Work–Life Balance is an Illusion: Replace Guilt with Acceptance

We walk with the ghosts of our patients every day of our lives. We chose critical care medicine because we love our work and are honored by the opportunity families give us to enter their lives when they are most vulnerable. We cannot develop these deep relationships that involve life and death then pretend those emotions and family stories do not enter our home lives. My work is my life and my life is my work. The concept of needing a balance between the two ignores that the fluid lines between work and life are frequently blurred. When I see an ill child who shares a trait with one of my children, such as same age, hair color, smile, or sassiness, I have unintentionally allowed my life to enter my work realm. Similarly, while I am on vacation at the beach and subconsciously survey the scene to detect who looks ill and play out exactly how I would resuscitate that red lobster of a man, work has infiltrated my life. I was riddled with grief and remorse while on maternity leave with my first child when I wrote and submitted my first NIH grant. I read articles on my smart phone while feeding. I did not nap when the baby napped as the mantra demands. I napped when I hit a writer’s block. I awoke at 02:00 a.m. while the baby was still asleep because I was motivated by an idea that entered my sensorium and I needed to sketch it out. I fielded questions from fellows seeking advice on their job search. I approved institutional review board submissions, phoned-in to research mentorship meetings, and submitted abstracts to national conferences. I also spent countless hours staring into the eyes of the child we created. When I returned to work, I was energized and felt rested, yet the constant chatter from my colleagues included statements judging my ability to have enjoyed my maternity leave. I must not have bonded with my child. How could my work–life balance be so off? Duringmy secondmaternity leave 2 years later, I made a promise to protect this valuable, precious time and to savor these magical moments. I disabled work email from my smart phone. I canceled all work-related meetings and slept. I did not submit any abstracts, manuscripts, or grants. The only articles I read were from the New York Times. My computer battery died unrecognized by me for weeks. I took that little girl everywhere and filled my day completely with child-centric activities. When I returned to work I was energized and rested. I was still immersed in guilt despite following the rules of maternity leave to a tee. This time guilt and overwhelming doom arose from themountain of tasks ahead ofme. It took three full days tomanage emails and re-establish regularly scheduled meetings. There were no lectures scheduled, no new research protocols to activate and I was swamped by clinical commitments. I returned home exhausted with limited capacity to be an active parent.Mywork–life had swung completely into chaos. I asked again, how couldmywork–life balance be so off? Two years later, I enjoyed the birth of my third child. I made no promises to myself. I put no restrictions on what I could and could not do while on maternity leave. I allowed myself to just be. I wrote when motivated, slept when tired, and parented when it seemed fitting. My days were fluid, unencumbered, productive, and loving. When I returned to work, I was energized and rested and guilt-free. As intensivists, we make hundreds of decisions daily (1) and I would venture to guess that most decisions are good ones. Finding the key to work–life balance for me was having trust in my skills