03 Feb 2016

By Andrea Merrill

If you had asked me about balance at age 10, I would have taken this question literally, immediately conjuring up an image of the balance beam that tortured me daily at gymnastics practice.  The meager 4 inches of smooth, brown leather mocked me as I struggled with simple jumps, handstands, and half-turns.  At 10, I was small but strong, shy but determined and I lacked the grace and finesse required for the delicate art of the balance beam.  I remember standing tall, trembling, arms held high as I willed myself to arch backwards into a backbend, to overcome my fear of falling, my fear of failing, likely a metaphor for life to come.

In medical school, balance became about understanding physiology, homeostasis, and how the body regulates itself.  What happens when the immune system runs rampant, unchecked, and begins attacking itself?  How does the body compensate when there is too much sodium?  Too much potassium?  Too much stress?

I have now reached my 5th year of surgical training (3 years clinical, 2 years in “the lab”) and I continue to struggle with this concept of balance, or more specifically now, “work-life balance”.  What does the term “work-balance” mean to me? As a woman?  As a surgeon?  As a person?

image1Unfortunately, when the term “work-life balance” comes up with regards to professional women, it often takes the form of “work-family” or “work-mother” balance.  A few months ago there was an article in the Huffington Post that asked male politicians questions normally reserved for female candidates.  Questions included:

  • When you were campaigning, did you get many questions about how you balance being a congressman and a father?
  • Do you consider yourself a feminist?
  • How do you and your family split up housework?
  • What advice would you give to fathers who are thinking of getting into politics?
  • During your campaign, did you get many questions about your family life and how you could juggle being a father while being a politician?
  • What does the phrase “work-life balance” mean to you?

While my first reaction was to laugh at seeing these typically “female” questions being asked of men, it was clear from their answers that “work-life balance” was just as important to them as their female counterparts. So why then does “work-life balance” seem to always be a gender issue, or more precisely a female issue?

I’ve been contemplating this conundrum often these days as I try to choose my specialty in general surgery.  When I entered residency, bright-eyed, gung-ho, and overachieving, I had aspirations of becoming a high volume academic hepatobiliary surgeon with a thriving clinical research “lab” on the side.  And then residency happened…and burnout…and then I thankfully started my research years.  Not everyone needs the time “off” to step back, reflect, and think about what they want in life, but for me this hiatus came at the perfect time.

IMG_8204(1)Additionally, I was very fortunate to have a wonderful mentor guide me through meaningful research on breast cancer.  I must admit, I had been very hesitant to consider breast surgery as a specialty previously, and am still unsure of my fellowship choice.  Some of my male colleagues and attendings have made snide remarks, implying that breast surgery is lesser surgery than transplant, vascular or cardiac surgery.  A male device representative at an academic conference applauded my research in breast cancer by saying, “Breast surgery is a great specialty for a woman because it allows her to raise a family and children.”  As a single female resident (with aspirations of one day having a family), this concept of “work-life balance” only being about me being a surgeon, mother, and wife is a hard one to grasp.  It doesn’t take into account the rest of who I am or my other interests.  It doesn’t account for my desire to write or to maybe one day be an associate editor of a medical journal.  It doesn’t account for my love of cooking, baking, photography or travel.

So it seems that I am still struggling to figure out what “work-life balance” means to me, how to interpret it in the context of my life and who I am, and how to achieve it going forward in my surgical career.  I think it has different meanings for different people and it shouldn’t be gender based.  For some, work truly is their life and that is where they derive the most pleasure and meaning.  For others, they seek alternate joys to balance out some of the hardships of what we do for a living, either in a spouse, children, friend, hobbies, or other academic pursuits.  “Work-life balance” is not one size fits all.

I think back to that 10-year-old girl, trembling on the balance beam.  I watch her slowly bend backwards, finally going for it, intent with concentration.  And then as her hands approach the beam, she falls, hard onto the ground.  She sits stunned for a moment, before she gets back up onto that menacing narrow beam of wood and tries to find her balance again.

IMG_8679 Andrea Merrill is a general surgery resident at Massachusetts General Hospital. Currently she is taking time to pursue an editorial fellowship at the New England Journal of Medicine. She eventually plans to complete a fellowship in Surgical Oncology. Her research interests include improvements in breast cancer surgery and gender disparities.


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author, and are not necessarily the opinion of the Association of Women Surgeons.

One Reply to “Balance”

  1. Great article on work life balance and being a balanced human being and finding joy in other pursuits outside of medicine.

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