Gifty Kwakye, 38, an assistant professor of surgery at the University of Michigan, was told by her medical school classmates that she was too “nice” for surgery. She never questioned her own drive to operate, but she did worry that it would be difficult to balance her work with dreams of being a mother. She hoped to start a family during the research phase of her training, when she had more control over her schedule, but things didn’t go as planned. Overcoming medical problems, she became pregnant three months before she was scheduled to return to clinical residency.

Transitioning from maternity leave back to clinical work felt like having “cotton wool stuck in your brain,” Dr. Kwakye said. She woke up every two hours at night to feed her baby. She was so dazed that she covered her home in sticky-note reminders: Bring the pump to work, the nipple protectors, the ice packs to keep the milk cold.

Worst was the guilt she felt spending 12-hour shifts away from her child. When Dr. Kwakye squeezed in a pickup at day care to relieve her husband, she watched her daughter run to the teacher and call her “Mommy.” That prompted a day care administrator to ask Dr. Kwakye whether she was on the list of adults approved for pickup, and the doctor had to explain that she was indeed the mother.

“The kid didn’t want to go to me, and I was like ‘O.K., I deserved that, that was fair, you have no idea who I am,’” Dr. Kwakye said. “But what that does to a mother is painful. I had a moment when I was like, ‘I can’t do this anymore; I’m failing as a resident and I’m failing as a mom.’”

One morning she sat in her car crying because she didn’t want to leave her baby. She wondered if she should have heeded the warnings not to pursue surgery. She told herself, “Maybe they saw something you didn’t see and you’re not tough enough.”

As health care providers, surgeons are painfully aware of the ways in which their professional commitments can harm their own health and their family’s. Alex Moore, a surgical resident at Brigham and Women’s Hospital, said that spending long days away from her 6-month-old baby was especially upsetting because she has studied the medical importance of mother-child bonding. Returning to the operating room after a 10-week leave felt “like your soul is getting ripped out,” she said.

A surgeon’s schedule isn’t just psychologically taxing, it also takes a physical toll. A resident spends most of the day on her feet. She may go eight to 12 hours without eating, or even drinking water. As one surgical resident put it, health often comes down to “Do as I say, not as I do” for doctors in training. Dr. Rangel, who had two babies, both born prematurely, wondered whether she was to blame for neglecting her health while pregnant.