A Reason to Stay

I never wanted to be a statistic, but here I am, one of over 4-million Americans who quit their jobs in July 2021.  They're calling it The Great Resignation, and numbers have continued to increase in August and September. Here’s what The Atlantic had to say: 

Quitting is a concept typically associated with losers and loafers. But this level of quitting is really an expression of optimism that says, We can do better.

I haven't written much about my reasons for resigning because they're complex and largely private.  But, I think 2021 has been the hardest year of my life and 2020 was no cakewalk either.  I wouldn't cite the pandemic as the number one or number two reason for this, but it created a foundation of unease, straining what was an already fragile juggle.  

The passing of my mother-in-law has made this year particularly hard, my husband and I still mourn her loss regularly, because of the way that she enveloped us in both emotional and practical (hear-babysitting) support. Her passing has also reminded me that I'll only live once.  People say 'your kids will only be young once.'  It's become a cliché for a reason; it's true.  Time passes and while working, I only get to bear witness to and influence a fraction of their time.  

Secondarily, the addition of another child into our home has disrupted the balance, leaving the rest of us a little more hungry for attention and focus from one another.  We are all grasping for stands of control, however small, in an attempt to regain some sense of steady state.  There are only so many hours in the day, and as I alluded to in my blog when I first returned to work in February, my family doesn’t always get me at my best if I’ve used up all my empathy and energy at work.  

My 4-million friends and I come from low-earning and high-earning jobs alike, across many disciplines and we cite many reasons; although it seems our logic isn’t as different as our backgrounds may be.  

Healthcare has been particularly hard-hit.  The pandemic has led to an "unprecedented exodus of women from the medical workforce." According to an article written back in October 2020, COVID-19 may have set back women's progress in the workplace back by 25 years, largely citing a lack of child-care options.   

I worry that my resignation may contribute to that set-back.  How will my exodus from a position in upper management affect, consciously or subconsciously, the decisions of the executives who supported me in their future hiring's?  Will they be reluctant in the future to give the next talented and passionate mother with young children a chance?  How can we as a society prevent that?  

As a result of all this, healthcare organizations have recently seen the #GiveHerAReasonToStay campaign, a call to action to find and act on specific ways to support women during this critical time in the industry.  Suggestions from the AMWA based on research in gender-equity, include fair pay, promotion, ensuring adequate time off, child care and a harassment-free workplace.  

Feminists, #heforshe-ers, egalitarians and generally good people, I respect and appreciate what you’re trying to do here, I really do. These changes are honorable and essential.  

Was I paid fair, promoted, given adequate time off, adequate child care and a harassment free workforce?  I cannot give an unrestricted and honest yes on any of those. Let's look at a few of these in more depth: 

Fair Pay?  We talked about my husband being the one to take a step back but that didn't make sense for us.  The least significant of several reasons is that he makes more money, actually about twice as much as me.  It would make for a whole other blog if we were to do the 5-why's on why that is, since I was in upper management and we're both physicians, but I digress.  While money has never been a deciding factor for us in our careers (so very grateful for that enormous privilege), I will continue to pay about $1200/month for the foreseeable future on my medical student loans, so it does play a role in our decisions.  

Time Off?  While working, I felt I was allotted adequate time off. I used mine aggressively in comparison to most of my colleagues, who all seemed to have 300+ hours in their paid-time-off banks, which probably speaks to the majority mindset within our organization; something that sorely needs to change.  

Child Care?  When it comes to the AMWA's mention of adequate child care, I have most certainly struggled with this, particularly since the pandemic began, but I have never once considered it a responsibility of my employer.  (Perhaps the fact that I’ve never considered this as anything other than my own problem says more about my own biases than anything else?)  Although we had a reliable nanny, the combination of my mother-in-law's passing and the unpredictable nature of school closings and quarantines wrought havoc on our back-up options over the past year.  All this caused me to reflect often on a quote I'd scribbled down from a now retired senior executive.  During a merger he gracefully said, "I don't know why independence has been associated with success."  This stuck with me but I applied it to parenting while working outside the home. I have often lamented the fact that I flew so far from my parents nest, missing them and the ability to have their assistance in daily activities with young kids.  

So yeah, I had some unmet needs or expectations there.  However, a single reason to stay, like fair pay, just isn't enough a reason for me. I’m not sure having all would’ve done it for me. I didn't have one reason to go, I had dozens, some I've only just now begun to recognize four months into my resignation. 

After this intense period of sacrifice, and now that I’ve taken my situation in such a wildly new direction, I’ve enjoyed rediscovering my own identity, priorities, triggers and pleasures.  

So, what did I like most about my work?  Being in patient safety, I felt like I made a difference at a macro level advocating for quality healthcare in my community.  I also really loved the authentic relationships I developed with many colleagues and my team.   

Interestingly, though, making a difference isn't what I miss the most since leaving work.  I miss the power of decision making autonomy.  Four unruly children second-guess my decisions more than anyone “at work” ever did.  

I don't miss making a difference, because (maybe it sounds cheesy but) I know that my presence with my kids is making a difference at home more than it was at work.  I can see daily tangible and intangible proofs of this. Maybe that wasn’t always the case... maybe some years ago my impact on our system's quality had been greater, and since losing some of that tangible evidence of or appreciation for my impact, maybe my work became less fulfilling.  I'm not sure.  

What I want to say to those gender equity #GiveHerAReasonToStay campaigners: Thanks.  All organizations should take these measures on to retain their top female talent. For some women in certain situations, they may be reason enough to stay.  However...

You can’t pin the Great Resignation on the trappings of academic medicine or gender inequity.  I’d rather blame the modern life, the myth of perfection, or that busy is the new cool. Our choices need to change just as much as corporate or academic America. 

Maybe our biggest reason to stay is that it's actually easier.  The discontented but passive choice.  It's easier to stay where we're at, miserable but safe, letting the villain in our overworked and overwhelmed lives continue to be the corporation rather than our own choices.  Rather than stepping out in courage to take the reigns on our own lives.  That's not to say the only brave choice is quitting your job.  But, my juggle had become unbearable.  Just check yourself.  Is the chaos in your family exceeding your capacity?  Or are you in a steady state most of the time? If yours is pretty steady, great, I'd recommend checking every 4-6 months.  If you’re grasping for strands of control like I was, look for what you can change.  It might be as dramatic as a change in your work hours or something small like removing a child's extracurricular.  They aren't entitled to it.  It's a privilege, one that our family might not be able to take on right now.  

“We can do better.” 

Yes, I certainly could.  I am choosing better for my family and me.   

While personal and organizational growth fueled me at work, I didn't have any time to stop and enjoy the view.  At work, there was vanishingly small time between large projects.  At home, I felt guilty for ever putting myself first.  Only giving myself permission to run after everyone else was taken care of including the dogs and if the run was only the duration of one tv show for the kids.  When I (often) took time off for vacations or appointments with the kids, I “paid for it” catching up during off hours in the ensuing days and weeks. 

Equity advocates, please don't make me feel guilty for going.  Sometimes, gender inequity is expressed through how much pressure we put on women to "do it all."  Like focusing on your family isn't enough. As if choosing to work below your intellectually maximum capacity is shameful.  

Feeling guilty is no reason to do anything at all.  

In the words of Adam Grant from a recent WSJ article, I've radically started planning my work around my life, instead of the other way around.  And, since that major course correction 4 months ago, the majority emotion I've experienced has been relief.  A destabilizing load of stress has been lifted from my shoulders.  

I've been busier than I expected.  Appointments with 4 kids, my own chronic diseases, therapy for kids and family, plus foster-adoption worker visits take up a remarkable amount of time; but now it's time I have to spare.  

Getting back in shape has also taken time; time I've happily lavished upon myself, free from the weight of any guilt at all. 

Last week I hiked the Appalachian Trail, alone, for four hours.  The trail was very rocky in the Clarks Ferry region of Peters Mountain and sometimes I wandered off the trail unaware.  It was a strenuous hike.  I prayed, sang, sat and ate snacks. I took selfies over the valleys below while balancing on rocks as the wind blew cold at the mountaintop.  It was a beautiful metaphor for this new season of my life.  

This time “off work” hasn't been easy.  Of course, I'm still working occasionally as a hospitalist to keep up my clinical skills and licensure.  But, when I was juggling it all, people would often tell me, "it'll get easier when they get older."  I'm afraid people who believe that are kidding themselves.  It's another myth or trap we fall into.  I don't see it getting easier when my kids are in middle school, discovering their own identity, sexuality, or learning to use social media.  I don't see myself having more time when they're in high school, sports, music or youth group.  We'd do women everywhere a favor if we started getting real about how challenging it is to "have it all."  

Even while choosing to simplify, this year continues to be hard.  

Hard doesn't have to equal unhappy, discontent or disappointed.  We just have to make space for the hard, and honestly I'm really proud of myself for doing just that.  

What I've always known but am just now coming to appreciate is that the love of personal growth that I attributed to work, has been happening in the more home-based parts of my life all along too.  I haven't given that up just because I left corporate management.  Time to think grants perspective.  And Audible happens to work while sitting in a waiting room, gardening or cooking, just like it did commuting. 

Trauma-informed parenting is the most humbling experience of my life, and that's saying a lot considering my four years of medical school.  I've got plenty to learn in this aspect of my life; it's only a slightly different form of leadership.  I'm becoming empathic, observant and wise in new ways everyday, thanks to those wild boys.  

Working with my kids is strenuous and unrelenting at times.  There is also quite a bit of laughter, rest and flexibility.  

Out on the AT, I had the chance to take in the richness of this new season of my life.  It's rocky, so I almost lost my balance a few times and could've fallen or sprained an ankle.  We’ve got a ways to go before we reach steady state.  But if we fall, we can just sit down and rest.  That's a pretty darn big reason to stay (at home). 

If it’s in accordance with His will, maybe there will be another season ahead where balance will come easy and my executive track ego (oops I mean talents) can take the lead.  All I know for sure is that for this season we've entered, I had to turn my focus inward, it was the only right choice for my family right now.  I'm already thankful for the results that choice is producing for my family and me.  

Anthems

On Sunday, July 4th, our praise band began the service with Raise a Hallelujah by Bethel Music and shared the writers’ story of singing praises “louder than the unbelief,” in the face of a family tragedy. 

To say the least, the story and song moved me. I sang, but the words wouldn’t come out, choked up with tears. I’d heard the song before, but on that day I really listened, humbled by the lyrics and their meaning. As we drove home, we talked about that kind of courage, and how we yearned for it, pretty sure we did not already possess it ourselves. 

Over the years, I’ve found many anthems to carry me along through rough and through wonderful times. Music is such a gift like that.  

In 2008, I discovered Third Day’s, (don’t you know) I’ve Always Loved You, and chose it for my father-daughter dance. 

In 2016, awaiting the birth of our second son, Thrive by Casting Crowns was on everyday in my house, inspired by "you know we were made for so much for than ordinary lives, we we made to thrive," we used the lines, “joy unspeakable, faith unsinkable, love unstoppable, anything is possible” throughout our messages regarding the adoption process to family and loved ones. 

In 2019, that same son ordered Nobody, also by Casting Crowns, on the radio, chanting along “I’m living for the world to see nobody but Jesus!”  Funny thing, he'd even request it at bedtime, saying, "hit it, Mom."  (If you've heard me sing you're laughing out loud right now.)

These songs have been like battle cries, inspiring me as I pushed forward against what feels insurmountable; they've focused me on my faith, allowing hope to course through my body. 

And that’s just what we needed on July 4th. 

“Discern work” had been on the prayer board in our bedroom for months. I’d been beating the pavement with my little frame as often as possible, begging for clarity and direction; unsure of where to go, but knowing I could not stay put. 

I told a few close friends, I’m going to need to hear the voice of God. 

Almost daily, there were struggles during and after "office hours," and the balls I’d become accustomed to juggling began to feel like they were made of lead. Guilt was piling up. 

Thankfully, my partner and I agreed, everything was on the table. We’d been reckoning with several options, and I thought I knew what I needed to do. 

Since the day I’d gotten the call about number 4, I’d known I was called to sacrifice. 

But on the 6th of July, a few dozen repeats into the Raise a Hallelujah stint, a perfect storm ensued. It was difficult in a number of ways, but my prayer was answered with beautiful clarity. 

Termination of parental rights occurred that day, too. 

Dang God, impressive timing, you are good. 

Later that night, I called my boss and told her I needed some time off. Last week I formally submitted my resignation. 

I raise a hallelujah, louder than the unbelief...

I'm gonna sing, in the middle of the storm

Louder and louder, you're gonna hear my praises roar... 

I raise a hallelujah, with everything inside of me

I raise a hallelujah, I will watch the darkness flee

I raise a hallelujah, in the middle of the mystery

I raise a hallelujah, fear you lost your hold on me!

These words didn’t make my miracle. But they did help my ears to hear, gave me those few last essential ounces of courage that I needed, and they’ve left me inspired each time I’ve run, walked or cried to them. This anthem empowered me to do what I needed to do. 

Necessary but not sufficient, of course, just like me.  

Bringing Home our 4th Boy

The preparation, home study, and education required prior to bringing a foster child into our home is practically identical to the process for a newborn adoption.  Of course, we expected fostering a 4-year-old to feel different than adopting a newborn.  But how?  

First, let me set the stage.  In November 2020, here were our family dynamics: I am a healthcare administrator who had been working from home since May. My husband an academic cardiologist working at the hospital, working a good bit of weekend overtime for COVID.  Nanny takes kids to and from school, they'd been 2 days at school, 3 at home, until December when they returned to full-time in-school instruction.  

Kids: 

    #1: 10-year-old high-energy boy, 4th grade 

    #2: 6-year-old high-energy boy, kindergartener and biological half-brother to the newest little guy 

    #3: 4-year-old easy-going boy, pre-K 

In December we brought home:

    #4: 4-year-old boy, and biological half brother to the 6-year-old 

Every parent and every child is different; but for us, many parts of adopting an older child have been easier, at least on the surface, than they might have been if the child had been a newborn.  Probably most notably, there have been no sleepless nights.  There's a constant need that a newborn brings which a 4-year-old does not and we're thankful we haven't had to negotiate all that.

The day before I left to pick up #4,  I began a 3-month leave-of-absence (LOA) from work to take care of him and integrate him into our family.  Of note, this was perfectly well received by all of my colleagues and superiors at work.  In and outside of work, though, I'm certain some people have wondering if and why this was necessary.  Even we wondered briefly if the sacrifice would really be needed and feel worth it.  

The plan for this LOA was to be able to be fully focused on the newest member of the family and the whole family, without the distraction of work which often tends to takes a front seat when you're in healthcare administration (particularly during a pandemic) or a physician.  The plan was to be my best self, in tip-top parenting shape.  And I'd like to think that I was able to accomplish that (for at least 10 of these 12 weeks anyway).  

We knew that all four kids deserved this.  We knew they'd be hungry for it, but we didn't know exactly how that would look, how it would show up, until we lived it.  

A great deal of these three months has been filled with laughter and love.  Our newest member has a contagious laugh, that's apparently genetic because it sounds just like his biological half-brother!  He loves to be chased and tickled and fits right into the Pfeiffer wrestling club.  He is an expert on the scooter, sings twinkle-twinkle and the ABC's, and loves to hammer on the piano.  I think he self-soothes with music.  He's naturally kind and friendly.  As mentioned, he sleeps through the night and also eats well.  He began preschool with #3 after we got off of our travel quarantine.  

But this was also my hardest parental leave of all.  Perhaps that's true for all fourth-time parents.  Maybe every subsequent new-child-leave is harder for the parents.  While the act of parenting gets easier because there's not as much uncharted territory to negotiate, the unprecedented nature of the new volume of children is perhaps always more challenging at first.  Reactions of the children who were already present in the home to the newest addition aren't unique to foster children, they happen with newborns and biologicals too.  However, in our experience the 4-year-old who can hide your stuff and hit back was definitely a little more challenging than a simple fussy baby.  In our home-study training we had learned that foster children may go through a "honeymoon" phase that lasts 4-6 weeks and this was one of the many reasons I elected to take the full 12 weeks allowed by my employer.  

While our family became integrated and relationships began to forge, there have been many battles too.  Initially these were over toys but then #2 requested, "Santa better bring #4 a lot of Christmas presents!" and Santa obliged, so that part has improved.  But the jealousy, whether over things, time, my lap, another's attention, the ability to feed the dogs, or do a chore, is an everyday, perhaps an every hour, facet of our lives that we are constantly negotiating.  And thus the continued need to pour into all four of these beautiful boys to help them become their best selves, confident, competent, and capable young men.  

Another thing we've learned through these past 3 months is that there is nothing too small to explain in detail, for our newest member.  There is nothing you should assume the new guy understands because he has no basis for understanding.  Nothing we do is normal to him, our routines are foreign and unfamiliar and our lifestyle has a lot of variables many of which he has yet to be introduced to or discover.  Some of this comes from a profound need for reassurance and at other times it's just simple unfamiliarity. 

Constant education about what we do and why we do it, about our jobs, careers, what the hospital is, what it means to be a doctor and what it means to be a nanny.  It's amazing how much you take for granted a four year foundation when it's grown day by day over the course of four years.  

Throughout all this time, the tiresome isolation of the pandemic drew on.  Celebrating the holidays in a socially distanced fashion while longing for physical connection with our newly expanded family was a serious period of struggle for me.    

Later in January, I went rogue a bit and took advantage of my time off, bringing #3 and #4 to meet a few more family members at the beach house in Florida which was a nice reprieve.  

Like with all parenting, the big important moments are unpredictable.  You can't plan for them and they don't happen on your time.  They cannot be scheduled.  The newest boy would open up in the most heart-wrenching but beautiful way, on a drive across town when I couldn't even see his face in the rear-view mirror.  The bigger boys would request a family meeting after bedtime when dad still wasn't home.  It wasn't always ideal but we had to make it work.  And if I wouldn't have taken this precious gift of time (the LOA), for each of us, then it would not have been nearly so achievable.  

This dedicated and focused time was a gift for all of us.  The time made many things achievable, it didn't make them easy.  At 8pm most days, neither Mommy nor Daddy seem to have much energy left. The boys still aren't getting along great.  When #1 asks how long will it take until it feels normal, Mommy and Daddy had been saying a year and now we aren't sure if it'll be that soon.  In no way do I feel like a failure, I absolutely do feel like a success.... BUT.... there's still so much more work to do.  So, we're taking that to the cross and laying it down.  

In summary, these past 3 months have been what we expected.  They have been rich.  Full of love, energy, and emotion.  We've been trying to teach all four boys through both actions and words, in little and big moments.  Praying they're all trusting us, that they have faith in us and in God, that everything will be alright.  

But I am also thankful and proud.  I have poured myself into my kids like I haven't in a long time, and I think they've enjoyed and appreciated this.  It's been fun for me.  I read a few books, like real paper books that I held in my hands.  I read dramatically less emails.  

My kids got me at my best.  Or at least when they got me at my worst, it wasn't because work got the best of me.  

During these past 3 months we've sown a lot of seeds.  We've toiled.  

Digging and watering, digging and watering.  

Praying for sun.  

Like everything that's worthwhile in parenting, we'll have to wait and see what grows.

 

A road less traveled

Adoption has been a love of ours, and something we find beautiful and sacred.  Just like with newborn adoption, we'd talked about foster-adoption back when we were dating although that was more briefly, to be honest. 

As soon as a birthmother with other children chose us for our domestic newborn adoption plan, however, we opened our hearts to loving her whole family.  We knew from the moment we met them, that her other children were precious.  

Even more so, as part of our open adoption plan, we were fully committed to doing anything reasonable to help members of his biological family.  I'm sure this looks different for every family who chooses open adoption, so this simply an accounting of our thoughts and choices, and is in no way the only way to do things.  But for us, we adopted our son expecting him to have hard questions for us one day.  To that end, all of our choices are made so that we can be confident that if and when he asks, we can honestly say we did everything within reason to love, stay connected to, and help all of his family.    

When we found out our son's birthmom was pregnant again, we began to pray for her and the baby.  We wondered if she might call us for help, but she did not.  We saw some pictures through Grandma and had the good fortune to talk to her once about a year later, when she reached out to us for something.  During that conversation, she told us that the boy's dad was a good cook and we were thankful to feel connected again.  

In 2018, we found out that she and the kids were struggling, and we began to pray for direction on ways to help.  We seriously investigated a few options.  We also seriously tried to discern Gods will and direction for the next leg of our journey.  Late that year, we sent a care package that was never received and for some reason, that small situation really propelled us in a new direction.  

For years, as part of our personal philanthropy and tithe, we have donated to a local homeless shelter, a pregnancy center and a foster care organization.  But, during the winter of 2018-2019, we sensed a call to action.  We knew we needed to do more than just write checks; we were being beckoned to change the way we were living, fundamentally.  We are uncomfortable with our comfort. Trying to put everything on the table and truly follow in the way we are called. Ultimately, I felt sure whatever the calling that I should still also be working in my current capacity. 

In February 2019, we signed up with Bethany Christian Services to become foster parents and began seriously considering fostering and/or adopting.  We took the introductory course which itself was inspiring and emotional, and our motivation soared.  

However, the next month, my mother-in-law was diagnosed with cancer and the need for chemo, radiation and surgery became apparent.  We knew Bethany required all the classes be completed within a short period of time otherwise they would need to be repeated, and so for practical reasons, we put our training on hold.  

During the fall of 2019, after her surgery was completed and we had planned to revisit the conversation, we got a call from CA-Grandma and also another friend from out in CA, that the boy (now 4-years-old) had been placed in emergency foster care.  I remember exactly where I was and told them both without hesitation that we would be willing to step up for this child if he needed a place to live.  They each asked if I needed to talk to my husband first, and I told them that we'd already talked about it (albeit a while back but I knew where he stood on this) and I knew he would be in agreement.  

And that's where this journey began.  Grandma and Grandpa stepped up and took him in, jumping through all the hoops needed to foster their grandchild, and provide the stability and love he deserved.  We regularly kept in touch with them, as well as the County social workers who understood our commitment to the family. 

The first big court date where we thought they might consider foster placement with us was in January 2020.  However, new issues were identified and the next court date 3 months later was planned.

We decided to plan an Easter vacation to Southern California for our now 6-year-old to meet his biological family and for all the boys to meet each other.  Unfortunately, Coronavirus came to the US shortly thereafter and it wasn’t until June that the court was able to proceed and approve us as potential foster parents. After that, it was sent to PA ICPC and we were able to begin our home study.  

As delays in PA tested my patience far beyond where it had been when the ball was in CA courts, we began to wonder what the purpose, or silver lining, of all the wasted time could possibly be. 

Ultimately, in December 2020, 14 months after being initially brought into foster care, a 4th child entered our family through the gift of foster-adoption kinship care.  I immediately began a leave of absence from work and have been enjoying getting to know this beautiful soul.