RESIDENTS NEED SUPPORT

I had not anticipated the intense excitement that the birth of my daughter would generate among my co-workers. How animated the people around me would become about my offspring is something that I had not even considered during the period leading up to her birth. Nurses who I'd worked with once or twice in the operating room were interested in all the details – her birth weight, hair colour, sleeping pattern, and middle names were all fair game. Baby cards poured into our Dutch home and eventually filled the entire (tiny) baby room. Everyone wanted to see the latest pictures and iPhone videos. And with all the congratulations I received at work, you might think I had personally accomplished something particularly difficult and rare. I think my wife would beg to differ. As an ophthalmologist-in-training, I had, of course, spent the whole pregnancy in a state of near-panic that she might be born with one of the rare ophthalmic conditions that I'd seen during my paediatrics rotations. Might she get congenital toxoplasmosis from our cat? Would she develop strabismus? Even retinal and optic nerve agenesis, which I had seen diagnosed in the OR, crossed my mind, although this was a possibility I couldn't even consider without hyperventilating.

Fortunately, she was completely healthy at birth, so my attention has shifted to more realistic concerns. These primarily regard my ability to combine fatherhood, residency and that vague notion we call 'life' into a productive and satisfying whole. People say that parenting is a full-time job. A senior resident described it as 'your core business.' However, both my work contract and my work ethic seem to say the same thing about my residency. Okay, so parenting and residency are both full-time commitments. And what about 'life'? A friend of mine, a cardiologist, has a motto that I am sure will keep his heart healthy and stress-free until he turns 100: 'Sure, you have to work hard, but try not to let your job interfere too much with your life.' With these three views battling for supremacy in my mind, each claiming primacy above the rest, I suppose I'll have to work out my own formula during the next three years of residency and potential fellowship(s) thereafter.

The main question is: Will I be able to combine working and studying with bottles and nappies and then still have time over for socialising, sports, travel, and culture? Will I be able to resist the temptation to bounce my daughter on my knee when I should be reading up on ophthalmic surgery? Will I be able to leave my books and my daughter at home while I myself go bouncing through the woods on my mountain bike? And will I be able to put my laptop away after hours of research work in order to play instead? Something tells me that these choices will rarely be mine to make, so I'll have to recognise every window of opportunity and grab whatever comes passing by. Fortunately, there are many similarities between residency and childhood, of which the most important seems to be opportunity. Both residents and children have the opportunity to learn, to make mistakes, to be supported by those with both greater experience and more extensive knowledge who are willing and able to solve big problems and fix big mistakes.

A second key factor is the advantage of exposure. Childhood, like ophthalmic training, benefits greatly from exposure to both what exists in real life and what has been written by others. Participating in varied travel, social and athletic activity is like examining lots of patients: they're all different and potentially interesting, and the more you see, the better you'll be able to recognise patterns, detect subtleties and appreciate the beauty and the significance of the details. On a lighter note, several baby-toophthalmology comparisons have spontaneously come to mind. My presence during my daughter's delivery was similar to my presence in the operating room for my first surgical rotations. 'Great that you're here. Remember as much as possible. Help when you can, but make sure you don't get in the way. And don't drop anything.' A hysterical crying fit is like a corneal ulcer – both are horrible experiences, their aetiology is frequently unknown, and there's relatively little you can do besides wait, hope and pray that they will get better soon. And changing a nappy is like removing a superficial corneal foreign body – easy to learn and easy to do, and something you can count on having to do daily for a long, long time.

Of course, there are more pleasant comparisons as well. Learning new babyrelated skills – like installing the car seat, setting up the playpen, or building the crib – are just like any surgical skills. They're generally a bit simpler, but no less important. Going for a walk outside is interesting and restorative, like a great lecture on an interesting topic. Seeing a baby smile creates the same feeling as telling a nervous patient that his eyes are perfectly healthy: a purely good sensation. And presumably, the whole of parenthood is like the arc of an ophthalmologist's career. You start your residency knowing nothing at all and feeling acutely incompetent, but there's a steep learning curve early on and before you know it you're doing more good than harm. You'll make tons of mistakes along the way, but in the end you'll end up with a happy child who's ready for independent life and happy patients who are ready to see the world with as much colour and clarity as when they were children.