The Sandwich Generation in Otolaryngology

The Panel

Recently, I was honored to be invited by Elise Graham, MD, to join her panel, “Beyond the Otoscope: Family Care for the Sandwich Generation,” which also included Jeffrey Simons, MD, and Kristen Echanique, MD, and was presented at the annual Triological Society Combined Section Meeting in Orlando. After months of prep, we shared our own journeys, key challenges, effective strategies, and lessons learned. While we are each at different life and career stages, remarkably similar themes emerged:

• Navigating work, caring for aging parents (whether you live in the same town or not), and raising children (even after they leave the nest), is difficult.
• Balancing senior career responsibilities while managing parental health issues and children transitioning into adulthood puts us at risk for both physical and emotional burnout.
• Managing early careers with young children means facing the daily collision of diapers, childcare, and pumping/nursing amidst operative cases, building one’s practice, and learning how to optimize each day through prioritization and identification of resources that make such integration possible.

What became clear is that while the challenges we experience in caring for both our children and parents are not rare, they’re simply rarely spoken about in our surgical culture.

Key Challenges We All Face

Regardless of where we are in our lives and career stages, these are the challenges we have faced and will face. While we are not facing them all at the same time, it’s a matter of when and which ones become a focal point:

• Time. It never feels like we have enough! Luckily, I learned years ago that despite how we feel, we ARE time! What and who we prioritize determines the amount of time and attention we give. Our life is the source of time.
• Childcare
• Eldercare
• Career Sacrifices
• Financial pressure
• Emotional and physical burnout. We are also aging and are at risk of physical and mental health problems at any stage, with additional risks that are inherent in a career in medicine and surgery.

The Illusion of Balance

We often speak about balance as though it is achievable with the right time management.

All three of us on the panel described something very different.

“Responsibilities don’t leave you, even when you’re on PTO.” I shared the reality of serving in leadership roles in addition to being on the frontline. Leaders are often excessively accessible, intended or not. Our input and guidance are needed from trainees, partners, APPs, nurses, clinic staff, surgery schedulers, colleagues, and, of course, patients and their families. Our own children still need our presence well into their adolescent years and young adulthood.