There’s a version of this story where I made all the right decisions.
That’s not quite what happened.
It was one of those mornings — multiple complicated patients back to back, switching between in-person and telehealth visits, the kind of morning where complexity compounds and suddenly you’re running thirty minutes behind before you’ve even had a chance to catch your breath.
My last patient of the morning was a telehealth visit. I had just finished with the patient before them — a complicated case that needed a real chart note, not a quick one — and I made a decision.
I left the chart open and went straight to the telehealth visit.
I told myself it was because the patient had been waiting long enough. Which was true. But underneath that was something else: I felt guilty. This patient is kind. They’ve been waiting for a while already. I didn’t want to make them wait one more minute while I finished a note.
So I prioritized their comfort over my system.
The telehealth visit went fine. When it ended I closed that chart, then went back to the previous one — the complicated one I’d left open — and finished it before I let myself eat lunch.
It all worked out. My morning charts were closed. I even made it to my daughter’s softball game on time that evening.
But I remember the feeling of those two open charts sitting there. The extra weight of knowing I had to go back. The effort of reconstructing details from a complicated visit that had already moved to the back of my mind.
That uneasy feeling — that’s cognitive load. And I had created it myself, out of compassion.
I’ve written before about the decision to close the chart even when it’s inconvenient — but this morning reminded me that the reasons we don’t are more complicated than I sometimes acknowledge.
Here’s what I’ve been thinking about since that morning.
Physician moms — women in medicine generally — carry an enormous amount of compassion. It’s part of what makes us good at what we do. We notice when patients are uncomfortable. We feel their frustration when they’ve been waiting. We want to make it right.
But that same compassion, when it’s not examined, can quietly work against us.
We stay late finishing something because we feel guilty leaving it undone. We skip lunch because we feel bad making a patient wait. We leave a chart open because closing it feels selfish when someone is waiting on the other side of a screen.
We think we’re being kind to others.
Sometimes we’re just making the evening harder for ourselves.
The good choice I made that morning wasn’t closing the chart during the visit. It was closing it immediately after — before lunch, before anything else, before I had any more time to forget the details I needed.
That decision protected my afternoon. And my evening. And my presence at a softball game I really wanted to be at.
I didn’t do it perfectly. But I did it.
And I’ve learned that in medicine, done imperfectly is almost always better than deferred indefinitely.
I help physician moms stop charting at night and get their evenings back. If this resonates, you can download my free guide at this link.
