The Sandwich Generation in Otolaryngology

On Christmas Eve 2024, my father was admitted to a community hospital in Los Angeles for acute cholecystitis. Luckily, I was already scheduled to start vacation and fly out on Dec 27th to visit family before Dave, Claire, and I went to Cabo. Arriving at LAX just before 9 a.m., I went straight to the hospital by Uber. I was sitting in my father’s hospital room when I realized how ordinary this moment had become.

The IV pump clicked softly behind him. Another patient shared this small hospital room, sleeping quietly and motionless, separated only by a curtain. I heard and saw nurses briskly walking in the halls through the open door, amidst bustling noises of hospital staff, intermittent crying, the utterances of a patient two doors down, and families arriving to visit their loved ones.

My then 79-year-old father was not his usual animated self. Instead, he seemed so fatigued, spoke very little, and barely opened his eyes to acknowledge my arrival from Ohio. I ached as a surgeon seeing him in the re-washable blue patient gown—they never seem to fit anyone—with snaps misaligned and falling over his shoulders. His exposed hands and arms were covered with bruises where, clearly, multiple IV sticks had either blown or been used up since ED and admission. I wished I had been there three days earlier instead of being on call.

I spent the next four days traveling from my sister’s house in Orange County to the hospital in Monterey Park (about an hour). During this time, between checking his labs, hovering over the nurses’ station—repeatedly asking when the hospitalist would be rounding, when the surgeon and GI consultants would arrive, and when a phlebotomist was coming—and insisting on telemetry, I was also on my laptop logged in to Outlook and EPIC reviewing the call schedule for the group, managing my inbox full of message and results from cases I had just finished, and responding to staff and parent messages.

While I was physically in a hospital room as a daughter, I was cognitively still very much a surgeon, a division director, a wife, and a mother, checking to make sure Dave and Claire were arriving from Orlando the next day and arranging the weekend logistics.

In that moment, I understood what the “sandwich generation” looks and feels like for all of us as a part of the shared human experience. Not in theory, not in a definition, but in the lived experience of being needed by two generations at the same time while still being needed at work.