Coping with an absent spouse.

Can anyone give me some suggestion on how they get by when there spouse is on a rotation where they are gone alot? My husband has been working 7 days a week for over 6 mo and I am about to lose my mind.





Thanks



Kris

Wow, I have never been alone with my kids on that kind of continuous basis. You must be strong to have held up this far!!! When I have been alone for a week at a time (when Andrew was out of town), I made sure I could get out of the house a lot. I either went to the mall to buy some good coffee, or I went to the park and let the girls play on the slides and swings. Sometimes I just drove around in the country, just to get out!



Can you get a babysitter in so you can get out on your own? Maybe get more of that on the weekends so your weekend has more slack in it for you, the way it would if Thomas were home on the weekend with you.



I feel for you!

I remember back to my husband's internship year when he was on ICU...which had the most unfriendly call schedule and literally counting the days....and then marking off the weeks...only 3 left, 2 left...halfway there...you know the drill. This is similar, only I can't count down the time...well...9 more months is an awfully long time!



In many ways, I have adjusted to this new schedule....it has become "normal" for us....but when the weekends approach I become upset sometimes...because we don't have that time together anymore to take the kids to the park or go through the mall....or anything. Any family time that we now have starts very late....We pick him up around 7-7.30 pm and then come home or go to Wal-Mart or the grocery store or something.



I can't even remember now what we used to do...or what it used to even "feel" like to have family days....I think that is sad. I ask myself on a daily basis if it is worth it anymore....not the marriage, that isn't what I mean...but the profession.



At night sometimes we will talk about what will be...house, minivan, etc...but in private moments I ask myself if all of the sacrifice is worth the cost to our family and our friendship/relationship.



Sorry this is so long....I am just looking to talk I guess.







Kris

I know exactly what you mean, Kris. At the interviewing stage I wondered too, on a daily basis no less, whether it was worth it. I had fantasies about him moving to wherever and me staying with my great job. Mind you, I was also pregnant with twins, so I had no idea how hard being an actual single parent would be, but I thought about it and it seemed mightly attractive to just get rid of all that stress!!!



We are only a year and a half out of residency, but really only a few months past the stresses of it. Andrew failed his board exams the first time around, so his first year post residency was full of problems: major depression from failing, stress from being a new doc on his own, stress from having the whole hospital where you are a new doc know about your failed exams, and stress about rewriting the exams the following year (you have to wait a full year in Canada to rewrite, and then you have to rewrite the whole thing over, even the parts you passed with flying colors).



So, now that he finally passed last June, we are just starting to

Wow...I don't know...that must have been really stressful for you guys...I can imagine that the board exams will be our next big hurdle too....That must have been hard for him with the boards...but at least he could console himself with the fact that it was a result of the pregnancy, etc....



So you guys moved 2000 miles awawy? How did you all finally decide on where you wanted to move? That is where we are really stuck right now. Did you guys buy a house right away or wait?



I would love to hear about the process.





Kris

Don't know what happened to the last part of my reply above, so here it is again...



-------------------------------

I know exactly what you mean, Kris. At the interviewing stage I wondered too, on a daily basis no less, whether it was worth it. I had fantasies about him moving to wherever and me staying with my great job. Mind you, I was also pregnant with twins, so I had no idea how hard being an actual single parent would be, but I thought about it and it seemed mightly attractive to just get rid of all that stress!!!



We are only a year and a half out of residency, but really only a few months past the stresses of it. Andrew failed his board exams the first time around, so his first year post residency was full of problems: major depression from failing, stress from being a new doc on his own, stress from having the whole hospital where you are a new doc know about your failed exams, and stress about rewriting the exams the following year (you have to wait a full year in Canada to rewrite, and then you have to rewrite the whole thing over, even the parts you passed with flying colors).



So, now that he finally passed last June, we are just starting to "calm down". So, now do I ask myself whether it's worth it? Yes, but not as often. Honest... Andrew seems a little less stressed now, and I cannot honestly tell you how much the exam fiasco had to do with the stresses of moving 2000 miles and starting a new job where no attendings check your work at the end of the day and keep you from making a fatal mistake. It's impossible for me to tease those two issue apart.



What do I see these days? Well, I see a bit more self-esteem coming back because he's not hammered by attendings in the abusive way they love to perpetuate. I see the extra money (just got made partner), having a house big enough to spread around in is glorious, and not worrying about where you are going after residency is nice (last night I was remembering how stressful that interviewing period was, what you are going through now). Kristen, do look forward to finally buying a house. Do look forward to less financial stress. And do look forward to weekends off (hopefully!!!) In the meantime, getting babysitters is a great coping strategy.



So, let's start a countdown for you. What's the exact date Thomas is done? I'll try to send a "YES, ONE MORE MONTH DOWN" message to you once a month!



The time will still fly because you are so busy. Just try to eat well (vitamins can't be underestimated in keeping you strong) and get enough sleep.

We moved from Toronto, Ontario to Alberta. That's clear across the country from the East to West. It cost about $14,000, none of which was covered by the partnership he joined. We had always rented up to that point, not being able to afford the expensive real estate in Toronto during residency.



When we arrived at our new home, we had rented a small town house and squeezed ourselves and all our stuff in. Most of our furniture was piled high in the basement. Good thing about Alberta is the basements are dry, so we didn't have to worry about water damage.



Anyway, our plan was to rent for the first year and then buy a house. We thought we'd see if we liked this city, which neighborhoods we liked, etc. Well, we were here two weeks and decided we couldn't stand renting one more month. So we bought a nice house within walking distance of the hospital. In retrospect, it was the right move, because we decided to stay here. We were able to put 25% down on the house, and even if we hadn't stayed here more than a year, I did the math on it and we still came out ahead with the house and our equity than if we had spent almost the same amount of money on a rental unit.



So, we ended up moving twice in two months with 7 month old twins. And now we are moving again because we found our long-term home. We're going to sell this house and move to a place that's 10 minutes into the country, overlooking the river. Are we crazy, yes. Is it fun to find your dream place, yes! Next year at this time, Kris, you could be moving into such a place. And believe me, it doesn't cost that much more than renting, you just need the bank's approval. We're paying about $1,100 a month for our 2400 sq ft house, when a 1000 sq ft townhouse was $900/month! It will happen for you...

I can't even imagine right now living in a nice house.....I would be pinching myself all of the time too, Lisa. I just can't believe that we might actually be here. I remember when we were finishing up residency....many of the women were buying houses and taking lots of pictures....and I was so envious....I felt like it would never happen for us....I still feel like it will never happen to us. It will be very interesting to see what my perspective is this time next year, won't it!



Thanks for the support, guys.





Kris

[Lisa]

My husband failed his board exams the first time around too. Then he did his fellowship and had to retake the board exams the next year (which was this past July). Every application he filled out for hospital privileges, licenses, everything, asked if you had passed part 1 and he always had to answer "no" and give an explanation for his failure. It was really difficult on him. I can't tell you what we went through to get here without making an *issue* of his failing part 1 during interviews, etc. He even signed the contract with the practice on the presumption that he would pass it the 2nd time around (his partners never really asked about his eligibility status and he never talked about it, hoping that he would pass in July). Then after he retook it in July, we had to wait until the end of Sept. to get the results. The practice was pressuring him for a letter of board eligibility and even one of the insurance companies required him to have passed before he could become a provider. It was stressful to say the least, especially since we had already bought a house and moved here and everything! But, he passed the 2nd time and that was a HUGE load off of us, so I know what you guys went through with that, Janet. Now he has to pass part 2 in a couple of years, but we have 2 years before we have to deal with that.



Kristen, Janet is right. You do have much to look forward to. I went through all of those years of med. school and residency, never really being able to imagine myself in a situation where we were financially well-off and actually having a life, living in a big beautiful house with the potential to make our dreams come true. But, it is here (10 years later, nonetheless) and I still have to pinch myself to make sure I'm not dreaming. I look out of the window of my 2900 sq. ft. house onto the bay at the sailboats and I can't believe it. It was wonderful looking at these big, beautiful homes and realizing the prospect of actually being able to live in and afford one; so exciting and fun! We felt a little crazy and scared for jumping in and buying this house, but we've been here for only about 2 1/2 months and the payments are NOTHING! I've even doubled up on the payments for Chad's student loan, no problem. And like I told you a while back, the banks were bending over backward to give us a loan. The light at the end of the tunnel is there Kris, just look hard and you can see it. All of these years of sacrifice are about to pay off. From where I am, I have to say now, that it was all worth it. Three or four months ago, I could not have imagined it, though. Just hang in there!

Kris, all I can tell you is that even though you can't imagine living in a nice house now, it can happen inside of a weekend! We started looking on a Friday, and then by Sunday had an offer in on our current house. It will happen for you. We went from a rundown house in Toronto (1000 square feet and last renovated in the 1950s) to a newer, nicely kept-up place here.



Lisa, I have never met another spouse who lived through the exam nightmare you and I have. How did your husband respond? Andrew was very, very angry and depressed. It also significantly hammered his self esteem. Wasn't it horrible that your husband had to explain and re-explain and cover up the whole thing when he could? Andrew had already accepted a partnership track job before he wrote the exams, and he had to contact them and tell them he failed. He fully expected that the job was history at that point. We'd already given notice on our rental house, I had already given notice on my job, and our twins were 6 months old. I was looking at the prospect of going back to work full time, putting the twins in daycare, and Andrew was looking at doing a fellowship for FREE (they'd already given all the other spots up for the year, so they said he could "volunteer" for a fellowship). It was pure torture. As it turns out, the governing medical body here in Alberta issued him a temporary license (based on "board eligability" and successfully completing a residency). We bought a house and moved 2000 miles even though he'd not yet passed. He worked for a year, then rewrote. His partnership depended on passing. And if he didn't, we had no paycheck (I had no work here in this new city and was staying at home with my babies), a mortgage, and no possibility of getting another job with any other group in Canada (you need your exams). So, we were looking into moving to the US. In 40 of the states you don't need your exams, just to be board eligible. So, we thought, "forget it Canada" we're outa here.



Waiting for the exam results the second time was so stressful it was surreal. Luckily, we only had to wait three days, and then the results were posted on the Internet. Andrew was thoroughly convinced he'd failed again, and he convinced me too (I wasn't there, how would I know!). So, we braced ourselves for the worse. I wouldn't want to go through that again. The pressure coming off us when we found out he'd passed was hard to believe. In fact, we didn't really believe it for a few days!



I have to say in the end the whole thing very much injured my husband. And it's hard to know if it's permanent. What was your experience?



Janet

[Lisa]

Well, the best word for my husband's feelings about failing part 1 was *embarrassed*. He was just so ashamed and felt incompetent. He thought that others would also view him as incompetent when/if they found out. It really bruised his ego. But, he had already accepted the fellowship and we knew that he would be doing that for the next year until the boards came up again. Although, going on interviews during that year was tough, wondering if the issue would come up and how he would explain himself and knowing that he would not be wanted if his interviewers knew. Here, you can practice without passing the boards, but you are not viewed as being "up to par" if you have not passed. The hospitals here give you 5 years to become board certified (which is a process where you have to pass part 1, be in full-time practice for 2 years before taking part 2, fulfilling all of the requirements to take part 2 and then passing it). So, now that Chad has passed part one, he has 5 years to pass the part 2 exam, which is an oral exam. When Chad was offered contracts from the hospitals here, one of them required that he already have passed part 1, the other only said that you had to be board certified in 5 years, so we signed the 2nd contract (which was a better contract anyway), then (Kristen can tell you this) it is a LONG process to get a FL license. Chad is licensed in 4 states and FL was the worst to get one. You have to fill out EXTENSIVE paperwork and send off for all types of correspondence and Chad had to explain why he had not passed his board exam. Then, when filling out the paperwork for getting credentialed at the hospitals, he had to explain again, all this time being totally embarrassed about having to answer that question and wondering what they would think and if they would still give him privileges. Then, after jumping the HUGE hurdle of getting a license here, he had to fill out paperwork to become a provider with the insurance companies and again on every application had to explain his eligibility status (on those, it just asked if you were board eligible and he would check "no" and say that he was taking his boards in July). The practice manager started asking for a letter of board eligibility for certain applications and Chad just told her that he wasn't board eligible, that he was taking his boards in July and WOULD BE board eligible after that (he never told them that he had taken the boards and failed once already, but he did have to say that he had failed on his license app. and hospital privileges apps. The practice never saw those.). Then we bought this house! (crazy, huh? But we were jumping in with both feet following our dream). Then, after we moved here, they finally hammered out the contract for the practice and it included the requirement of having passed part 1 in order to be in the practice, never having asked or having Chad tell them that he had failed last year. He signed it before we had the results hoping that he had indeed passed. Janet, when Sept. came, I could not even function because I was so worried about those results. I just wanted to sit at the window all day and wait for the mailman to come. I paced the floors for 3 weeks before those results came! I even called the board to find out what was taking so long! At one point Chad told me that when the results come in the mail, not to open them until he gets home and I told him that he had to be crazy. I had been in agony and when that envelope comes, I'm tearing into it. When those results came, I just thanked the Lord God. I think I got a couple of gray hairs over that. When we woke up the next morning, it was like, we could breathe and live and everything was OK.



Now, my husband is fine. He doesn't have any long-term effects over failing. He put all the old wounds behind him when he passed and it was easy since he never had to tell his partners that he ever failed it. When part 2 comes, he's going to take whatever the best review courses are and he's going to put everything he has into it so that he passes it the 1st time. I think he'll do better the 2nd time. In the oral exam, you have to present 10 of your cases, they ask you questions about those cases and others you've done to see if you are competent enough to be certified. I think that one will be better because it is obvious that he is a good surgeon, just sitting down taking a written 300-some-odd question test with these grueling questions that have more than one answer is excruciating. You can be the best surgeon in the world and still not do well at that.



Anyway, as far as your life changing over night, that has been our experience too. We went from a tiny, 50 year old little dumpy house to this big brand-new house on the bay literally OVER NIGHT! Our income went from the bottom of the scale to the top over night. There are not many professions where that happens. When Chad walked in the bank to open his business checking account here, the CFO came out to meet him. You just wait, Kristen. And when it happens for you, we'll be here cheering you on.

I guess the process here in Canada is a little different. There isn't a two part system of exams like you describe. There's just one set, three days long, that includes the written (bell curved), the OSCE, and the oral. If you fail the oral, you fail everything and need to rewrite everything the next year. When Andrew failed the first time, he failed the oral, but passed the other components. He fell apart because of an agressive examiner that rattled his composure. He was too upset to think clearly after that and it spiralled down. I think he should have passed the first time, as he was prepared, even though we had the twins months before. In fact, I moved to my mother's house an hour away for three months just to help him prepare better for the exams. We moved home the day after the exams.



Anyway, he had to rewrite the whole blasted things again, not just redo the orals. The orals are three hours long, and they can ask you anything. You have no idea what they'll ask. They tend to pick esoterica that you'd never see in a real practice. In fact, there have been articles written by recent residents saying the radiology exams are unduly tough in Canada. Many Canadian residents also write the US exams, just to keep their options open. In general, the feeling is that the US exams are longer, but more reflective of real practice situations. Therefore, more fair. Also, the failure rate is lower. They actually failed 20% of the radiology residents the year my husband wrote. And there's a shortage here in Canada! Many of the radiologists were furious at the Royal College of Physicians and Surgeons of Canada (the exam body).



All in all, it was an unfair exam, and the cases were really wishy washy. There was one case where the examiner was asking things and wanting one answer. My husband, having just worked in Toronto with a leading radiologist in that particular field told the examiner that there are two answers and that the films didn't give enough information to go with one answer or the other. The examiner didn't accept that (they didn't have as up-to-date knowledge), and they failed him on that case. Stupid, stupid, stupid!!!



Having passed now, my husband's resolve is to get involved with the college and somehow, someday to make the exam process better for residents. He said nobody should have to go through failing under such dubious circumstances.



Sounds like the whole process is much more human and forgiving for you down in the US...



Janet

[Lisa]

I do think that it is more fair here. I think that the Orthopedic board really works with a lot of doctors and other experts to try to make the boards fair, but yet make sure that the doctors have to maintain a good knowledge of the field. They really go through the questions to make sure they make sense and are fair. They still end up removing around 20 "iffy" questions after they take the test. Of the 778 candidates that took the part 1 orthopedic boards this year, 616 passed. As far as part 2 goes, I don't know how they go about regulating that and what the examiner asks.