Building balance

Balance in Practice

Margaret Parsons, MD

Dr. Parsons is in private practice in Sacramento, Calif.

Dr. Parsons and her son, with him wearing a sweater she knitted.

Dr. Parsons and her son in front of one of her handmade quilts.

Fingerless mittens, cowl, and a hat on the holiday gift pile.

Handwoven scarves completed by Dr. Parsons.

Knit shawl and hat.

A completed shawl worn by Dr. Parsons.

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When I come in to my practice in the morning, I begin with the first patient and go nonstop until it’s time to leave for the day. I also have an eight-year-old son and a husband on the city council, and the schedules for our meetings, practices, and work-related trips make it necessary to be looking ahead at the same time we’re leading these busy, full lives. That’s often the reality of achieving balance in our practices and lives. It takes time, planning, and organizing to make sure that you ever get the time to relax with your family.

Luckily, I’m a very process-oriented person. It’s why I’m constantly working on a project — if you see me at Academy meetings or on the volunteer activities and committees I participate in, there’s a good chance you’ll see me pull out my latest knitting. I like to do things that I can plan and measure, or take on projects that produce a result.

The weaving and intricate needlework is a metaphor for how we, as physicians and family members, produce something out of everything we take in during a given week. Depending on how well you’re able to manage the disparate threads of your life, you can end up with a stunning, intricate result. Or, some weeks, you get mismatched grey mittens. It happens to the best of us. The important part is to be aware of your process and know that you’re the one in charge of achieving that perfect balance.

Knit picking

I came to knitting and needlework as a way of releasing tension and relaxing. Since childhood and into adulthood, I’ve checked out books from the library and taught myself to knit, quilt, and needlepoint. Now I have a project with me everywhere I go. I always have three different projects in development — something easy, something of medium difficulty, and something very involved. Depending on where I’m going, I’ll have the perfect project to accompany my activity. I can get a simple hat or pair of socks done in a matter of hours. But a lacy shawl with complicated details comes in handy for a long, boring flight. [pagebreak]

Knitting is portable, and I like to be able to have something to do with my hands while I’m in a meeting or attending my son’s soccer practice or taekwondo class. If I’m not moderating a session at the Annual or Summer Academy meetings, chances are I’ll have a simple project going while I sit in a session. It distracts my hands and helps me focus on someone speaking or on an issue I’m trying to think through. I spend a lot of time volunteering with both the AAD and other local medical organizations, so I spend a lot of time working on my technique. Of course, I’m listening while I stitch and when there’s something I need to take notes on, I stop and take notes. But when you really listen, you realize there are only a few things you need to write down, especially as an adult learner with a core base of knowledge already established. The notes I stop to take are the things I want to add to that base.

Part of the reason that knitting has become such a big part of how I achieve balance is that carrying out a knitting project speaks to a lot of the things I do well as a dermatologist. I like to make a plan, look at a pattern, and have something at the end of the process. I approach the challenge of a very math-heavy pattern and fine yarn just like I would an issue with a patient or the practice. In knitting there are simple patterns where you just go along and you don’t have to think a lot. We all have patients who come in who we can look at and know immediately what’s wrong and how to fix it. And then there are complicated lace patterns where there are charts, and you’re counting stitches, and you’re memorizing and repeating sequences. I think we all have patients we can compare to this, too.

There’s also a planning element to knitting that I enjoy. Say I’m making a sweater for my son and I know he’s long-waisted. If I knit with a certain size needle the yarn will knit up into a different gauge. So I have to knit samples, which is called swatching, and measure the gauge. Then I apply that to the pattern of the sweater I want to make, and then I put the geometry and the math together to make sure I make something that will fit him and not have too long of sleeves or too short a body. You end up doing all of these different steps, from making samples, to measuring, to adjusting, to adding and subtracting stitches or rows, to adapt the general pattern you want to follow to fit the specific person you’re making it for. And again, isn’t that just like treating a patient? You take the knowledge you have and the facts in front of you and work with them to do the best thing for the particular person you’re working on. [pagebreak]

To see something go from a ball of yarn to something lacy and lovely that you get to wear or give to someone is a joy. There’s an aesthetic pleasure in working with the yarn, feeling the fibers, choosing the colors. And when I’m done, a lot of what I knit goes directly into my Christmas pile. In both my family and my husband’s family, we value hand-made things. So it may be simple things like hats or fingerless mitts because people always love them and they’re easy to make. My husband always requests socks, as they are custom-fit. And then each year there will be one more complex special gift and that rotates. For my mother’s 70th birthday I made her a beautiful lace cashmere, delicate, detailed scarf. And these are combined with other homemade things homemade ketchup and jam usually goes into the Christmas box as well. (To read more about my other hobbies and see some of my knitting, check out the online version of this article at

Of course, there’s never enough time, so like anyone else, I have to prioritize. Family and practice is always first. Sometimes my things get put aside for a little bit. But never for too long.

Working in health care, especially as a physician, is very stressful now. You have to spend some time away from your practice to be able to come back rejuvenated every morning. It’s important to recognize the need to step away and do things that you love and enjoy. If you don’t, you’re not going to be your best self every day. And it takes effort to be your best person — being healthy, taking care of yourself, and finding that you take that time away to come back stronger physically and emotionally. The fact that I can work with yarn while also spending time at one of my son’s activities or hearing a talk from a colleague makes it a persistent part of my life. [pagebreak]

Staying Fit

Beyond my knitting, another crucial part of keeping sane and fulfilled — another very important thread to me — is making sure I’m able to keep up an exercise regimen. I enjoy time on the bike or elliptical, as well as yoga and some hiking.

I didn’t realize what a big part of my life it was until a few years ago, when I badly tore my meniscus and wasn’t able to turn to that familiar routine. For six months, the most I could do was 10-15 minutes on a bike, and a lot of the time, I wasn’t able to do anything at all. After a while, I just didn’t feel good. I couldn’t sleep as well as I was used to, and it was then that I realized that I’d always exercised in one way or another for my entire life. If I had a stubborn problem, I’d take that time while exercising to think through all the different angles, which helped a lot. 

What I hadn’t realized until it was taken away was that this exercise regimen was the unseen stitching that was vital in holding everything together. I think about that a lot on days when I had an exhausting day at my practice and want to skip the workout to collapse onto the couch. While my knee issues have ended the dream of becoming a long-distance runner, I’ve come to really appreciate how important it is for me to make the time for exercise. I place a pretty high priority now on planning and scheduling time to be in the gym, or at a yoga class, or on a ride or hike.

In the Kitchen

It helps to have an incredibly supportive husband, and we both try to schedule at least part of every weekend to have some time around the house. Even at home, I have a handful of projects I like to work on. We have a garden with both vegetable beds and perennial flowers. I use a lot of what we produce in the cooking and baking I do. Like my knitting, it’s another process that requires precision in planning and execution, yet leaves room for personal and artistic touches.

I’ve actually always really enjoyed making things in the kitchen. Baking was my first love. It was either culinary academy or medical school. And as it happened, I trained at Tulane in New Orleans, where I learned so much more about food. Even now my kitchen is equipped with a baking station. I make ketchup, jams, and other things that I can make in the kitchen and give to people. It’s yet another thread in my week, and helps me connect with another — time at home and with my family.



Staying Fit
In the Kitchen
Staying Fit
In the Kitchen