in the last episode about all also these individuals, if you're in the sandwich generation, you may also be tending to aging parents, not only your own, but maybe your in laws. And that all can take a toll. And so it's important to recognize there is a different burden that many women feel they share. Having less free time than men do, likely because they're taking on more of those duties. And so if you think about then the added jobs that happen around the holidays, for many of us, there might be extra cleaning, putting up and taking down decor, planning for family and guests, maybe even hosting a meal or guests in your home. And then you're supposed to just magically create extra time in your day to take care of it. We all just have the 24 hours. And so I just want to make sure we're aware that if you're feeling more stressed and it looks like other people in your family are feeling excited about the holidays. There's a really valid reason for it. So let's just acknowledge that and kind of say, okay then, now that I know that this is going on, it's not a figment of my imagination. You can that change your mindset about the circumstances you find yourself in if you're like a traditional woman in the United States, which is where those research stats are pulled from?

Yes. I think of it as an kind of invisible labor. And then it gets unrecognized because it's not like it's a to do list that gets shared. A lot of it is kind of the expectation that we're just going to magically take care of it and take care of everyone else. And at least that's how it was in my family, especially when my kids were younger. And you know that it just, I felt like it fell on my lap and I did it with love, but that didn't mean that I wasn't stressed out about it. And every year I would say I'm going to do it differently next year I'm going to ask for more help. I'm going to start earlier. And then I didn't. It was, I like that load year after year. So it makes sense to really think of how can we do it differently this year and, and to know that we are not alone, that it's not that you're doing anything wrong. Like I love it when we can say this is something that the research shows. We're not just complaining. This is a known fact.

Yeah. Well, I want to share too. And I didn't bring up, I was just talking about the extra work that's involved and I didn't share. Also, there's a couple of other key factors. And one is a lot of people, even as person working in medicine, may be feeling some financial burdens. There's a lot of unknowns out there. And so there's this added stress of the extra purchasing, whether it's extra food and gift buying, that we might feel pressured to spend too much or increase debt load. And so just acknowledging that there's this financial burden that when the general population is surveyed, they report that's one of the biggest stressors is the added financial burden. And then also oftentimes there's this added layer if you're missing a loved one, maybe it's your first holiday season without somebody important to you acknowledging not only are you dealing with more work and maybe more stress but now you're also moving through grief. And we just need to acknowledge that and be aware of it and have that self compassion that Joanne and I are so fond of talking about and have some grace for ourselves and say, oh, no wonder this feels so heavy this year. It's the first year we're moving through it without this tradition, without this family member. And just be aware of that and honor it.

Yes. Thank you for bringing that up. Grief is something that definitely comes up. I know as a psychiatrist, I pay attention to that. And we had talked about the holiday blues and all of that in previous episodes. And to have compassion not just for ourselves, but for people around us. And even if you've dealt with it really well, even if it happened years ago that you lost a loved one, it can feel different. And referring to this last episode that I was talking about our energy being like a tank in a car, gas tank in a car, and that there's leaks. And sometimes grief is like that little hole in the tank where it's draining mentally and emotionally, even if you're dealing with it well throughout the year. So, again, be aware of this. It doesn't need to change. Just be aware of that for yourself or maybe someone near you. And we also talked about, is it different? Even more so in women in medicine? What do we need to know?

It is different for women in medicine because the other added time and work burden happens for them at work. And so these studies are based on women physicians. And when we compare how many minutes a woman physician spends in the patient room compared to their male physician colleagues, it's somewhere around two to three minutes longer per room. And it may not seem like a lot, but you add that up over each week, and it can be significant. An hour or more per week. And then women physicians, I haven't looked up the numbers, so forgive me if they've changed a bit, but I know when I did initial research on this, women physicians were spending one and a half times longer in the electronic health record than their male colleagues. That's enormous. It was something like 66 minutes per day for men to 108 or something like that every day. And you take that added time burden, and that's a lot of extra weight that they're carrying. Because women do medicine differently than men, they tend to get even better outcomes. But my question is always at what cost? So now you've got a triple added burden. As a woman physician, you would have added time burden at work. You now have an added burden for your household and childcare duties. And now you also are carrying an extra burden with the holiday duties. So it's no wonder that you might be feeling stress or maybe even dread or doom coming with the holiday season. And it's not surprising when we look at the research.

And I was thinking also that in, like I talk about with my friends and what are you doing for, you know, normal questions of what are you doing for the holidays? Are you going out of town and what are the kids doing? And things like that. And for us, it's not automatic that we're going to have time off during the holidays. It's not like things slow down. Actually, for a lot of specialties, you get busier during the holidays, and maybe even the quality of the visits might get a little bit more draining or a little bit more difficult. So we have that as well. Like, it's not. The pace doesn't slow down during the holidays. It can actually go up. And institutions are not the nicest in giving days off. So. Right. So to think about it.

Yeah, And I think you brought up good points about if you're in primary care, if you're in psychiatry, if you're, you know, you may have higher patient needs. I talked to one client this week that was just like every patient that walked in the door was complicated. It wasn't just the one thing. It was multiple things and lots of work to be done. And so again, or people trying to cram in their visits before their insurance might change and at the end of the year. So there's so many pressures that some people might have time off around the holidays. And as Joanne said, it might be even more intense for your work around this season. And then the other piece unique to women in medicine is that we have such a high threshold for what we are willing to tolerate, such a high threshold for what we are willing to take on. And we're so good at problem solving and we're so capable of that, it oftentimes makes us resistant to asking for help. And so can we acknowledge that in ourselves and say, hmm, what can I do to not have a traditional outcome and do something different?

Yes, it's what I say of the resilience that can go against us. So we have to be very, very careful because it can be different. So, Erin, tell us, what can we do so that it's. We're not repeating patterns that are not serving us.

One thing that I think happens way too little is reflection, taking time to pause and ask what went well last holiday season and what did not go well? And of Those things, what do you have control over? And so when we think about I had no time, I didn't get sleep, I ended up getting sick then saying okay, is that a time and energy burden? What can I do about that differently this year to have a different outcome? And that's where I'm, I've got my coaching hat on here because coaching is all about future oriented, reflecting on the past, learning from things that didn't go well so you can make it even better next time. And if you don't take time to reflect, you're going to have no learning ability from past experiences. So what's under your control that you can do differently? And something as simple as delegating, you can pay someone to do something. Joanne has shared that she has someone who comes and helps put the decor up around her house. Someone might pay to have a teenager wrap their gifts. You might have the cleaning lady who comes once a month increased to twice a month or right before the holiday guests are arriving. So what are those places where you can take it off of your plate and put it on someone else's either for free or paid in order to free up some time and energy bandwidth that you have? One of the other normal default modes is you just give up your own self care. So one research article talked about women are very likely to cut into their sleep and you may need more sleep around the holidays, not less because again you're adding all of this extra work and burden to your workload. And so think about if you are compressing or giving up on some of your self care, how is that going to help you show up at your best when you have even more work to do. So our default can be I just don't have time to go to the gym, to work out, to go to bed on time, to do my meditation, whatever your jam is, and I would say now is the time to ramp it up and say how can I lean into that self care so that when things get stressful or difficult, I'm going to show up as my best. So that's where starting something now, it's like putting little pennies in the bank. Maybe if you meditate five minutes, go to 10 and that way by the time the holiday extra stress arrives, you're already prepared, you're not having to go into reactive mode. And so those are some of the the tips I would recommend. And we talk about the basics of self care. I'm gonna look at some notes I took from earlier this week. Self care can be as simple as going to bed 10 to 15 minutes earlier, staying hydrated, where's your water bottle? Having appropriate nutrition, moving your body, doing something calming like meditating and taking a break. And so just it doesn't have to be complicated, it doesn't have to be perfect, but starting somewhere and then the last thing I want to bring up. Joanne has used the, the term if you want to have something turn out better, just lower your expectations. Right. So really what can we do about the expectation that we're going to have the perfect gathering, we're going to have the perfect meal, we're going to have the perfect family dynamics? It's never going to be perfect. Can we have it perfectly imperfect and be able to enjoy however things roll out, whatever mishaps happen so that people are together and you can actually be fully present and connecting with those relationships that are so important to you. Instead of having this dialogue running in your brain about all of the work that needs to be done, all of the to do lists, I would like you to be able to be fully connected, fully present in the moment and by doing this prep work, be better prepared for that joy around the holidays instead of just kind of surrounded by what might feel like just a bunch of stress.

This is also helpful. I know that so often we end up feeling like we're not doing enough or if we're not feeling well, we feel like we're, we're doing it wrong and we beat ourselves up and we don't talk about this. So it's so important to review this information and know per the research, you're not alone. This is something that a lot of us are struggling with. And again, as women in medicine, we have sometimes that extra burden and that it's okay to ask for help. And so helpful what Erin shared of what we can do that can be, can make a difference because we want to do something different so we get a different outcome. So reflection of thinking what has worked then what can be better in control what you can then. I love that, right? Like do not sacrifice your self care and maybe build in recovery time because you might need a little bit more of a break in between all the events than that you normally do and pay attention to those basic needs. If you want to feel better, lower your expectations. And the phrase of can we have it perfectly imperfect. And I would love to add, create new traditions, simplify what can feel overwhelming and even create something new that's a little bit simpler but yet gives you the same connection, family, time, satisfaction, joy, but guarding your energy mental, physical and.

Emotional so that just triggered my memory. On a call recently, one of my clients shared that they used to spend so much time decorating their tree and using every ornament that was given by relatives. It was just this heavy burden. So they decorated their tree more simply. And when the season is over, they saran wrap the tree, they put it in the garage for storage. And the next year all they do is they unwrap the tree and bring it out. And that burden has been erased for years. I was like, that is a very unique solution to a problem and well done.

That's interesting, right? Like, I think we can all adopt a version of that so that we can make things simpler and that we can start looking forward to it instead of this anticipation that by itself it's anxiety provoking. So, so helpful. And that, that's a good one. And I hope that this was as helpful to you as it was for us in talking about it and doing all the research. And we would love it if you could share these episodes. The more listeners we have, it's easier for us to spread all this goodness and be of more assistance. And with that, stay tuned. Our next episode is coming right up.

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