The Doctor is in … all the time by Jennifer Patel

Time.  When it comes right down to it, the medical relationship is all about time.  At first it’s the kind of time that seems like it will never end.  Medical school (don’t forget almost interminable route of MD/PhD chosen by some), intern year, residency — hey — why not tack on a few research years and we might as well do a fellowship while we’re here.  God forbid someone chooses to change a specialty along the way.  Best-case scenario you’re looking at 7 years (after college).  Worst-case scenario??  12, 15 … done ‘right’ I suppose this truly could go on forever.  Even if you’re lucky enough to have a spouse who nails down a specialty with a true beginning and end for training there are still board exams and renewals, CME credits, conferences – and those omnipresent blasted pagers.

When training does come to an end, it’s still all about time.  My husband chose one of the more “lifestyle friendly” specialties.  (He’s a Pathologist, which I maintain is only not part of the ROADE acronym because ROAPED doesn’t sound quite as appealing).  He has minimal (home) call, a handful of weekends a year where he is actually scheduled, and could work 9 to 5, Monday through Friday.  After all, there aren’t a whole lot of Pathologist emergencies.  During training I could count on him being home around 5:30 or 6PM most nights (please don’t hate me).

After training I realistically expected that he would work more than this.  After all, it’s his first year out of training, there’s the ‘adjustment’ to be made, and he’d want to prove himself.   What I didn’t’ realize is that even when the ‘work’ of the day is done:  all cases signed out, on schedule with any projects, talks, research he may be doing … he’d still want to stay at work.  He still would stay at work.  On days where I say “Please try to be home by 6PM so I can make it to X.” Sometimes he does, sometimes he doesn’t.  Originally I thought this was due to a tricky case, or something that had to be finished.  Only recently I’ve come to realize that 9 times out of 10 it’s really because he “got caught up in something” and lost track of time.  Lost track of time?  Please!  My husband is one of the biggest technology hounds I’ve ever encountered.  The guy has an alarm on his computer, his pager, his phone, his PDA … any or all of these could be set to ‘remind’ him he needs to attend to his family (absurd that it doesn’t bother me to think he NEEDS a reminder).  He simply doesn’t do it.  Each and every time he apologizes, swears he’ll try harder, he’ll set an alarm.  He doesn’t see how I can perceive this as a slight towards us.  Of course it isn’t meant to be hurtful, so how can I take it that way?  At the same time he attempts to make me feel guilty because he’s working “for us”.

There’s always a lot of talk about how lives change in the Narnia-like vision of ‘post-training’.  For many, more autonomy over their schedule means more free time, or at least more predictable time.  For most it is the first time in their career that leaving at 5PM  a few days a week isn’t construed as a sign of weakness, but a long-earned reward.  In our household this newfound freedom has only pushed my husband to work more.  It’s finally his choice, so NOW he wants to be a workaholic.  I’ve known the man for nearly 18 years and this is the first glimmer of workaholic I’ve ever seen!  This has caught me totally off guard – not my favorite place to be.

Time management is a hard balance to strike in most families.  Marriage, career and family are truly a juggling act.  While so many non-medical marriages fall prey to the dream of “Happily Ever After”, medicine has pretty much beat that one out of us.   The trap many medical families fall for is “Happily Post-Training”.  Post training life IS much of what I expected.  It just isn’t the cure-all I’d built it up to be in my head.   I blamed so many things on the stress of training, the uncertainty of our future, the politics of his program … what do I do now??

This goes against everything I was raised to believe.  In my family we always said “The most important thing is to establish blame.”  If I don’t watch out I might have to take some responsibility for any relationship short-comings myself.  For now I guess I’ll just blame the dawkter.  He’s not here to notice anyway!