Meet Dr. Andrea Bouman, an ER physician in the Upper Peninsula of Michigan. In this episode of The Nine Oh Six, Andrea reflects on her journey of pursuing her passion in medicine to serve her rural community, while starting a family along the way. Hear from her as she shares her experiences as a student at Michigan Tech and as a resident at Henry Ford Hospital, as she overcame self-doubt and leaned on her support system to get to where she is today.

TRANSCRIPT: Episode 8: Becoming an ER Doc as a Breastfeeding Mom

[0:02]

Andrea: I thought that in order to be successful in both realms, I would have to be able to give 100%, 100% of the time. So I was trying to live the life of a stay at home mom, while also living the life of a resident.

[0:21]

Archita: That was Andrea Bouman. In this episode of The Nine Oh Six, Meha interviewed her childhood friend Andrea, who is an emergency doctor in the Upper Peninsula of Michigan in the USA. All through her young adult life, Andrea was really sure of two things. One, she really wanted to start a family as she grew older, and two, she wanted to pursue a career that gave her an opportunity to serve her community. And in this episode, she breaks down how she found a way to start that family, all while asking herself the questions and figuring out how if and when she was going to do this, and breaks down how every woman or man can pursue their passion, have a career, and also have that family that they desire. While it's not always perfect, and she does feel like she's pouring from an empty cup at times, she's learned over the years to lean on her support system, to see her through. Here is Andrea Bouman.

[1:34]

Andrea: So one of the things that I knew was really important to me, as a new mom was being able to breastfeed and I didn't know what that would look like or how that would be possible with my job. I think working in the emergency department is a little bit unique in that we don't have breaks or lunch break, not that you may not, you know, stop and eat between patients but you really don't have any designated time because there's always patients. And so I think it's a little bit different in that way. And I just didn't know. This was a big question I had about whether it would even be possible to be able to breastfeed and still be able to be present and active at my job. And with the realities of it logistically, could I even do it?

I will say that the one the one reason the one thing that I will attribute being able to be successful at that, was really the support of my colleagues and my faculty there while I was in training, because anytime I would leave for 10 minutes to be able to pump meant that everyone else who was there would have maybe a little bit more to do or watch out for for those 10 minutes I was gone, because the work doesn't pause. You know, the patients are always there. Results are always coming back. Patients always are having something that they need.

[2:52]

Meha: And logistically like you. You pumped in a closet?

[2:55]

Andrea: No. So I was lucky in that we actually we had a lactation room, which I know a lot of people aren't lucky enough to have. We had one actually right in, it was a separate room within the big break room for all of the staff that worked in the emergency department. And so I was able to kind of think ahead of time about roughly what time range would I try to go and try to go sometime within whatever hour time range I would set to myself and sometimes

[3:21]

Meha: Before your boobs start hurting.

[3:24]

Andrea: Right, I know. And sometimes it would just be nowhere near the time I thought I'd need to go because there might be a critical patient that was there that I would be very intensely busy with for two hours, and you can't walk away from that for 10 minutes to go pump. And so I just had to be really flexible on the times. And so sometimes that meant I would pump pretty early into a shift because I had the time to be able to do so. And sometimes I would pump you know, a little too late in the shift, or else I would have to just be really intentional about saying to myself, okay, I know, part of me wants to do XYZ and once I check those three things and those are done then I can slip away to pump. But more things would always come up. So by the time x, you know, x, y, z were finished. There's all you know, there's 10, more things that need to go. And it's just a never-ending list. And so I had to be really intentional, and just almost forced myself to just pause and set things down and realize that I have other colleagues there, you know, who will take care of the patients those 10 minutes, I'm gone. And the world's not going to come crumbling down if I step away for 10 to 15 minutes, and that was really hard to do.

[4:26]

Meha: Could you explain why it was important to you to be able to breastfeed?

[4:32]

Andrea: Yeah, I think it was important because I think I mean, there's a lot of health and medical benefits that, you know, we learn about in school and people who aren't in healthcare, learn about in other ways in the community. And so I knew that was important, but I also thought it would be important for me for bonding reasons. And I think that for me, I already was struggling with this idea of trying to balance being the mother that I wanted to be with work. And so it was really important that I find a way to still do to still breastfeed and not have to sacrifice that for the sake of my career. And it was hard. You know, it wasn't, you know, I had to be so intentional about it every day. And that's not right for every person. You know, that's not it just for me, that was what was right. And that's what helped me to feel like I was still being able to have that balance at home. And so you just do it, you just find a way to do it.

[5:25]

Meha: So how was that journey and figuring out how can you pursue your passion, while also having a personal life.

[5:32]

Andrea: So that was something that was always in the back of my mind for as long as I can remember. One thing that I always got held up on was whether or not I'd be able to still have a family and still have the family life that I wanted. I remember when I was a freshman in college and sitting in the first intro to the medical field class and the instructor was talking about a career in medicine that week and had put up some numbers on the screen in front of the room about the number of hours worked by physicians while they were in training, you know, 100 to 110 hours per week. And he really made an emphasis on that, because I think he really wanted people to understand that something that takes a lot of work and commitment to be able to move forward and have a career in medicine.

And I remember that moment so profoundly. And that's a question that I circled back to, more times than I can ever count over the next several years. Am I making the right choice to go into this field? Or am I sacrificing another part of my life that's really important to me. And then, when I was in residency, I ended up having my daughter and it was so wonderful and I and before she was born, I was always thinking, can I still be a good mom? Can I still be a good doctor? Can I be good at both at the same time? And then I think I just realized, you just find a way to do it. Sure I could always do more work, there's always more committees I could sit on or be involved with. Sure, there's always more that I could do at home, I could go to more mommy and me classes or you know, there's always more, but I feel like I've been somehow able to find that, that balance that is comfortable for me.

[7:26]

Meha: And earlier, when you mentioned that, every day, you think about the balance of okay, you could be doing more at work, or you could be doing more at home with mommy and me classes, right. So have you come to accept that there are those sacrifices? And how have you gotten to that point?

[7:46]

Andrea: I think I'm getting there. At first, I'll be honest, in my journey to try to find what balance would look like for me, I overdid it. So every time I mean almost every day I wasn't working. I was trying to do something with Harper, when she was young, first six months or so when I'd gone back to work. So I might get home from work at four in the morning. And I would wake up with her when she woke up at seven. And we would go to a mommy and me yoga class, and I would be with her all day. And then I'd go back to work at 3pm and then come back and do something similar again the next day.

And I think I overdid it a little because I thought that in order to be successful in both realms, I would have to be able to give 100%, 100% of the time. So I was trying to live the life of a stay-at-home mom, while also living the life of a resident physician with 60 hour work weeks or 80 hour workweeks, and I got a little exhausted. I was able to sustain it for a little while and then realize at some point that I just wasn't doing - I wasn't doing the right thing, in either way. I was able to be both places and give my best of both places.

But I was tired. And I think I was starting to pour from an empty cup. I didn't have much energy left for myself. And so since then I've been able to dial it back a little bit. So we're not doing quite as many things like mommy and me yoga or library playdates or we're not doing that every single time I'm off and every day that I'm home, but we're still doing some and I still feel like the time that I'm home is still quality time and I think I've just had to re-establish what I see as being a good mom and realizing that being a good mom is being there and being available and it doesn't mean going to every little activity all of the time. And that I just need to find the way that that looks for me.

[10:00]

Meha: Andrea, how did you survive even like, days of two days of that? Working all night sleeping for three hours being with your baby all day. That's huge. But

[10:12]

Andrea: Well, I wouldn't recommend it to anybody. I mean, I was happy and you know, I still feel like I was able to do a very good job at work. I don't feel like my performance at work, suffered, you know, I but I was tired. And luckily, I have a very supportive husband who helped me realize that I needed to change that.

[10:33]

Meha: I do want to talk about him because Andrea, you and I are sitting here doing this interview, okay. And you just told me that you heard your baby crying. And then you're like, Oh, nevermind, it's good. Although Troy has a meeting, he's able to take Harper to the meeting. Like who does that? Oh my gosh.

[10:52]

Andrea: It was luckily a fairly informal meeting. But still, he's I mean, he's phenomenal. I never ever could be where I am in any respect without his support.

[11:06]

Meha: It's like we can do a lot if we have the support to do it. And sometimes we don't. We're not open about the reality that having an equal partner or sometimes a partner doing even more than you is one of the factors to success.

[11:27]

Andrea: Yeah, well, I think I've been, you know, lucky beyond words, and that we were able to sort that out from the start.

So, Troy and I were engaged by the time that we moved for me to start medical school. And so he's really been along this entire journey from before I was applying, and when I was still trying to decide if this was definitely going to be the right path for me. And so all of those moments where I'd had some of that doubt of whether I could do it, or whether this was the right choice, and could I find this balance. He was really the support and encouragement that I could do it and that we would find a way as a team.

And so I agree with you and that being able to have some support system, however, that looks having support looks different for every person. And, and I think that makes a tremendous difference in being able to get to where you are someone to be encouraging, you know, when you're not sure. And there were days where I was exhausted and just didn't know if I, you know how I could get up the next morning to keep going and it was really having his encouragement that me to push along and to get through and to realize that we could do it and to get to where we are.

[12:36]

Meha: Sometimes we have a support system or a BFF who also happens to be our life partner. Sometimes we take them for granted. How have you found ways to focus on...how do you get through the difficulties of that and focus on the appreciating who you have?

[12:56]

Andrea: Yes, well, I will definitely say that it is too easy to accidentally take for granted, I definitely have gone weeks and probably months at a time without remembering to do things like laundry or dishes. And somehow they're magically done. You know, we're in this together. And again, for me, my together is with my husband. But I think anyone who's really trying to pursue where they're going to, it's remembering that as you know, as much as we're able to do on our own, it's really the support of those around us that can help us to get there. And I think trying to remember that periodically.

[13:33]

Meha: So how do we though, as the partners who are being supported, appreciate that more?

[13:39]

Andrea: I don't know. It's a great question. That's probably a good question for the partners who are being supportive. Realize how much we appreciate it. But I think for us, we were lucky in that we were able to find a way to balance things for both of us when we moved, for example, to Grand Rapids for medical school. I was able to kind of have some input between two different campuses for Michigan State either to Grand Rapids and in Lansing. And in Grand Rapids there had some opportunities for Troy, he actually went back to Grand Valley and got his MBA during that time. And then when we moved back up to the UP and I was in Marquette for some clinical years, he was able to come back to Houghton and to spend some time here at Michigan Tech and grad school, starting his PhD and working on his master's in mechanical engineering. And so I think it's a little bit of give and take, being able to try that find that balance of support for both. Certainly, some days I feel like it's more take than give from me when I'm so depleted, and I feel lucky enough to have had that support from him and being able to keep everything else in life running along.

And it's just trying to, I don't know, I guess I don't have the answer. I guess that's the short of it. Certainly there are many times where I've gone to him and said, I don't know how I could do this without you And I feel like basically in more words than this kind of that I'm doing more take than give. And he always reminds me that we're a team. And so there will be moments where I have more take, there'll be moments where I have more give, and in the grand scheme, it balances and falls together.

And I think I've just had to come to terms with that too. I think for a long time, I felt a lot of guilt because I felt like medical school and residency and then later, you know, being a mom on top of that was taking up so much time and energy from me that I kind of let everything else slide that I was needing so much support that I would feel guilty about it, that I felt like everything we did in life had to be on the terms of my career. And I think it just took a long time years really to kind of let go of some of that guilt and realize it really is a joint thing and people wouldn't be doing it and doing that support, if they didn't want to.

[16:00]

Meha: One thing you said, there were points in your journey, when you said, am I making the right choice? Could you speak to that a little bit more?

[16:09]

Andrea: I think one of the most challenging times was when I was in college, I actually for a brief period of time, had considered fairly seriously going a completely different route and pursuing a career in student affairs. I was in college I had had several different jobs while going to school full-time. Several of them were in kind of the Student Affairs under that umbrella. There was one point after I'd already been accepted to medical school but hadn't yet started that I thought pretty seriously, and actually had applied for a job in the field of student affairs.

Obviously, I didn't go that route. And I'm grateful for that. Now, I think had I done anything else I would have always felt an emptiness and hollowness of not going through with, you know, my real passion and for my career.

[17:04]

Meha: When you were trying to figure out what you if you can pursue a career in medicine, where do you feel deep within you that this pressure was coming from?

[17:17]

Andrea: You know, I think I was putting it on myself. Actually, I know I was. I think as women, I think we put a lot of pressures on ourselves. I think we think about the balance, whether it's a personal drive, or whether we're feeling the way from society to be able to be the quote, unquote, perfect mother, and still be able to be successful in our careers.

And I remember actually, when I, when we first found out that I was pregnant and expecting my daughter, and I was so excited and over the moon, the very next thought that I had was, okay, now, what is this going to mean? For me for the rest of my training? At that point, I was near the end of my first year of my residency. The program I was in the second year was really where the most growth and the steepest learning curve was expected to occur. And I realized that I felt nervous about what does this mean for my training? What are the other people in my program, going to think? I was nervous to tell my program director, I, you know, was afraid that it would seem like I wasn't...I was afraid I just wasn't going to be able to be as good as a physician, as a learner, in that important training time.

And so I remember feeling so nervous and I went to my program director's office to tell him pretty early on so that they could help me figure out how to work that and how to work my maternity leave into our shift schedule and what it would mean for my training, and I was really nervous to tell him and he was very kind person, but I was afraid that I don't know it would be problematic for my residency. And as I told him, he broke out into a huge smile, and kept telling me congratulations and he was so excited. And he didn't even bring up the fact that it was going to impact my training, or didn't even mention that it would push back my schedule, or that it would be hard to be as focused during my training and to be as good and those are all the things that in my mind, I was afraid of, in my mind, I was thinking, and he didn't say any of those. And then he almost seemed surprised that I had felt it was going to be such a big deal to tell him. And then when I thought about that afterwards, when I got home, I thought, why is that? Why did I think that? That anyone in my program would care. And I realized it was just a pressure I put on myself. I had presumed I wouldn't be able to take time away from training, I had presumed that it would negatively affect my ability to learn everything that I needed to do and gain experiences that I needed to gain. And in reality, that wasn't the case.

[20:06]

Meha: But do you think, as young women, when you first say, maybe in high school or college when you were doubting whether you can pursue your career, passion and balance with the family? Do you think you didn't have enough examples of seeing where people were doing that?

[20:28]

Andrea: So when I was young, and when my siblings were young, my mom had taken a break from working to stay home with us. And so she was home as a stay at home mom for my first few years until I was starting school and same for my siblings. And then she went back to work part-time for a while and then eventually full time. And so I think because of that, my mom's an amazing mother and I feel so lucky to have had her. And I think for some reason, in my mind, I thought to be able to try to be as good of a mother as my mother was, I should be home too. That's not to say my mom isn't a career woman to an extent right now. You know, she works as a counselor, as a therapist, and I think she's phenomenal in her career. But I think she was also so fantastic as a mother that I set my standards looking a little differently than what I thought I'd be able to achieve.

[21:21]

Meha: Andrea, do you think that part of it is society?

[21:26]

Andrea: You know, I think so. I think that there's so many different opinions out there about what it what does it mean to be successful? What does it mean to be a successful career woman? What does it mean to be a successful mother? What does it mean to be a successful wife or, you know, all together? What does this look like? And I do I, you know, I think we put a lot of pressure on ourselves, but I also I think there is influence from society about what it means to be these people and you know, I think it's realizing that that's different for everyone.

Being what it means to be a successful mom, to me, meaning being able to be home and there for Harper when I can and having important meaningful moments with her and helping to raise her, you know, with important values. Whereas for someone else, being a successful mother might mean being able to be there for every event and doing drop-off at school and pick up at school every day. And I think it's just different for each person what they feel.

I think success is defined by ourselves. But the pressure is there to compare to everyone else.

[22:42]

Meha: Tell me a little bit more, then, overall in your life, Andrea. How do you define success?

[22:48]

Andrea: I think success is really a fluid thing. In any moment in any different point in our lives. I think I would define success as being able to be happy with me, happy with who I am, happy with the way my life is going. But I think it's dynamic. At this point today, do I feel like I have some degree of success? I would say yes, I would say I'm very happy with where I'm at in my career, I'm happy where I'm at with my family. And I think success is being able to wake up in the morning and feel happy about who you are and happy about the life that you're living. And it doesn't necessarily mean being perfect at or doesn't at all mean being perfect at any one of those. But being able to feel good about who you are and what you're doing. I think that's the only way I could define it.

[23:48]

Meha: What shaped you to get to where you are today?

[23:51]

Andrea: Well, so it's kind of a funny story. When I was in high school, I actually thought I wanted to go into teaching. And so I was trying to do a career tech class. Where I could observe some time with teaching and early childhood education, and I couldn't fit it in my schedule. And so that's how I ended up being involved in the health careers program. Instead, I thought maybe healthcare would be interesting. And then at some point, during that experience in the hospital over the year, I started to think, wow, I could really see myself doing something in this field. I thought, man, I really am amazed to see what everyone here is doing and how they're helping people. And I'd like to be a part of that.

[24:30]

Meha: What, at that moment in high school, and you're exploring a different career paths, what clicked for you when you think about what you want to do in your life?

[24:41]

Andrea: Yeah, I think it was some of what I was exposed to. And just being amazed at seeing patients who were really sick and seeing how physicians in the area were able to help them which at that time, it was such a kind of new thing to me as I was just starting to explore career paths. And then I remember also really reflecting on how being here in such a rural and isolated community, I would see that there were patients who would need to go elsewhere for a lot of their care, or we just didn't have the specialty of availability here that you may have in a bigger area. And so that made me realize how important it really is and how how much and rural communities, especially people who really can understand the unique situations and some of the unique needs of this community can really be impactful.

[25:32]

Meha: Reflecting on new time at Tech, could you talk about any experience that you could point to in any way, Andrea, that you feel shaped you to who you are today? What was it about Michigan Tech?

[25:46]

Andrea: I mean, I think that the people who work in the university really genuinely care about the students. And you know, even the jobs that you have, I felt like on campus weren't just about having a job to get a task done and make money to pay for your tuition. I felt like a lot of the jobs and the opportunities for students were designed in a way that helped you to develop skills and really gave you some transferable skills that you could take and apply to a career in anything. And the perk was just that you got paid and it helped pay for your tuition.

But really the whole goal I felt like because everyone there was so supportive of the students and wanting to help them to be successful in whatever way that meant for them. I felt like a lot of the opportunities both in organizations or in student jobs, you know, the supervisors were really focused or the leadership was really focused on how that experience could help develop you as a person.

I think that one of the great things about being at Michigan Tech with it being a smaller school and just the school that it is, is that I was able to dip my toe into a lot of different things. Oh, I was able to be in involved in different student organizations, I was able to be involved in the concert band, I was on the, you know, was involved with the cheerleading team, I held several different jobs in both in Student Life in some mentoring roles as a teaching assistant for, you know, anatomy classes, and for some kind of study skills classes. And it was really combining all of those different opportunities that I had, through those experiences and just the skills that you pick up as part of that, that really helped me to refine what my interests were more broadly.

So I knew I was interested in medicine, and that's one thing, but kind of the combination of, of all those different things helped me to develop skills and leadership and organization and public speaking and you take all of that and I think it helped me to create my personal identity and what it was that I valued in both a career and in life.

[28:08]

Meha: I love that the way you phrased that - it helped you create your personal identity.

[28:14]

Andrea: Right? Yeah. Because I don't know, it wasn't just one thing. You know, I think it was just, you take little bits away from every little experience and and together, it just, it combines to create that identity. So all the jobs that you've been like with orientation, for example, part of my job was helping to develop one year the training for the 70 student leaders that would come in two weeks early in the fall to help guide incoming first-year students through their orientation week. And in the training that these 70 students, 70-some student leaders would go through was a week long training and not just about what they would do each day for the orientation and the technical aspects that had some parts of it.

But there days devoted to diversity training, days devoted to just information and skills needed to really develop and cultivate a safe campus environment and organizational skills and time management skills. And all of these things were really built into this orientation. And so I think that that really showcases how much they cared about the students there to devote an entire week long where they're paying the student workers to be there, that really is largely devoted to helping those student leaders develop their own skills.

[29:40]

Meha: One phrase you said that's intriguing me, and it's something that now in my adult life I think a lot about is that you mentioned in this training, you said diversity and inclusion training. Growing up for 18 years of my life there Andrea, not once, and I could say this with a hand on a religious text, did I ever feel discriminated against. Right? I'm asking you, now that you are where you've returned to the UP. Do you think diversity is a topic whether in a college campus or outside that people need to discuss or be aware of or appreciate?

[30:18]

Andrea: You know, I do think that the community is really unique in that compared to other small towns, we are privileged to have more of a diverse community than than many other small towns just because of the university that's here. With that, I think that was one of the wonderful things as part of the training that student leaders went through at Michigan Tech was about, you know, diversity and inclusion, to help really kind of continue to foster that culture in that environment where everyone could feel welcome and comfortable and to really help others who may not have been lucky enough to grow up in a community like this, where we do have some diversity in many forms of the word, you know, help people who may not have had that opportunity growing up to really understand that that's what we're about here. And I think that's something that's really wonderful and that we really value as part of what makes this community what it is.

[31:26]

Meha: So you mentioned the rural communities and I'm, but what I really want to ask you that, why or when or how did you decide to move back to the UP? Or was it something that you always knew you wanted to do?

[31:39]

Andrea: So it's funny, when I was thinking about it, I realized that I really couldn't picture myself practicing anywhere else. This community was really my introduction to healthcare and my introduction to medicine, both through experiences in high school and in college. And anytime anyone ever asked me why I wanted to go into medicine or what I wanted to do. I think my answer was always that I wanted to get as much exposure and experience as I could to come back here and serve the community that helped me develop this interest or cultivate my interest in medicine in the first place.

[32:17]

Meha: Incredible.

[32:19]

Andrea: I think I would not be able to be where I am in my career without the mentors that I had here. The patients here that allowed me to observe and participate in their care when I was learning. And so it just made sense to me that this is where I want it to be when I pictured myself as a physician. I only ever pictured myself here.

[32:46]

Meha: If you could say something to yourself, when you're say 20 years old, 22 years old. What advice would you give yourself?

[32:54]

Andrea: You got this girl! No, I mean you know, I, you know, I think, you know, part of the thing is, I think anyone who is really a planner is always thinking ahead about, okay, what do I need to do? What are the steps I need to do to get to where I want to be? And I think I've had to just realize that sometimes, you know, you have to just kind of let it go and you just make it happen. Right. So was residency more challenging with a kid than it would have been without? Absolutely. Did I make it work? Yeah. How? I don't know. I just did, you know? And so I think I would go back in and tell myself that and you can do anything you put your mind to, and you don't have to know ahead of time how you're going to do it. You just get in that situation and trust yourself that you will figure out a way and you will.

[33:49]

Meha: And a question Andrea that we ask on every episode. What do you love about yourself?

[33:58]

Andrea: I feel very proud of myself. For being able to be at this point, I'm proud that I found a way to be able to be a good mother and still follow my career dreams and goals of trying to help people and serve others through a job in medicine.

[34:19]

Meha: Thank you, Andrea, so much for your time. Really enjoyed our conversation. I'm so glad that you were on our show.

To learn more about our podcast, check us out at thenineohsix.com. The Nine Oh Six is produced by Meha Chiraya and Archita Fritz. Subscribe to us on your favorite podcast platform to tune in and hear the stories that will elevate and inspire you.