Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. Through stories from my behavioral pediatrics practice (with details changed to protect privacy) I will show how contemporary research in child development can be applied to support parents in their efforts to facilitate their children’s healthy emotional development. I will address factors that converge to obstruct such support. These include limited access to quality mental health care, influences of a powerful health insurance industry and intensive marketing efforts by the pharmaceutical industry.

Wednesday, November 2, 2011

Creativity Needed in Balancing Family and Career

This past summer I wrote a post in response to a New York Times Op Ed that criticized women physicians who work part time. I concluded:
Being a mother is both an awesome privilege and an awesome responsibility. It is in a sense the greatest act of creativity. It makes sense that women who create in this way can also create their own professional lives. By embracing this creativity, both as mothers and as professionals, we can aim to find new and important ways to contribute to society, while at the same time being present in the lives of our children in ways that support the healthy development of the next generation
This idea holds particular relevance for me now, on the eve of starting a new job.

When I was in my late 20's, I had what in many ways was an ideal job. I was practicing pediatrics at Revere Community Health Center, an affiliate of Massachusetts General Hospital. I loved my colleagues and had a wonderful patient population. I was on staff at MGH and on the faculty at Harvard Medical School, where I had the opportunity to teach interviewing skills to first year medical students.

One of the best parts of the job was that I did supervision around my cases, a form of training usually reserved for mental health professionals, with Michael Jellinek, chief of child psychiatry at MGH. He helped me address the complex emotional needs of my most challenging patients and sort out my feelings when they got in the way.

One particularly memorable patient was a young teenager with poorly controlled diabetes who had experienced significant emotional trauma. As an example of enactment of my rescue fantasy, I always agreed to see her, even when she came very late for her appointment. On a couple of occasions, when she was on the verge of hypoglycemia, I gave her my lunch. Speaking with Dr. Jellinek allowed me to be a more effective doctor for her.

The only downside of that time in my life was that I was single. Then I met my husband, who lived in New York. As he had an established ophthalmology practice and a daughter from a previous marriage, in order to be with him I would have to move. As I was in love and wanted to start a family, it was an easy decision to make. But leaving my job, and in particular my work with Dr. Jellinek, was sad and painful.

To sum up the next 20 years- I had two children, worked part time, teaching and practicing general and behavioral pediatrics. In 2000 my family relocated to the Berkshires where I took a job in a busy small town practice. In 2004 I began to study as a scholar with the Berkshire Psychoanalytic Institute in Stockbridge. There I discovered, among others, the work of Winnicott and Fonagy, and the growing discipline of infant mental health. I stopped doing general pediatrics in order to be able to keep up with the increasingly busy lives of my then school age children. I began my writing career, first for the Boston Globe and then for my new book. Keeping Your Child in Mind. I enrolled, in the fall of 2010, in the UMass Boston Infant-Parent Mental Health Post-Graduate Certificate Program in which a group of fellows from a range of disciplines met for one 3-day weekend a month for 10 months.

On the Saturday of our February weekend there was an op ed in the New York Times about a mother's struggles with managing her rage toward her child. With my mind in high gear as a result of the intellectually stimulating environment of the weekend, I composed a letter to the editor, which was published the following weekend.

That night I received an email from a pediatrician on staff at Newton-Wellesley Hospital who I had met at a conference a few years earlier. He had read my letter and had an idea.

Dr Jellinek, who is still chief of child psychiatry at MGH, but now also president of Newton-Wellesley Hospital, was embarking on a major initiative to expand child psychiatry services. This pediatrician had followed my work through my writing, and knew that I had once worked with Dr. Jellinek. Perhaps, he thought, there would be a place for me in this new plan.

Nine months and many meetings later, plans have been finalized for me to start a program (one day a week for now, as I still live in the Berkshires) at Newton-Wellesley Hospital integrating services of OB, pediatrics and psychiatry to promote early childhood social and emotional health. It will focus on perinatal emotional complications and address the emotional needs of the 0-5 age group. Dr. Jellinek is as kind, smart and thoughtful as I remember him. The only difference is now I call him Mike.

Though I could not have recognized this as they were happening, the discontinuities in my professional life, made to accommodate family, have led me to a very good place!

1 comment:

  1. My mentor always said there were no accidents in life, and that I would find great satisfaction when I began to see elements from my past coming full circle back into my life. It sounds like you are embarking on one of those magical moments!

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