A screeching sound comes from the swing as my kids are swinging, cars in the distance make their rumbling noises, children playing at the park are squealing in delight. Eventually, a plane landing over our heads overpowers it all. It is an early evening on a nice summer day. A warm breeze is blowing, and the pleasant smell of lilacs lingers over us. However, my mind is somewhere else, unaware of my beautiful surroundings.

It is back at the hospital with a consult patient who has a platelet count of 2000.

I think to myself, Did I do everything right, will she be OK overnight? It quickly wanders to the patient with marantic endocarditis, extensive thromboembolic events, and now, new hemorrhagic cerebrovascular accidents. He is unlikely to get through the night; I did not get a chance to say goodbye. A young patient with persistent fevers and lymphadenopathy comes to my mind; I hope it’s rheumatologic and not lymphoma…

My kid screaming “Higher, higher mommy,” brings me back to reality. As I push the swing harder, I become aware of the lovely environment that surrounds me, the smell of lilacs in the air, and my kids with their playful faces as they swing higher and higher. Even the horrendous screeching sound from the swing doesn’t bother me today. I start to appreciate the happy, peaceful moment. I try not to let my mind wander back to the dark hallways of the hospital.

Beginning fellowship with a 2-year-old son and a 1-month-old daughter was extremely anxiety provoking. My husband would joke with me, in hopes that a protective layer of sarcasm would make my insomnia disappear. My husband would say, “You know, you will be just fine.”

Now, more than halfway through my fellowship experience, I know I am fine. However, I am still juggling tasks as I try to balance my life at home and life at work. Who will babysit tomorrow night when the nanny leaves but we have to work late; whose turn is it now: my mother, mother-in-law, sister? I’ve realized that raising my kids is a whole-family endeavor. Certainly, I could not make ends meet without them.

As my daughter, Alexandra, began to speak, she referred to her nanny as “Mommy.” I was devastated. I wondered if she thought I was an occasional visitor at home who comes to play with her at night but then leaves in the morning before she’s awake. My son, Adam, would try to make me feel better by saying, “Mommy, she’s just saying this because she misses you.” When Alexandra does wake up early enough, before I depart for work, she does not leave my side.

My heart melts as I watch her enormous tears trickle down her cheeks in an attempt to stop me from leaving. Adam attempts to reason with her by saying, “Mommy has to go help the sick at the hospital, and daddy has to go to work to make money for our toys.” Alexandra stands for a minute and thinks about what he’s said, and then bursts out crying, as she tries to have her way-her real mommy at home with her.

After the swinging and sliding at the park we finally head home. Both Alexandra and Adam want to watch a cartoon during dinner. I am too tired to argue, and too tired to teach, for the millionth time, the proper table etiquette. I place the iPad on the table, and we eat dinner and enjoy good-old-silly Tom and Jerry. Bath time goes fairly smoothly, and as always, is filled with fun and splashing for my children but frustration for me.

Finally, bedtime…As I sit on the beanbag chair in the middle of the room, I doze off before Alexandra and Adam do, and my bedtime story turns into work-related random words, thoughts, and conversations.

Adam wakes me up. “Mom, that’s not how the story goes, tell us the right one,” he says. When they’re finally asleep I feel exhausted. I’m glad to see my husband has cleaned up after dinner. I can get ready for bed…But wait, what about my reading list, my manuscript revision, and looking up my patients for clinic tomorrow? As I lay in bed, I decide I’m too tired. These things just have to wait until the morning.

During work on the following day, I am angry with myself for not looking up my patients before clinic. I am so far behind. I thought I promised myself I would always be prepared… After clinic I have a research meeting. Should I cancel it? I did not make the necessary changes to the manuscript… No, I’m a professional. I will not cancel last minute… The meeting turns out to be quite fruitful. I will submit this project as an abstract at ASH prior to full publication. Great… add “prepare a poster presentation” to my long to-do list.

In the midst of my day, I receive 3 new consults. Since I don’t have a resident with me this week I will have to see each of them by myself. So much for going home early today… I’m glad kids are rather forgiving. These consults are not as straightforward as I’d wished. With my attending we take our time, work on their needs one by one, investigate the peripheral smear, arrange for plasmapharesis, and contemplate whether we’re dealing with TTP or aHUS. Have to add these to my reading list.

Finally, after a full day, I’m excited to head home. When I arrive home, 2 happy smiling faces come running to me. They are not angry that I’m late, but simply excited to see me. I hold Alexandra and Adam close, kiss them dearly, and wish to never be away again. My worries, to-do list, and stress instantly disappear from my mind. I feel liberated. I am filled with love and happiness. This is how I feel every evening when I realize what is most important in my life. I love my profession, I enjoy building my career, and continuously feel challenged by my field, but above all, I am a mother. The unconditional love from my children goes beyond any achievement at work.

After the same park, dinner, bath, and bed routine, I feel exhausted but gather up enough energy to edit the manuscript late through the night. Given the time on my clock, I am too embarrassed to e-mail it out to my attending. I’ll e-mail it tomorrow morning.

In bed I think to myself, Is this what work-life balance is supposed to be like? If so, it is very tiring... Transiently, my long-ignored reading list comes to mind but I’m too tired to dwell on it and quickly doze off into deep sleep. When I wake up the following morning, I feel accomplished. I sneak out quietly, to not wake up Alexandra and Adam.

Dr Sobol is a practicing fellow at Loyola University Medical Center

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