September 6, 2018

Dawn commented on my last post, and the end of her comment read:

“I am wondering how you handle overload/overwhelm. I tend to shut down and then nothing gets done. Do you have ways to climb out of that?”

Oh Dawn.

Good timing.

Because I am definitely in that zone, right here, right now.  I honestly was hyperventilating at work today, staring at my inboxes (yes plural; there’s the electronic medical record where we get results and patient/staff questions, and there’s my outlook work email, and admittedly I had my gmail open at some points too) and gazing at the multitude of meetings ahead in my outlook calendar.  Every day seems to have some sort of logistical challenge built into it — like – I have a meeting at 3:30, but it’s in another building I have to drive to, and a 12:30 meeting but an 11:30 patient who is allowed to come up to 30 minutes late and be seen . . . etc, etc, etc.  Add in the pumping, which I am basically obsessive/compulsive about because I seem to produce just enough and only with great effort . . . 

Also, add in:
– chronic work stress from clinical duties (unfortunately, certain things do not seem to be getting less stressful with time)
– residency responsibilities (which seem to be exponentially increasing – and I DO have time blocked off for them, but it’s hard to really keep things compartmentalized and I feel like I am just getting more behind every day)
– the teaching (and coordination of med students), which I do not have the time to prepare for the way I would like
– the fact that I have to coordinate childcare coverage for some days our nanny will be out soon (I have multiple options, but none will be stress-free)
– workouts (because honestly without them I feel even more on edge)
– the podcast (though thankfully we’ve had a bit of a break due to some strategically pre-recorded episodes!)
– this blog 
– new school year for A&C
– multiple pages of worksheets and @$*@#! BOOK REPORTS every week in first grade 
– G’s extra appointments for her blasted helmet
– the pumping (yes, I know I already mentioned it)
– anxiety ABOUT the pumping
– SLEEP DEPRIVATION because G is still not sleeping through the night (typically wakes 1-2x, I feed her, she goes back to sleep — which I know is perfectly normal at her age and could be worse)

(PLEASE NOTE, after rereading this post I recognize this is all really very . . . low-level.  I have no real problems.  I have amazing help (from family, our nanny, my colleagues), healthy children, and no real stressors.  So, that’s really important to note.  But I will say that I still am struggling a little.)

I had an attending during my training who had multiple children and at some point — when they were young — it seemed like she just sort of gave up.  It was infuriating to be her trainee at that point, to be honest.  I DO NOT WANT TO BE THIS ATTENDING. 

But I do feel like I am currently in a bit of a low point.   I recognize the pumping is temporary (down to less than 3 months!), and without it I will be less stressed.  But I stubbornly DO NOT want to give it up now; I honestly feel anger and a sense of oppression when I think about my ‘right’ to breastfeed G being taken away from me before I am ready (and having gone this long, I’d like to make it to my Dec 1 goal).  

I don’t know what I am trying to say with this post.  In part, I guess I want everyone to know that I do NOT always have it all together, in case that was unclear.  I wanted to write out what feels difficult, so I can see that some of it is temporary.  And — back to Dawn, and her question.  How can I — we — climb out?

My answer to her was that I often like to take some time to just slack, as much as possible, only to return stronger at a later date (this was sort of my mindset as I took most of August off of working out, for example).  The idea of “Low Power Mode” on the Happier Podcast resonated with me.  I also am trying to just focus on ONE thing at a time and not look too far ahead (unless I’m looking ahead to fun things next year, which is pleasant!).  Yet I am struggling to figure out what that could really look like right now.  

If you have ideas for me (or Dawn), please share.


  • Reply Sara March 10, 2019 at 7:06 pm

    I really appreciate your honesty, Sarah. And so sorry you are feeling overwhelmed. Hope things get better for you soon. I don’t think I have any great strategies, as I think I get overwhelmed to some extent every.day, but lowering the bar helps. And also writing down everything I really need to get done and focusing on finishing something – it could be anything. I also find that having a clean, organized space helps me relax. It kind of annoys me that I am wired like that because keeping things neat and tidy takes time away from more "meaningful" stuff, but I have tried to just accept it (and hired a house cleaner to help me!) I’m curious about the idea of "low power mode" and any other suggestions people have 🙂

  • Reply Michelle March 10, 2019 at 7:06 pm

    So, I currently have an 11 month old and a 4yr old, (but no third older child like you!) but I have been trying to give myself grace for the entire first year with a baby. The first year is just so hard! Even if everything is going perfectly, and you have the perfect baby, and even if it”s not your first baby.

    I kept trying to get caught up at work/get ahead, plan anything for home, and then getting frustrated that my mind wasn”t catching up to actually doing more than the bare minimum. But I”m giving myself until my baby is 1yr old, and then I”ll try to return to my former self. Maybe I won”t get back to that person ever again, but I”m going to try. Just not yet!

    And honestly, the sleep deprivation makes everything feel 10x worse than it actually is! Don”t forget to give yourself some grace on surviving through almost an entire year without sleeping though the night even once!

  • Reply Oldmdgirl March 10, 2019 at 7:06 pm

    So, this summer I met with a potential future boss at my fellowship, and he basically gave me a laundry list of things I needed to not only do, but do perfectly, in order to get hired as an attending. I was already doing most of these things (not easily. Hi residency, I”m looking at you.) and every time I said something to that effect, he would add another thing. I started to wind myself up about how I couldn”t possibly get everything done, how there”s no way I was going to be successful, etc. and hen, I don”t know, I just stopped. Because I realized that I could only do my best, that if he didn”t value me as a future employee that was his loss, and that we could move elsewhere if need be that we could move elsewhere for me to get the job I wanted, and that other institutions would want me. Also that month I had a bunch of research obligations and a pretty intense clinical month too, which didn”t help my feelings of overwhelm. So I sat down and figured out what I could realistically accomplish, and tabled everything else until later. And you know what? I got through it, and things are very good right now. I feel happier and more relaxed and productive than I have in years. As I”ve said before, sometimes you must let things go. Sometimes I”m doing so and being patient with yourself, you will get to a place where you can get more done than you dreamed.

    Also, I think you need to dump some of these new school responsibilities onto josh. There is no reason a weekly book report should be your responsibility only. People hear what my husband takes care of — and it is a lot — and give me the side eye. But you have to decide what you really want: to do everything and be a martyr, or to offload some things onto the other parent. Ps – the babysitter can help with homework too, or maybe it just won”t get done. Let. It. Go. She”s six. It doesn”t matter.

  • Reply Marci Gilbert March 10, 2019 at 7:01 pm

    Don”t have good tips but like the realness. This too shall pass? I am sure you”ll figure it out!

  • Reply Jenny March 10, 2019 at 7:06 pm

    Thanks for the realness Sarah! I’m a physician doing inpatient consults and twin mom of 16yo boys. I am feeling similarly over-stretched and overwhelmed, although my list of reasons is much shorter than yours! 😉 I’m Canadian, and so I didn’t return to work until my boys were 10mo, which was a real life saver! (I truly can’t imagine juggling a 3mo old and going back to work!)

    One thing that I’m thankful that I did was reduce my clinical load by 1 day/week. It seemed like too little work at the outset, but I’m still feeling overwhelmed! It’s so easy for clinical stuff to take over, and it’s so hard to set limits with my time when I am actually caring for patients (for fear of negatively impacting them). I already spend some of my "days off" catching up on notes, speaking to other practitioners, etc. I also decided not to take on anything extra, aside from doing lectures and teaching seminars (aligns with my value/priority of education) because I knew I needed to give myself some time and space. I notice that I still get resentful when people ask me to do additional things, but then I try to calm down, see if it aligns with my values/priorities. My family is such a high priority, that for the most part the answer is no! I am trying to deal by making a priority list, and really sticking to that.

    I’m SO glad to hear that you’re still exercising! That’s amazing! I’m trying to do this too. I need to switch my mind set to it being something I NEED in order to be able to take care of others all day long. I love that you do it first thing in the morning to ensure nothing else pushes it out!

    Sleep deprivation is probably making this all worse! I know this is a controversial suggestion, but have you considered doing sleep training for G? I broke down when my boys were about 7mo and did sleep training because I was so exhausted I couldn’t take it anymore. They’ve been sleeping through the night since, and it’s a game changer!

  • Reply Ash G March 10, 2019 at 7:06 pm

    Solidarity! Mine is 9mo today and while things feel like things might (knock on all the wood) be getting easier we still have a lot of this too…including a lack of sleep and a complicated relationship with the pump and bf in general. I’m just trying to figure out how to prioritize and taking it one day at a time. Thanks for the reminder that it isn’t just me!

  • Reply SusannahEarlyBd March 10, 2019 at 7:01 pm

    Thanks for your honesty. It”s so nice to hear “real” thoughts from someone about how overwhelming even non-major stuff can be. I”m totally overwhelmed with different things right now and appreciate this. Xoxo

    • Reply theSHUbox March 10, 2019 at 7:06 pm

      YOU are doing amazing – just look at your happy WELL-FED baby <3 <3 <3

  • Reply Sarah K March 10, 2019 at 7:06 pm

    What is it with so much homework in first grade? I have learned from more seasoned parents that apparently it is acceptable to just tell the teacher that you don’t believe in homework at this age and just.not.do.it. SO – consider this permission if you want to consider that option! And pumping will be over before you know it. You’re so close!

  • Reply Holly March 10, 2019 at 7:06 pm

    Always appreciate you sharing the struggles as well as the highs! We need more of that on the internet.

    I found myself wondering throughout the post – "I wonder if Josh feels this way too?" I echo oldmdgirl’s comment on offloading some things to him. I know he has a more demanding job and that there are some things you just can’t offload onto him (like pumping or your podcast). But in this season where you are SO stretched and doing LOTS for your family (pumping, coordinating childcare, supervising homework, extra appointments for G, etc.) on top of your own busy job, it doesn’t feel fair for him to not share the burden. Do what you guys always recommend on the podcast – ASK or TELL him to help on specific things! Especially on anything that can be done around his call schedule – he could easily take on some of the childcare coordination or homework supervision (early AM he’s home, if I remember correctly!) off your plate, even if you have to do the more during-the-day things like G’s appointments. Get through this as a team!

  • Reply Jeanna March 10, 2019 at 7:06 pm

    I think a good old fashioned vent always helps 🙂 Paired with some perspective and gratitude, of course, which it sounds like you have. It sounds like you are answering to a lot of people right now…family, patients, administration, residents, and the pump (haha). I think it’s ok to recognize how hard that is. It also sounds like a case of "too much for one person in one work day" which is so true for so many fields. I know in the past you have used personal time to catch up on work situations, and I think that can be okay if it makes you feel are sane overall. Or maybe you could ask for an option to work some of your off days in exchange for comp time (or $$)? Best of luck…you are doing great!

    • Reply theSHUbox March 10, 2019 at 9:00 pm

      Oh, interesting – like an occasional catchup day to exchange for day off later. Harder to do when primary responsibilities are seeing patients – but I could probably wrangle a day or two in the name of catchup and desperation 🙂 Interesting idea!

  • Reply Ana March 10, 2019 at 7:06 pm

    I don’t have any "tips" per se, because in truth, its just a really really busy season. If you want to drop something that isn’t absolutely essential (podcast, more intense exercise goals, organizing the book club, etc…) you have my permission. But I suspect the answer is no…so I agree with the comment above re: fully immersing yourself in this season—the good the bad and ugly, and finding the sparks of joy in every day without focusing too much on what didn’t get done or what is looming ahead. In addition to my daily/weekly/monthly to-do lists, I’ve been doing an end of the week "ta-da" list of the things I’ve accomplished. Its really satisfying and helps me keep perspective when I’m feeling overwhelmed and like I’m completely behind. Even if there was an afternoon or even a full day that I wasn’t laser-focused and productive, I still accomplish a decent amount each week in my personal and professional life.

  • Reply Dawn March 10, 2019 at 9:00 pm

    What an awesome thread! I think the best thing about it is for ALL of us working moms to realize we are not alone and that it’s just really d#@$ hard to do everything we feel like we want/need to do. Maybe just acknowledging it every single day-that this is a hard season and to show some self-compassion and remind ourselves that this too shall pass! Easier said than done but worth trying to be intentional about being conscious of the "hard/difficult" time. Acknowledging that we have made it this far and definitely "stacking our wins" and counting our blessings. Thanks for all the feedback and Sarah –know you are doing a great job as mom, mentor, wife, Dr. friend, blogger and more . Many mommy hugs sent your way!!

  • Reply Susi March 10, 2019 at 9:00 pm

    Gosh – your post couldn’t have come at a better time for me. I’m in slightly different time of life (my kids are 7 and 10), buy boy am I overwhelmed and being hard on myself. I was thinking of sending an question in for the podcast along the lines of "how do you cope in seasons of major overwhelm where you are feeling burnout with everything at work/home?" I think the thing I’m thinking might help me is sleep – I don’t get enough. I try to do exercise, but fitting it in just feels like another "to do".. I feel like I need a month or so off live to recharge my batteries, and when that’s done to not quite run so full on.. Failing that – I’m not sure 🙁 Thank you for being so real and honest – it appears you’re not alone at all in this! Big hugs…

  • Reply lawyermom March 10, 2019 at 7:01 pm

    This new mom needed this realness today. I”ve been struck by how many times on the podcast how moms of very littles are exempted from the strategies (a recent example is waiting to train for a hard half), and while perhaps not intentional, I suspect that makes sense. I need to hear that in this season. I also loved the “steeping in this season” suggestion. I am such a growth mindset person and I need to remind myself that there is growth happening now, it”s just a bit more of a little person than me right now.

  • Reply domain murah March 10, 2019 at 7:01 pm

    – chronic work stress from clinical duties (unfortunately, certain things do not seem to be getting less stressful with time) i feell this in my life

  • Reply Wonders of world March 10, 2019 at 7:06 pm

    To travel the new wonders of world you must know the places

  • Reply Cartoon HD March 10, 2019 at 7:01 pm


  • Reply Julia March 10, 2019 at 7:01 pm

    i very much appreciate the realness here. good for you for putting the words together about why it’s makes you feel angry to think about stopping breastfeeding now. I felt some of that and didn’t put it together that is what I was feeling.

    • Reply Julia March 10, 2019 at 7:06 pm

      As for suggestions…I’d say that taking a few moments to meditate is very helpful for me, but i don’t do it nearly consistently enough. Also, writing things out helps me. Or brainstorming all of my options of what I might do to change things around–sometimes these are very drastic options of career change, but are interesting to think about how I could make them a reality

  • Reply Sarah Dambrosio March 10, 2019 at 7:06 pm

    Just want to send a virtual hug, and echo many of the supportive comments. Also, in lieu of everything you do, I would love to know- when do you have time to read?!? Your prolific book lists (and membership in TWO bookclubs) are boggling my mind!

    P.S. I just stopped pumping for the twins (reached my 6 month goal! With HEAVY supplementation) It”s SO grand to be done, and the 2.75 months will be over before you know it!

  • Reply OrganisingQueen March 10, 2019 at 7:06 pm

    Sarah, I did Gretchen Rubin’s Deep Dive to the Four Tendencies course and something she said that really really helped me is this: as an upholder, you need to clarify for yourself (out loud verbally) why you are doing something. If you feel upholder tightening settling in (and if you don’t mind me saying, I think there’s some of that going on 😉 you should also tell yourself, "I can stop this and I can always pick it up again later" As an upholder, you will do it when you’re ready.

    I didn’t read through comments but off the top of my head, as examples, if you exercise 5 times a week, maybe 3 times is the new normal for now, and the other 2 times can be spent catching up. Or spend a day recording 4 podcasts, and have nothing for the rest of the month. or delegate the homework to the nanny and just check it (that’s what we do with our twins).

    To Dawn’s question, I talk with my clients of setting a minimum effective response in my Break out of overwhelm course, and do just that while you climb out of overwhelm.

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