What should I say?

[peggyfromwastate]

My husband is trying to decide what to be when he grows up. He really loves surgery-- especially ortho. When he came home each day during his ortho rotations he was animated, excited, happy... When he came home after Family Practice, Psych, and Internal Med he was somewhat interested, but definitely not excited. He is really struggling with lifestyle vs. what he really wants to do.

He knows that he wants to be a surgeon. It seems that the only surgery that lights his fire is Ortho. His second choice is ENT, but he doesn't like how detailed the procedures are, and how "teeny tiny" the instruments are. Being in the military, Ortho is one of the worst specialties to go into. I want to be supportive, really, but this is a huge deal and I'm just not sure what to do. I kind of think that he has to do what he loves, but of course I'm worried about lifestyle and all that.

So I was really wondering what I should tell him? He asks me for advice, and it's almost like he wants permission to go into Ortho. I have told him that he needs to do what he is meanto to do-- or else he won't be happy... But then again, if he's deployed for 6-8 months out of every 2 years, and when he's stateside he's working 100+ hours, does being "happy" in his profession outweigh the bitterness the kids are surely going to feel? It is really hard to get perspective on this kind of thing when you are choosing a specialty, I think...

[Vanquisher]

Do a search for my posts. Read them. Show pertinent ones to your husband. Have a talk. Reassess.

If you want to talk about this more, pm me, and I will gladly call you or you can call me and we can discuss this. I can't possibly list all my feelings about this in one post.

[SuzySunshine]

I always get to play the "do what they love" wife. My DH is in neurosurgery (group groan), but he LOVES it, he also thought about ENT but couldn't get in to it. I know our life is hard and I know that it will get easier, though not much, after residency. But I'm one of those people that never found my true calling and therefore if you have I truly beleive you should jump on it.

With that said, I don't know anything about being a medical doctor and how that affects things. Are you committed to the military for 4 years or for life? Good luck, there are a lot of posts on this board that will give you some great insight.

[DCJenn]

Peggy-

The plus to ortho in the military is that he'll be literally at 'the cutting edge" (pardon the pun) of what is new. They are desperately needed since Iraq is blowing off more body parts than actually killing people. (Neurology is next door to ortho at WR- ortho takes care of the body and neuro handles the heads!

Mac will owe seven years- so the chances of him being deployed are well, let's just say, better than average- but the chances of him bein gdeployed in any specialty are better than average. Seriously, the only specialty that I am aware of that the Surgeon General has said that there is no need to deploy is Child Neurology (and Rick isn't exactly thrilled about that as it'll impact him long-term). But, it's more likely that since he'll have years of training ahead, that this will be overish before he's done. He may have to backfill but that's not likely while in training.
I don't know of any Army people deployed mid-training. (one AF ER doc but that's because she was first trained as a surgeon and switched gears)

So, the question really becomes lifestyle- and there are some advantages to specialized training- like you won't be sent to po-dunk. But surgery is still surgery. It will have an impact on your family life. Rick has a friend from medical school who is starting a surgical fellowship now- let me do some research and I'll let you know what the scuttlebutt is on that end of things.

Jenn

[Flynn]

Peggy,

Like Heidi I have some strong opinions on surgery (ya think??). We have come out of it with our marriage intact and are looking at life post residency now --- but many many many many many (ok I digress) other people we know have not. We are one family who made it through (or close enough) but we did 4+ years of residency without kids. Your situation will be very different because your children are older.

Read my past posts. PM me if you want. Have your DH PM me!!!!! I will even give you my home phone # if you think that would be helpful. That would be better actually -- he needs to know first hand from SPOUSES and not from the docs what living this life is like. Maybe then his "love" for ortho will be put into perspective.

Loving what you do IS important. I feel very strongly that it isn't the only consideration and your children are old enough to miss the void their father WILL leave if he goes into surgery. It's hard on the spouse -- it's MUCH harder on the kids.

Doing "the surgery thing" with no kids is challenging -- best case scenario. I think it goes into a whole other league when you have children.

I feel very strongly that a surgery residency tests every bond you have. IF he chooses surgery your marriage will be strained and tested to the fullest, parenting will be tested, the children's love for their father will be tested....and it goes on and on and on and on. Is he ready for that? Are you ready to support THAT kind of a decision? If you are, go for it. If not -- start talking with him NOW about what this will mean for YOUR FAMILY.

Ok, I'll stop.

Annie? Kelly? Lori?? Anyone want to pick up here?

I cannot stress what a HUGE decision this is.
Research your fanny off before you give him the "go" on this. PLEASE.

PLEASE use me as a resource to ask further questions. It is IN NO WAY an imposition.

[planet]

I don’t quite know where to start. A lot of good points have been posted regarding specialties and ‘doing what you love.’ The emotional part of me wants to scream “Run, fast! No Surgery, No!” while I have to somehow write a more coherent explanation. We are now past halfway through internship year. I can’t speak at all to the military aspect, just internship.
Some realities that I am sure Heidi and Flynn can portray very well are that
1) You WILL be a single parent!
This means that when you are sick and the kids are sick you will very likely not be able to rely on your husband at all to pick up slack.
2) There will be stretches when your kids will only see their dad if they stay up late, but then dad will probably be too tired or busy to pay much attention to them. If you end up having the kids, especially younger ones, asleep around 7ish then there will be stretches as long as a week when they will not see dad at all. Be prepared to hear comments like “Dad lives at the hospital.” And “Will dad visit us today?”
3) Loneliness abounds. Forget about companionship for most of the rotations. I’m sure everyone has their adaptive habits. I have becomes SO much more selfish over this year as a result of basically having to meet all of my own needs. In fact, recently when my older ds had an ear infection and we were at the peds I answered, “Oh I gave him to dh at 1 am so I slept well most of the night” before I realized that he was asking how my SON slept!
4) Sex, um…let’s just say if he isn’t a WBTYM before he will be during internship.
5) If you don’t have a ‘functional’ relationship I don’t see ANY hope. Dh and I have a pretty good (preinternship) relationship. This year has tested so many aspects. We’re still together and still love each other, but resentments are there now.

I don’t think it should be about putting your foot down or giving permission. I think some probing questions are more appropriate. Perhaps asking your husband what about Ortho turns him on would help lead into looking at other specialties. He can set up rotations to see how he likes them. He should definitely read the posts here or talk to others who have gone down that road. Dh just finished working with a surgeon who he says is passionate, talented, truly extraordinary…and on divorce #4.

[planet]

Sorry to be so pessimistic. Tough times lately. These points naturally refer to our experience so far. I’m sure some handle it better than others.

[SuzySunshine]

Dh just finished working with a surgeon who he says is passionate, talented, truly extraordinary…and on divorce #4.

I'm sorry but that's just not fair to throw out there without knowing anything but that.

Don't get me wrong you should be having a frank conversation with your husband about all of this but at the same time you guys have to make the decision that is best for you. I knew what I was getting into when my DH chose his specialty, it has the highest divorce rate of surgical specialties. I don't have kids, I don't stay home with kids so I have my own life, I have my own job, I have my own friends. There are evenings when I'm home and DH isn't here but its not the end of the world, for me. With kids in the picture it would be worse, I'll admit that but I still beleive that this has to be a decision the two of YOU make. I hate to say it but the negative stories come out on this board a lot more than the positive ones. I have several ortho friends, with and without kids, that are surviving through residency and their marriages aren't anywhere close to divorce. Take everything here with a grain of salt because everyone's sitation is different. Good luck.

Perhaps asking your husband what about Ortho turns him on would help lead into looking at other specialties. He can set up rotations to see how he likes them.

Very good advice!

I hate to say it but the negative stories come out on this board a lot more than the positive ones. I have several ortho friends, with and without kids, that are surviving through residency and their marriages aren't anywhere close to divorce. Take everything here with a grain of salt because everyone's sitation is different. Good luck.

Us? Negative? Oh, Cheri -- I'm hurt!

[planet]

Dh just finished working with a surgeon who he says is passionate, talented, truly extraordinary…and on divorce #4.

I'm sorry but that's just not fair to throw out there without knowing anything but that.

Cherie,
You’re right. It was a low blow and not fair to throw in, just indicative of my mood. My MIL is on divorce #6 and she has no profession.


I think that's why I am so sure my dh wants to make our marriage last!

[twinsmom]

Just a little chime in - if surgery is in his blood, have him take a peak at Derm Surgery. For three years in med school, dh was positive he was going into neurosurgery. He would look into other specialties, but there would be points that he wouldn't like about them, so come back to neuro. He spent some time with a neurosurg, and for the most part liked it, but also found some mundane things in it as well, but was still going to go for it....
Fast forward to 1 month before ERAS opens, and I get a random call on the answering machine from DH saying, "I've been thinking, maybe I'll go into derm..." . I can't really remember the rest of it, I was busy scooping my chin off the floor. When we sat and talked about it, he said he got a chance to shadow a dermatologist for a while and was COMPLETELY fascinated by it, especially the Mohs surgery part (yes, there is a WHOLE surgery specialty in Derm!).
Of the two of us, I was the one who questioned him more because I was afraid he would still want to gravitate back toward a more "meaty" surgery field... but the more he has gotten into Derm, the more he LOVES it!! It has everything to satisfy his surgery genes, and the lifestyle to satisfy the family (although, there is a LOT of research that goes on, so when they give the hours in the hospital per week (about 40) and you start to jump for joy, you have to remind yourself that this doesn't include all of the research/reading time, which usually equals out to most other residencies...).
Well, just my 2 cents. I won't weigh in on the 'gotta do what they love' debate, I am really up in the air about that one... plus I'm mad at dh right now, so my view would be a little slighted now anyway :argue: .
Good luck with the decision!!

Jen B.

I agree with Jen B. She summed it up well. I would add that the research time is softened by having a (usually) well-rested spouse. I don't know about the military angle of it. I think DH has met military derm residents working in non-military residencies (and that is about all I know).
One thing to consider, though, is that the Mohs field is filling up. There are still jobs to be had but less geographical flexibility than before.

[Rapunzel]

Another surgery-ish subspecialty to check out is interventional radiology. They tend to do all the cool, new, "innovative" (ie often experimental) stuff with cool gadgets/weapons (well, they often look like weapons to me ). It requires a relatively relaxed five year rads residency (relative being the operative term there) and then a more intensive two year fellowship. IR attracts the surgery types that are interested in bringing in a ton of money and who still want to have somewhat normal family lives. The caveat is that they do tend to have surgery hours, but, on the other hand, the residency isn't going to destroy your family.

[peggyfromwastate]

Thanks all! I will look into the other posts. I know that I have missed out on a ton since I've been in dial up land...

I really did resent my dad as a kid for his schedule, but not so much now. He is a chronic workaholic-- way more than necessary for an ER doc. A sane ER doc can still be really involved in their family's life... My dad took extra shifts, etc. so he really wasn't that involved, and my mom resented it, blah blah...

From what I know about the Ortho residency in the military, the hours are "a lot better" since the gov't imposed the 80 hour residency limit (this is what the interns thru chief resident told DH when he was rotating); I've heard that the miliitary residency programs are better about sticking to the 80 hour week. I kind of look at it like a really "sexy" surgery-- so fast paced/big tools/etc. I think he's being lured in... He says he "loves surgery" but then he was really bored in ENT and complaining about how long the surgeries lasted, and he really liked the clinic days. On the other hand, he didn't really like clinic in ortho, but the surgeries were "so awesome".... We clearly have a lot to talk about on this topic, but now he's in inpatient surgery and he has call and is working 36 hour shifts...

Anyway--- I have some research to do! Thanks everyone!