Clinical Advances in Hematology & Oncology

January/February 2024 - Volume 22, Issue 1

Letter From the Editor: Taking Leave

Over the past two years, two of my younger male colleagues have experienced the birth of their first child. These were wonderful times that brightened the mood of our entire group. Our institution grants six weeks of paid paternity leave, which both of my colleagues took in full right after the birth. My initial advice had been to stretch out the leave in increments over several months, based on the logic that there is little to do those first few weeks as long as grandparents are around to help. However, a weekend drive to the mountains with my wife, during which we reflected on our own experiences, made me reconsider the advice I had given. 

A little over 25 years ago, our first child, Eleanor, was born. Earlier that year, my wife and I had moved to Boston, bought a house in nearby Milton, and started new faculty positions. We spent all our savings on a down payment and home preparations and rolled my hefty loans into a second mortgage. It was an exciting but turbulent time. I was stressed about my still-new job, living up to the academic faculty expectations, and meeting the growing responsibilities that come with caring for advanced-stage cancer patients in a health care system that was still new to me. I was a first-year instructor at the Dana-Farber Cancer Institute, and there was no institutional paternity leave policy at that time. So, when Eleanor was born on a Friday, I was back to work on the following Monday.

During our recent road trip, my wife shared with me how disappointed she felt at my reaction to Eleanor’s birth. Instead of sharing in her growing excitement and anticipation of this new life entering our world, she felt that I was distant and disengaged. I like to think that I eventually grew into a good father, but the truth was that my mother and mother-in-law both had extensive visits that first month, essentially relieving me of a lot of childcare duties. What none of us realized was that we were perpetuating a system that allowed me to prioritize work over spousal support and parental bonding.

As a consequence, I never committed the time to bond with my new family. I passed over those magical moments that come from being present for hours every day with a brand-new human being. I missed sharing those times together with my spouse. Instead of being present with my family, I kept my attention on work. 

Over the next few years, my career slowly advanced. I received a young investigator award, published some papers, and wrote several clinical trials. I was fortunate to work with some of the most preeminent clinical and translational researchers in cancer. But I didn’t learn how to support my wife in her career, prioritize time with my children, or even maintain healthy self-care. As a consequence, we found ourselves looking for other environments where we could have more balance.

We moved to North Carolina 20 years ago, where I developed my career while becoming more involved in the everyday lives of my girls and eventually learning how to support my wife’s career. Nonetheless, I still struggle to limit my commitments to work. I have never taken more than two weeks at a time off of work. This brings me to the concept of leave. 

The idea of leave is not a new one to academics. Tenure is granted to faculty, in part, to give them the protected status to leave their environment and to study elsewhere, free from the burdens of their institutional commitments. The goal is to return renewed, with a refreshed perspective on life and career. Very few people in medicine take advantage of such breaks, especially in oncology, even though they have the potential to extend or refocus the career of someone at risk for burnout. I understand that a year-long sabbatical is a long time away for a clinician, but maybe we wouldn’t need a year away to refocus if we renewed our lives with a little more regularity. I like to think my younger colleagues have the right approach.

I regret not having taken off more time to share in the awe of new life as it unfolded over those first few weeks. Maybe someday, as a grandparent, I will have a second chance. But until then, I will live vicariously through the joy of my colleagues and will look for my own opportunities to step away from work as an empty nester. More on that another day. 


Daniel J. George, MD