Can I Rant?

[MrsK]

Not that it doesn't suck sometimes (a lot of times). We all come here to vent at times like that. I'm sure every person here has numerous stories of occassions when the doctor spouse was unavailable when they really needed to be there. Medicine doesn't care if the kids are sick or it's the holidays or there is a funeral. Medicine is a selfish beast gobbling up doctor spouses.

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[Meenah]

I'm so glad you were able to make it. Can I just say "I love you all"!!!!!!

[MrsK]

I'm so glad you were able to make it. Can I just say "I love you all"!!!!!!

Right back at ya

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[Jim in Virginia]

I can understand why employers would want complete devotion, would want to "own" their employees, and how an ethos can develop within a profession. But it doesn't take a great deal of thought or observation to realize that doctors can't give their full attention if their spouses are miserable. My wife sees this; she has said she always has a lousy day at work if I am unhappy, and a good day when we are close and working together well. Unfortunately, that has not yet produced a lasting commitment on her part to focus her attention outside of work on our relationship and our family; her attention still turns to her friends far too often, her addiction to her phone continues. This intern-year misery of spouses is no secret, so why don't the programs provide a couple of hours of instruction on how to minimize the misery?

[TulipsAndSunscreen]

Because they’re busy cramming thousands of hours of actual medical knowledge in their heads until it’s reflexive.

We’d all love more sensitivity training. But just like any other very intense job (the military, intense business careers, corporate lawyers), the job doesn’t care about your personal life, they want you billable. For every hour of the intern labor they lose, they have to pay someone else and much more to cover it.


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[MrsK]

Unfortunately, that’s the reality of medicine. Actually, it’s the reality for a lot of professions. But doctors especially have to be able to set aside their personal lives to focus on their work.


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[WolfpackWife]

I'm convinced some of the more malignant areas of medicine view families, spouses, children, and non-medical obligations as liabilities. There's a reason the divorce rate for medical marriages is higher than the normal population. In theory, wouldn't it be lovely if administrators and faculty cared about a doctor as a whole person...but that's not the reality. You're just lucky if you land in a program or a job that has less of that malignancy than others.

[Jim in Virginia]

Yet productivity suffers when residents don't know what they should be doing to keep things calm and well-functioning at home. An hour or two during orientation, before the residency starts, might pay off in dozens or hundreds of additional hours devoted to the job rather than to putting out fires at home. Other industries have recognized this and adopted more family-friendly policies. And there are some efforts residency programs make, such as inviting families to any social events for the residents. But apparently they don't recognize that many married residents might need some explicit discussion of what the impact is going to be on their spouses and what they can do to make their home lives as happy as possible, or maybe they see that this could be beneficial but don't know how to go about arranging it. I imagine some people in this forum could write up an excellent script for persons who would lead such a discussion.

[alotofyarn]

I think ultimately, they just don't care if med students, residents, and attending physicians have a well-functioning home life. Maybe things will change as the older generation starts to retire and the whole "this is the way we've always done it" mentality starts to fade, but I'm not optimistic. We know that they're happier and more productive at work if they're happier at home, and I'm sure there is science behind it, but mostly it just doesn't matter. J was upset last night because I asked him not to take the late case but to let the on call guy do it so that he could come home and I could go to a ballet class I've been wanting to attend. He thinks it's going to make him look bad. But there was no useful way for me to respond and remind him that I turn down work ALL THE TIME, frequently to the detriment of my own career, because I have a commitment to my family. I don't get judged for it, and he shouldn't either. It's such a stupid double standard. So I just kept my mouth shut and told him that I appreciated that he made that choice so that I could do my thing. I needed it for my own sanity, which also makes me a better wife, mom, and worker, which allows him to be a better worker.

[WolfpackWife]

Yet productivity suffers when residents don't know what they should be doing to keep things calm and well-functioning at home.

I actually don't think this is true at all. Residents have to function and be productive, no matter what. I think one of the demands of medicine is to be able to completely shut out what's going on at home, regardless of what that is. We don't have children and my husband is incredibly attentive and involved on our household and our relationship when he can be but as soon as he leaves the house, anything we have pending, anything we need to take care of, anything we've had strife over...is forgotten or at best, put on the back burner until it can take up space in his brain again. I've learned that lesson over and over again and I've recalibrated my expectations as necessary. They are productive and functioning because they have no other choice, not because their home lives are organized and calm. If strife or disorganization at home negatively affected residents to the point where they couldn't be productive, they'd wash out of programs pretty quickly, I'd imagine. It's all part of their uncanny ability to compartmentalize important "life things" over the course of training, I believe.

[rufflesanddots]

I think there is a growing push to promote/protect resident mental health. It's slow going and difficult to implement, and some programs are probably more sincere than others, but maybe interpersonal stuff will get folded in.

Jim, I agree with you but I don't think an hour or two information dump in orientation will fix it. It takes effort, time, and practice to learn and use new communication techniques (or even admit your relationship needs them). Add that task to the 80+ hour weeks of residency life and the partner's/family's commitments, and it's easy to see why this is a pervasive issue.

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[Jim in Virginia]

"I actually don't think this is true at all."

Not true "at all"? Perhaps you haven't had as much turmoil at home as we have had, precisely because your husband is "incredibly attentive and involved" in your household and relationship when he can be. I don't know if your experience is the norm, but I am happy for you. I wish it were my experience; I would be very happy. My guess is that there are many married doctors who are not incredibly attentive to their spouses when not working, and some who are quite indifferent. For all, or nearly all, I think residency imposes substantially greater demands on their time than their pre-residency commitments did (my wife's work commitment went from 0 to 80-90 hours/week), and that means they need to be very mindful of how they spend what little time they do have outside of work, giving first priority to their spouses and children (if any), and that will likely mean giving up some things they used to do with their free time (e.g., socializing with friends, entertainments). Your spouse seems to have understood that, or simply was naturally inclined to do that, without explicit discussion. My wife does not get it, and as a result we are not functioning well and her work is suffering. Yes, she functions, she gets through the shift, but her energy and enthusiasm are diminished. I can tell her innumerable times and in various ways that I need her to be focused on me and the kids outside of work, rather than on her friends, and that my needs have changed as a result of the residency and relocation, but I don't know if she will ever really get it unless she hears it from some outside objective party. A marriage counselor could help, but what resident has time for that?? It seems to me it would be more efficient for the programs to do something proactively to get new residents' heads in the right place in terms of family life before they even start.

[WolfpackWife]

"I actually don't think this is true at all."

Not true "at all"? Perhaps you haven't had as much turmoil at home as we have had, precisely because your husband is "incredibly attentive and involved" in your household and relationship when he can be. I don't know if your experience is the norm, but I am happy for you. I wish it were my experience; I would be very happy. My guess is that there are many married doctors who are not incredibly attentive to their spouses when not working, and some who are quite indifferent. For all, or nearly all, I think residency imposes substantially greater demands on their time than their pre-residency commitments did (my wife's work commitment went from 0 to 80-90 hours/week), and that means they need to be very mindful of how they spend what little time they do have outside of work, giving first priority to their spouses and children (if any), and that will likely mean giving up some things they used to do with their free time (e.g., socializing with friends, entertainments). Your spouse seems to have understood that, or simply was naturally inclined to do that, without explicit discussion. My wife does not get it, and as a result we are not functioning well and her work is suffering. Yes, she functions, she gets through the shift, but her energy and enthusiasm are diminished. I can tell her innumerable times and in various ways that I need her to be focused on me and the kids outside of work, rather than on her friends, and that my needs have changed as a result of the residency and relocation, but I don't know if she will ever really get it unless she hears it from some outside objective party. A marriage counselor could help, but what resident has time for that?? It seems to me it would be more efficient for the programs to do something proactively to get new residents' heads in the right place in terms of family life before they even start.

Actually, I'm not always a big fan of how my husband has compartmentalized some tings. It's just happened because that's what the job demands. I'm not saying any of that to act like we haven't had turmoil - we have - but my husband's productivity hasn't (to my knowledge) been affected by whatever has gone on in our home, because he just can't let it (or doesn't). The job just won't allow for that external stress and strife to affect him. And maybe that's just him. In fact, I'd argue that I have WISHED a few times that our "life stuff" that plagues me during the day, that is all on MY PLATE would crop up in his mind a little bit, but I am very, very doubtful that it does. And when he comes home and has clearly forgotten things we've discussed or need to discuss, it's frustrating. This isn't necessarily a good thing, but at least in my household I don't think our cohesiveness or lack thereof is something that determine his productivity for the day. His ability to be in a "good mood"? Maybe. But I would think that would be the norm for most doctors, because you just can't bring that shit into work with you - and if you do, the job is so much that it easily allows you to push it to the side. But everyone is different!

[MrsK]

"I actually don't think this is true at all."

Not true "at all"? Perhaps you haven't had as much turmoil at home as we have had, precisely because your husband is "incredibly attentive and involved" in your household and relationship when he can be. I don't know if your experience is the norm, but I am happy for you. I wish it were my experience; I would be very happy. My guess is that there are many married doctors who are not incredibly attentive to their spouses when not working, and some who are quite indifferent. For all, or nearly all, I think residency imposes substantially greater demands on their time than their pre-residency commitments did (my wife's work commitment went from 0 to 80-90 hours/week), and that means they need to be very mindful of how they spend what little time they do have outside of work, giving first priority to their spouses and children (if any), and that will likely mean giving up some things they used to do with their free time (e.g., socializing with friends, entertainments). Your spouse seems to have understood that, or simply was naturally inclined to do that, without explicit discussion. My wife does not get it, and as a result we are not functioning well and her work is suffering. Yes, she functions, she gets through the shift, but her energy and enthusiasm are diminished. I can tell her innumerable times and in various ways that I need her to be focused on me and the kids outside of work, rather than on her friends, and that my needs have changed as a result of the residency and relocation, but I don't know if she will ever really get it unless she hears it from some outside objective party. A marriage counselor could help, but what resident has time for that?? It seems to me it would be more efficient for the programs to do something proactively to get new residents' heads in the right place in terms of family life before they even start.

I’m not saying that you are wrong, that things should be different. But what you are describing is not unusual for for a medical marriage at all. We are 4 years beyond residency and we still have problems with time management, exhaustion, priorities. While it’s not fair and it’s definitely not good for families, this is a reality for doctors. Especially during intern year, they basically eat, breathe, and sleep medicine and there is very little left. They are exhausted and I’m constantly frustrated that my husband is not “present” in a meaningful way when he’s home, snoozing on the sofa and roaming around like a zombie. I’m sure everyone here has a million stories, especially those members who have been on this forum for decades, about how unaccomidating medicine can be. We really do all just take what we can get.

I mean, we have spouses who have literally missed the birth of their children, funerals for close family members, countless birthdays, holidays, school recitals, family vacations. Once, when my children were small, my husband was unavailable for family portraits. It really takes a lot of patience, independence, and sacrifice from the medical spouse.

Of course, we don’t all martyr ourselves. We come here to vent. We will all gripe about how ridiculously unfriendly this profession is for families. We rely on other medical families to help us when they can. We have a motto here that is ‘medicine is not a pass to be an ass” however. Meaning, that the doctors can be oblivious, exhausted, unavailable, overwhelmed, etc. but they can’t be jerks. Neglect is an occupational hazard but abuse is not permitted.




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[MrsK]

Actually, I'm not always a big fan of how my husband has compartmentalized some tings. It's just happened because that's what the job demands. I'm not saying any of that to act like we haven't had turmoil - we have - but my husband's productivity hasn't (to my knowledge) been affected by whatever has gone on in our home, because he just can't let it (or doesn't). The job just won't allow for that external stress and strife to affect him. And maybe that's just him. In fact, I'd argue that I have WISHED a few times that our "life stuff" that plagues me during the day, that is all on MY PLATE would crop up in his mind a little bit, but I am very, very doubtful that it does. And when he comes home and has clearly forgotten things we've discussed or need to discuss, it's frustrating. This isn't necessarily a good thing, but at least in my household I don't think our cohesiveness or lack thereof is something that determine his productivity for the day. His ability to be in a "good mood"? Maybe. But I would think that would be the norm for most doctors, because you just can't bring that shit into work with you - and if you do, the job is so much that it easily allows you to push it to the side. But everyone is different!

Yes. Exactly. Doctors really don’t get to have a bad day. They cannot afford to be preoccupied because the cat died, the kids have the chicken pocks, and their spouse is annoyed with them. Just consider what you need when you are seriously ill, what you expect from your surgeon. You need your doctor to be able to set aside her own drama, roll up her sleeves, and get the job done.


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