Good Enough

I always wanted to be a doctor. As a child, I was raised on a steady diet of medical dramas—ER, Grey’s Anatomy, and glossy Asian serials (Love Revolution - in a time where Jdramas were a thing) where everyone moved with certainty and never spilled coffee on their white coats. Those shows made medicine look effortless: quick diagnoses, tidy resolutions, perfect hair. Youth has its uses; it lets you believe you can do hard things and convinces you that you will be the exception.

Real training cured me of the gloss. Medical school was brutal: memorisation that bled into the early hours, practical exams that compressed weeks of learning into ten jittery minutes. Basic specialty training (or Junior Residency as you call it now - yes, I was of that vintage) was not kinder. I studied at stoplights and on call-room floors, never fully sure which mistake I might make the next day. Becoming an consultant did not switch hardship off. The work changed—but the weight remained. And yet, I would not trade any of it away. I love this job: the puzzle of physiology, the privilege of proximity to other people’s lives, the colleagues who shoulder the midnight with you.

From the time I was a girl, I also wanted to be a mother. I assumed it would be simple. Many of my friends became pregnant without thinking much about logistics. I thought my endometriosis would fade into the background; it didn’t. One blocked tube later, “simple” turned into bruised thighs, timed injections, clinics at dawn before ward rounds, and the anxious choreography of IVF—hoping my body would keep pace with my calendar.

When I finally became pregnant, I developed hyperemesis. I was nauseated in clinic, sick on the walk from radiology, still telling myself I could do it all. Later, with placenta previa, I kept working until a sudden bleed reminded me how human I was. A crash cesarean followed—metal trays, bright lights, a blur of voices—and blood that seemed to drain faster than it could be replaced. I came home with a baby, a new scar, and a nervous system that startled at everything. Postpartum anxiety introduced itself like an overattentive colleague who refused to leave.

I pressed on. I pumped when free, typed into Citrix while pumping and prayed that I would not leak in clinics or scopes. Most days I left for work before my son woke and returned when he was asleep, well pleased that I had “done it all,” even as the ledger of my life stopped balancing. With my second child, the adrenaline that powered the myth finally wore off. I could not be infinite on both fronts.

So I did what felt both radical and utterly ordinary: I went part-time. I could not give up medicine, and I could not give up being there for my children. I told myself I had found the reasonable middle. I did not anticipate the shape of the guilt that would follow. When the children were sick and I was at work, I felt like a bad mother. When I called in to stay home with them, I felt like a bad doctor. I watched the pendulum swing and thought the fault was mine for not holding it still.

The culture of medicine did not invent this dilemma, but we perfect it. We ask trainees to master uncertainty yet are reluctant to tolerate it in ourselves. We talk about human limits while designing schedules that imagine none. Even my own specialty betrayed me. As a gastroenterologist, I routinely talk about the mind–gut axis, about the biopsychosocial model of health. I coach patients to look beyond lab values, to honor stress and sleep and support systems as real physiology. Somehow, I exempted myself from my own advice.

There was also the quieter shame: the sense that part-time work meant I was wasting the investment others had made in my training. In medicine, the language of “full” and “part” seems harmless but carries judgment. Full-time, full-hearted; part-time, partial. It took me a long time to understand that the fraction of a contract does not measure the fraction of a clinician.

I did not discover an elegant solution. What I found instead was a sturdier vocabulary. I learned to renegotiate the story I told myself about competence and care. “Balance” implies a poised stillness that never matched my life. “Alignment” fit better—an acceptance that different seasons ask for different weights, and that integrity lies in adjusting on purpose.

Practically, that meant naming what matters most in this season and letting other good things wait. It meant asking colleagues for explicit backup and offering the same in return, not as special favor but as normal practice. It meant blocking pumping time on the schedule in ink, not as an apology wedged into the margin. It meant speaking aloud—in meetings, not whispers—about childcare gaps and school pickups, so the next person would not have to invent courage from scratch.

Institutional change helps. Lactation spaces that are not improvised offices. Job descriptions that do not read like tests of moral worth. Promotion pathways that recognize excellence over time, not only achievement at speed. Leadership that names family responsibilities without shunting them to footnotes. None of these erases the trade-offs; all of them make the trade-offs more honest.

Somewhere in this, I learned to be gentler—with myself and with colleagues making different choices. Some of us work full-time and find deep meaning in the constancy of the wards. Some step away from paid work for a season to raise children or care for parents. Some, like me, choose a fraction on paper to protect what cannot be measured on paper. None of these paths is morally superior. They are responses to the lives we are actually living. The right choice changes over time; permission to change with it is a kindness we can extend to one another and to ourselves. We are not extra credit assignments to be graded. We are people, doing enough.

What surprised me most was what happened in the clinic when I stopped pretending that I was unlimited. Patients noticed. They did not ask me for a performance of perfection; they wanted presence, judgment, and an honest plan. I became more deliberate about handoffs and clearer about what I could do in the time we had. I was less likely to gloss over uncertainty and more likely to tell the truth about close calls, because I no longer believed that competence required silence.

At home, there were small calibrations. I still miss school pickups. I still show up to clinic after sleepless nights. I now try to measure myself less by minutes present and more by the quality of attention. It is not always equal, and it is not always enough. But my children know what I do and why. They have seen me arrive late and still kneel to tie a shoe. They have seen me apologize—to them, to colleagues—and try again.

The story I once inherited from television asked me to choose: to be the shimmering, tireless physician or the endlessly available mother. The story I am learning to write is messier and kinder. It says that most days the work of love—at the bedside and at home—looks like attention and repair. It says that a “good doctor” and a “good mother” are not opposing theses to be defended in court, but practices to be tended over years.

I still love this profession. I still love my family. I am not perfect at either. But I have stopped assuming that perfection is the point. “Good enough” is not a consolation prize; it is a discipline. It is the decision to be present where I am, to ask for help when the edges fray, and to extend to myself the same humane standard I advocate for my patients.

In training, I learned that the body seeks homeostasis—a dynamic, living balance, always adjusting. Perhaps the shape of a life in medicine is the same. Not stillness, but steadying. Not all at once, but over time. And on most days, that is enough.

Victoria Ekstrom is a narrative medicine advocate who’s constantly seeking the balance between compassion and professional distance. When she’s not busy with work, she’s chasing after her two kids and her 10 year old dachshund.