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Balance

Real-life Superheroine: LK

January 11, 2020

Since I started this blog, I’ve wanted to share the stories of other real-life tired superheroines out there. These are women saving lives, often while serving as the breadwinner of their families. It takes a ton of courage to share one’s story in a public forum. And with the hope that others might benefit from it, L.K. has offered to do just that. In this post, read about her career arc so far, along with her hopes for & questions about the future. Enjoy!  -Tired Superheroine

The superheroine in training

I’ll start with my intern year in 2003. It was a tragic one. My first husband had received a kidney transplant 10 years prior, for complications related to Henoch-Shonlein purpura. During my intern year, he was diagnosed with lymphoma, and spent the year undergoing chemotherapy. Later, he underwent an unsuccessful stem-cell transplant. After my first year of radiology residency, I stayed home to take care of him, delaying the start of my second year. He died three months later. I returned to my program and soldiered through, but I will not lie, it was rough. 

Finding love again

By post-grad year five I was back on my feet, and had met my second husband. We married the summer after I completed residency. We were aspiring surfers, and I was an avid rock climber at the time. We decided I would postpone fellowship for one year to work locums while enjoying a gap year of travel and adventure.

But that didn’t happen. The program at the University of Washington made an administrative error, and they were one fellow short. So on match day, I received a call from the fellowship director begging me to join them a year earlier than planned. With some discussion, we settled on an October start date, which left me and my husband four months to get married and go on our honeymoon. Our trip included a month of surfing in Portugal and climbing in Greece, followed by a month of surfing in Central America. 

Time to make some life decisions

When we came home, we decided if we were going to have kids, we’d better start trying. I was 35. I figured we could try for six months, then consult an IVF specialist. But by December of fellowship year, I realized I was pregnant. My due date fell a month before the end of fellowship. Therefore, I decided to work straight through the year, forgoing any vacation, so I could finish fellowship before giving birth. I worked so much, that when I finagled a three day weekend off to spend with my husband, it felt like the highlight of my year.  

Crush your goals in a white dress… why not?

Pregnancy as an IR Fellow

The first trimester was rough. I felt like I was walking through cold molasses while the other fellows ran circles around me. But by the second trimester my energy returned, and it was boundless. Whether I was up at the crack of dawn, operating late in the cath lab, or attending to another pelvic trauma in the middle of the night, I did it all. In retrospect, I have no idea how I did it. It was probably fueled by my love of interventional radiology. 

During this time, we had very little savings. We had purchased a house with a gigantic mortgage in Seattle. So on my weekends off, I flew across the state of Washington to work locums. With my impending maternity leave, I felt I had to provide a financial buffer to ensure we could continue to cover our mortgage before my first attending job began. 

A source of support

I had one unbelievably supportive attending during my fellowship: Karim Valji. He’s the current Chair at the University of Washington, and also a bit of an IR rockstar. Here’s a story about how his support helped me through as a fellow. 

I went in for my six month review with the fellowship director at the time. For me, it was more like three months into fellowship, because of my late start. Despite this fact, the director told me he felt like I wasn’t as confident as the other fellows, and that my skills weren’t as good. I listened politely, and went straight to the bathroom to sit on the toilet and cry. 

They can’t handle a real-life superheroine

The very next day, I was scrubbed in a case with Karim, and as I slipped in a nephrostomy tube he said, “I just love working with you. You are so much more confident and skilled than the other fellows.” 

I stared at him dumbfounded, before explaining what had happened in my review the previous day. After the case, we retreated to his office. He explained the way he saw things: I was the only female fellow they’d had in over five years, I was pregnant, and I was still out-performing the others. He figured they didn’t know what to think; their egos just couldn’t handle my presence. I don’t really know if it was true, but he claimed I was running circles around everyone. His words gave me the support I needed to soldier on in what was an otherwise hostile and misogynistic environment. At least we never had a journal club at Hooters…

Attending life begins

I started my first job out of fellowship with a three-month-old. My husband, previously a landscape architect, left his prestigious job to become a stay at home dad.

This happened at the apex of the economic downturn ( in January of 2010). Therefore, many radiologists in Seattle due to retire decided to keep working because their retirement accounts had suffered. As a result, there were no IR positions, and we had to leave Seattle. We headed to rural Washington for work- not part of the original plan. We didn’t want to sell our house in Seattle because it was worth $100,000 less than what we’d paid before the crash. As a result, we had to rent it a rate that only covered half of the mortgage. We were forced to pay for the other half of the mortgage, as we found a place of our own in the new job location.  

In the wrong job as a new mom

My first position was not a good one. There was one other interventionalist who had zero support from his diagnostic partners, and so abandoned any hope of building a robust practice. This left me on my own, fresh out of fellowship, to play tug-of-war with the surgeons and interventional cardiologists. I attempted to start an interventional oncology program with a hostile group of oncologists. To add insult to injury, I was to help replace the night-time radiology service. That meant covering eight weeks of nights at 74 hours per week. 

My pumping routine consisted of sneaking away from the reading room a couple times a day. I’d frantically pump while standing in the bathroom of the fluoroscopy room. This involved tenuously balancing my equipment on a soiled linen container, while hoping no one would come in for a procedure while I was there.   

A financial awakening

I discovered Mr. Money Mustache (MMM) three months into that job. At my wits end, I thought, “There is no way in hell I can sustain this for 30 years.” I had watched my first husband waste away and die two weeks after his 30th birthday. There was no way I was going to spend the precious time I had remaining working like that.

I soaked up every word MMM wrote. I had never been a fan of debt, and never had a credit card. The only debt I carried was $30,000 in student loans from medical school, and the albatross of a house that we now owned but couldn’t afford. I lived at home through medical school and for four years of residency, before moving in with my now husband. Being frugal was always just a part of me. 

In diving into the world of financial independence, I educated myself ruthlessly. I learned everything there was to know about low-cost index fund investing

Random opportunity strikes

Nine months into my first job, I met another interventional radiologist at a wedding, and he recruited me to his group. I have been with that group for nine years now, and boy, did I luck out! I actually thought my first job was OK. I mean sure, I often worked six days a week, and I worked a ton of nights, but I got to do some IR, and it was easier than fellowship (even if it was harder than diagnostic radiology residency).

In contrast, my new group was a lifestyle group. When I was hired, we had about half the year off. We worked some long shifts, weekends and evenings, but we never worked nights. The biggest point of friction between members of the group was between those that wanted to work more than 65%, and those who wanted to work no more than 60% time. It was amazing. 

A shift in work-life balance

With me contributing to the childcare more, my husband was so much happier. He even went back to work part-time in his field. I was able to have another baby, and this time, pumping and nursing were so much easier, since I only worked part-time. The thing was, everybody worked part time. So I wasn’t marginalized in any way for raising my children; I was working just as much as everyone else!

Financial independence

Despite my good fortune with the new job, my desire for financial independence has always been a driving force for me. We sold our house in Seattle, and I paid off a $500,000 group buy-in in 18 months. Now, everything that’s left over goes into tax-deferred savings or low-cost index fund investing. We have started to diversify with real estate. We own a rental property, have invested in real estate syndications, and have even self-directed a Roth IRA (which is pretty awesome). Now, about 60% of my post-tax income goes into some kind of savings vehicle.

An uncertain future

We are now approaching financial independence. I still love interventional radiology, and diagnostic radiology too. The question I am wrestling with is, “What do I do next?” I have a pretty good job, and life is very comfortable. Is this it? Although I get quite a bit of time off, the lifestyle-oriented partners have retired, and the younger partners want to work more to make more money. To this end, we have tightened up staffing so that each radiologist now works more. 

But I want more time, not more money. My husband and I want to delve into slow travel adventures, and our kids ( seven and ten years old) have had enough travel experience to also be interested. I’d love to spend more time traveling with my family now, and focus back on my career as the kids get older and go off to college.  

Real-life superheroine reflections

What about my skills?

I have explored trying to work abroad, but I’m not sure if it’s worth the trouble if we only plan to do it for a six month to two year period.

Should I pursue mission work? Does it exist for radiologists? I’m not sure. And really, we want to see multiple countries, not just hunker down in one place. I’m exploring whether this is realistic. Being a physician makes a gap year difficult. Especially in a skill-based discipline. I worry about taking time off from IR: would I be able to jump back in? I’m not sure it’s like riding a bike! One thing is certain: I am not ready to leave radiology for good.

The circuitous path to financial independence and beyond

It’s funny, when I set out for financial independence a decade ago, I never imagined I would end up here with this dilemma. I figured I’d make enough and get out. But I’m not ready to stop, maybe just reroute. If I could just figure out what comes next…

There you have it: a snippet of life as a real-life superheroine. Once you “make it” to the attending level, the road can still be windy. New challenges can arise. It’s a good lesson for us all. We should do our best to appreciate where we are in the journey, wherever that currently is. While attending life is a light at the end of the (training) tunnel, when you get there, it isn’t just rainbows and unicorns. There will always be decisions to make, forks in the road, and dilemmas to solve.

Women in interventional radiology, other procedural fields, and surgical subspecialties are scattered around the country, sometimes disconnected from each other. But there is strength in numbers. We can help each other navigate these beautifully complex careers. Reach out and connect with another real-life superheroine. To share your comments and questions with L.K., you can email her at kiviatleah@gmail.com.

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