The Full Writeup on Michelle Au

Here is my full review of This Won’t Hurt a Bit (and Other White Lies): My Education in Medicine and Motherhood and the full transcript of my Q&A with author Michelle Au, MD. See the original post here where I’m giving away a signed copy!

I definitely knew I’d read this book too fast when I heard Michelle read. It is a book to be read slowly or else you might miss the insights and the humor that is coming every other line or so. I read it in bed on a sickday in just a sitting or two in my reading-on-a-sick-day way. Now I’d like to go back and listen to it in the car or read it in little bites.

There is much you expect from a medical residency memoirs. Outrageous anecdotes. Sleep deprivation. Learning experiences. These are all there and done well and with humor and insight. What separates this book from other similar ones I’ve read is that the author feels so human, it feels like someone telling you the story as they sit across from the table. Some medicine memoirs can feel so lofty that you don’t necessarily feel so connected to what’s happening.

My biggest criticism is probably that I wanted more. More of the day-to-day, more anecdotes, more about her family and her son. But every memoir can’t tell you everything and Michelle really wants to convey the experience of residency, and she does that very well.

The release is really well timed, this is a great summer read that will make you feel all smart and impressive but also make you laugh regularly. Also an excellent choice for book clubs, working families, or anyone who has an interest in medicine.


The Full Q&A

This is the unedited Q&A. I didn’t change any of the questions or answers on the blog, I just removed some for length. Here is the interveiw in its entirety. It was conducted via email.


1. As the wife of a resident, I obviously have an agenda. You and your husband are both doctors and suffered through residency together. What advice to you have to us poor souls who are married to residents? How can we get the right balance of being supportive without being resentful of all the time we lose?

It’s tough!  I think in some ways it was easier to be a resident married to another resident, because as difficult as the path was and as amplified as the time constraints to our relationship were, I was grateful that I very rarely needed to explain why it was that I got sucked into an emergency and was going to be home late yet again.  Honestly, it’s hard for anyone not to resent the ordeal of residency and, by association, resent your spouse for being part of it, but I think you have to remember that it’s not a selfish choice, nor does he have much say in the matter.  It’s hard not to get frustrated sometimes, because let’s be honest, residency is extremely stressful and can at times feel like a punishment to both the trainee and those in his life.  But compounding that with pressure at home for not being there enough is one of those tug-of-wars that no one can really win.  As the spouse of a former resident myself, sometimes the best thing I have done is just held my tongue and trusted that my husband would sort out for himself how best to allocate his time.  He loves his family and I know that, given the option, he will do the right thing.


2. On the flipside, what advice to you have to residents about making it through the long haul without losing touch with their spouse?

This is something that Joe and I are still trying to work out, so if you figure it out before us, let us know!  You are told all through med school that your patients receive top priority for time and attention.  Throw some kids in the mix and that gets complicated, because of course, your children also get top priority for your time and attention.  The unfortunate result of all this is that, simply by a matter of triage, time alone with your spouse usually get shunted to a lower priority, simply because most of he needs of the relationship are not as immediate as those of your work and your kids.  But that doesn’t make it right.  We’re still working on it ourselves.


3. You write a lot about your first son, Cal, who was born during your residency. How different was your experience when you had your second child while you were an attending?

Well, first of all, I feel like the act of being pregnant in and of itself was less of a big deal once I was finished with my training.  Cal was born three weeks into my first year of anesthesia residency, and I think, whether it’s a fair perception or not, that very fact of me having a baby was viewed as much more of an anomaly or some sort of statement about my lack of commitment to my training and career.  I have had people tell me to my face that having a baby during residency means that you will be a mediocre resident and an inadequate parent.  How do you respond to something like that?  (Mostly I just stammered and changed the subject.)

In contrast, my second son, Mack, was born six months after I graduated residency, and it was just construed as much less of a political statement.  I was a 30 year-old married woman who already had one child, it didn’t seem like such a big deal to have another one, and the point I was at in my career seemed to people like much less of an impediment.  I want to point out that all these forces were external, however.  I loved having Cal when he came along, and we made it work, and our process for Mack was similar.


4. The book has a mix of humor and honesty I really admire. How did you decide what stories from your training days to put in the book? And did you have any qualms about starting the book with the particular anecdote you chose?

Ah yes, the opening salvo!  The moment I decided to write a book, I knew that I wanted to start the story in media res (that is, “in the middle of things,”) and through the multiple, multiple drafts of the manuscript, that first scene remained basically unchanged.  I just wanted to pull people in, immediately and viscerally, into what the tone of the book would be, which is that training in medicine is basically ordinary people being put into extraordinary and occasionally ludicrous situations, and being called on to do things they never thought they’d be able to do, both large and small.  Medicine and parenthood are a lot alike in that way.

I had no qualms about putting stories in the book that made me look clueless or silly, because really, that’s the essence of being a medical trainee—being aware of how little you know, yet being undaunted and working hard to be better.


5. We just left Atlanta after my husband finished his MD/PhD. Was it a big adjustment after New York? Can you eat some Chik-Fil-A for us?

Atlanta and New York are so different that it’s hard to enumerate the ways that we had to adjust when we first got here.  Probably my biggest transition was learning how to drive—I’d grown up in Manhattan my whole life, and as a result, I didn’t even have my driver’s license when we first got down here.  That was…hard.  But Atlanta is great, it’s really easy to live here, especially with kids, the weather is great, and Southern people tend to be incredibly charming, what with their “sir” and “ma’am” and all that sort of thing.

As for the Chik-Fil-A, don’t worry.  I’m eating enough for the both of us.


6. There are a few really prominent medical memoirs but they’re not too big of a genre. What made you decide you wanted to write your story? Did you know right from the beginning that motherhood would play such a big role in the book?

I’ve always written, and my writing has always been in largely the same vein—non-fiction, humorous, experiential.  The first draft of my book was much more external (meaning more about the hospital and the patients, less about me), my editor forced me in my second draft to inject more of myself into the story, because, in her words, the manuscript felt like it was missing something.  I think I had deliberately tried to stay away from writing too much about myself, because I felt somehow like it would be an exercise in egotism, but I realize now that she was absolutely right.  The information about the individual informs the story of the development of the doctor.  Writing the book more as a memoir as opposed to a collection of discreet clinical stories also made it much warmer, and much funnier.

Also, in making my book more of a memoir (as opposed to straight medical non-fiction) meant that it was only natural to deal with a huge turning point in my residency, which was having a baby early on in my training.  As a modern medical resident, I have long grappled with the task of work-life balance when trying to juggle two all-consuming jobs—that is, medical training and parenthood. I’m pleased to be one of the few female medical memorists to dive into a topic that is only going to be talked about more and more.


7. Do you see any signs that the medical profession is turning more mom-friendly?

Well, the medical profession is overall turning more people friendly, which basically translates into being more friendly for parents as a whole.  Of course, most of the changes are related to work-hour regulation from a patient-safety standpoint, but until they start dictating how we’re supposed to spend our freetime (and I suppose it’s not a stretch to think that they might, given that there are sleep mandates built into the system now), we’re still free to use that time for what we want, be it family or friends or hobbies or what have you.

I still don’t think that people love having pregnant residents, and I understand that totally.  Residency is incredibly taxing, and having people have to cover a resident who is out for a six-week maternity leave (even if she does “pay it back”) breeds resentment, there’s no way around it.  But it’s becoming more common across all fields, and I think normalizing that experience is going to be helpful.  The fact of it is that most residents are in their 20s and 30s, and people who are in their 20s and 30s naturally want to have friends and spouses and families.  Everyone else outside of medicine gets to have these things.  So I don’t think it’s too much to ask for young doctors to have them too, so long as they don’t short-change their training and commitment to patient care in the process.


8. Will you actively discourage your kids away from medicine like your parents did?

If Cal and Mack decided to become doctors after living in a two-doctor household (for good and for bad), I would be thrilled and proud, because it would mean that somehow, Mom and Dad did something that they thought was cool.  But I would want them to have really made the decision for the right reasons.  Becoming a doctor is a long, hard path, and I would want them to think, reallythink, about what they really want, and if becoming a doctor is the only way to achieve those goals.  I think being a doctor is the best job in the world, but I also think that you really have to believe that in order to get through the process intact.


9. You’ve blogged for a really really long time. How have you made time for it?

I think my blog is going to have its eleventh birthday this October, which is incredible.  My blog is older than both of my kids’ ages combined!  My blog is a sixth grader!  (Sorry, I don’t think of my blog as a child, but seriously—eleven years?  I’m old.)

But honestly, part of why I’ve been able to keep my blog up for this long, and why I keep making time for it, is because of my readers.  I have such a depth of archives now that I have people who have been reading since the beginning, or people who are new to the blog and are able to look back at the progress of my life over the past decade—fairly formative years, I daresay.  And I get a lot of e-mails—not even questions or requests or anything in specific, but just e-mails from people to tell me “thanks.”  Thank you for showing us that this is possible, that it is possible for a regular person to get through medical training and have a family and retain a sense of humor. People say that reading my blog makes them laugh, and gives them perspective and hope for their own paths for the future.  So that’s why I make time for the blog, even with the other thousand and one things I do every day.  Because I have the best readership on the internet.  I would never have written this book without them.

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