The joy of motherhood is undeniable. Watching my three children grow into their individual personalities has been extremely rewarding, rivaling the accolades I have received in my career. The truth is that my life would not be complete without my children—nor would it be complete without my career. For the past 27 years, my daily pursuit of happiness has included seeking the perfect work-life balance.

I did not plan the timing of my pregnancies based on my career path because there is never a perfect time to have a child as a physician. I was at Harvard Medical School when my husband and I started talking about having children. We thought about how the timing of my pregnancy would affect the amount of time I could spend at home. Having a child in medical school or in residency meant that I would likely spend less time with that child in his or her first few years of life than if I was in a flexible practice setting. However, if I waited until I was done with my training (in my mid to late 30s), I could face fertility issues.

THREE CHILDREN, THREE CAREER STAGES

I had my first child in September of my fourth year of medical school, and by that time there was some flexibility in my schedule because I was interviewing for residencies. During my 6-week maternity leave, I was interviewing for residencies; my son had just turned 2 weeks old when I went on my first interview. I started my full-time clerkship 4 weeks later, and we hired someone who cared for my son in her home.

Although it was hard for me to leave a newborn, my son’s caregiver turned out to be an amazing person. I began to realize that it was OK for my child to love the person who was taking care of him when I was at work. Just as I can love all of my children, my child can love people other than his mother and father. Therefore, the most important thing is to find someone you trust to take care of your children—to love your children—in their early years. You must not feel threatened by your child loving someone else.

I was a resident at the Jules Stein Eye Institute of UCLA during my second pregnancy. In fact, I was the first woman to have a child during residency in the Jules Stein program, and I do not think the program directors knew what to expect. They obviously wanted me to do everything that the other residents did, and I did, but the faculty was also generally understanding. Bradley R. Straatsma, MD, the founding chair of the Department of Ophthalmology and the Jules Stein Eye Institute at the UCLA, was incredibly kind to me. He came up to me 1 week before the Ophthalmic Knowledge and Assessment Program (OKAP) exam—which was to be held 1 week before my due date—and said, “Lynn, I don’t think you need to sit for those exams this year.”

Maternity leave after my second child was brief; I combined 2 weeks of maternity leave with 2 weeks of vacation. Child care was a challenging combination of au pairs followed by nannies, until we found a family that has been with us either in a live-in or live-out capacity for the past 22 years.

After residency, I went into private practice for 5 years. I had been in the practice for 3 years by the time my third child was born, so the practice was well established when I went on maternity leave. However, I tried to squeeze in patients who needed regular follow-up before my due date and did not schedule return visits until a couple of months after my due date. I tried to arrange both the call schedule and my regular patients in such a way that they would not need to come in for a visit when I was out.

I came back within 2 or 3 weeks to do some part-time work in the office and operating room, addressing the more crucial cases. I also tried to anticipate those patients who needed ongoing care so that they would not make demands on my partner. I returned to the practice full time within 6 weeks. I had a wonderful partner at that time, and my maternity leave was easier than what some of my colleagues in private practice have gone through. I stayed in private practice with the same partner for 2 more years.

ACADEMIA VERSUS PRIVATE PRACTICE

Having children influenced my decision to leave academia for private practice. With young children and a husband who was also an academic, I was not sure I could meet the demand and rigors of the academic ladder. Therefore, I stepped out for 5 years when my children were young.

Reentering academia is not a common path, and it is not something that I would recommend. Had it not been for a US National Institutes of Health (NIH) grant for physician scientists, I think it would have been nearly impossible for me to construct an academic life that included basic science. However, I worked hard and have been involved with academia ever since. I am currently the Associate Dean for Diversity Affairs and a Professor of Ophthalmology at the David Geffen School of Medicine at UCLA.

One of my primary duties for diversity affairs is to ensure recruitment and retention of a diverse faculty, and that includes women and underrepresented minorities. In addition to plugging the leaks in the academic pipeline, which seem to be more significant for women and underrepresented minorities, and creating programs that promote networking within the career trajectory, I am able to mentor young faculty who are trying to juggle family responsibilities and their tenure clock.

POINTERS

Throughout my experience balancing motherhood and work, I have learned through trial and error. One of the most important things a working mother must cultivate is flexibility. The first component of flexibility is to let go of any hard-and-fast preconceived notions. You can imagine how something is going to go, but it never unfolds exactly the way that you imagine it. For instance, child-care arrangements, the kind of school you choose for your child, and your spousal duties are likely to change over the years. When I was in residency, my husband went to all of the nursery school activities. Later, when I was in private practice, I would schedule my clinic around my children’s activities so that he could concentrate on his work. One year you may be doing more, and the next year those duties may fall to your partner.

You also have to have flexibility in your career because you might be doing different things in different years. And that is OK, especially for young women who may have different goals and aspirations. They should keep in mind that not everything has to be accomplished by the time they are 40 years old. You can change what you do and reinvent yourself over the years; I certainly did.

I learned that demands for my time changed over the years, both at work and at home. When my children were young I was needed for developing their life skills, and as they grew I was needed more for discussions and advice. I had to be flexible with my work schedule to be there for my children. When I was working, I made sure that my children were surrounded by love. It is extremely important for whoever is taking care of your children to love them.

Additionally, if I could pay someone else to do any household duties, I did so. Time is really priceless; paying someone to clean the house or do the laundry allowed me to concentrate on what was really important— making sure that I gave enough time to my kids, making sure I had time for my significant other, and making sure I had a little time for myself. Staying healthy allows me to maintain enough agility to take care of everyone around me—my patients, my significant other, my children, and my family and friends.

I think it is also really important to become involved in professional societies, because that gives you networks of people to collaborate with. In particular, my involvement in both Women in Ophthalmology and in the American Academy of Ophthalmology (AAO) were pivotal in helping establish my career and providing opportunities for professional growth. Becoming involved in organizations gives you a perspective outside of your own niche.

Lynn Gordon, MD, PhD, is a Professor of Ophthalmology and the Associate Dean for Diversity Affairs at the David Geffen School of Medicine at UCLA. Dr. Gordon may be reached at e-mail: lgordon@ucla.edu.