What should I say?

[SueC]

Peggy--how in the heck are you?!! I've been wondering about you!!
I'm one that says let them do what they love, but I'm not a surgery spouse, and I know that is very different. We had some pretty bad months, and year three of fellowship was the worst year in our marriage by far, but we made it through.
Heidi--don't quit posting! You aren't bringing the board down, that's what we are here for.

Dear Peggy,

My husband chose surgery initially, after med school, because it very much fascinated and excited him, unlike any of the other things he had seen/done during his medical school rotations. At that time, we were pregnant with our first child and though we had been warned repeatedly about the challenges involved, we had no real idea what it would really be like. Well-----for us, it was often hellacious. We went in optimistic and ready for the challenges to come..........but we just couldn't predict or imagine how very, very, very difficult it would be to maintain ANY type of healthy family lifestyle. We thought we could do it....we were sure of it!!!!!! We had 3 babies during the first years of surgery and dh's workload was incredible. The only times we saw him were when he was completely exhausted........otherwise, he was at the hospital. He left every morning before the kids were up and returned home after they had gone to bed. He missed all their first milestones and was often too drained to fully appreciate them anyway. All 3 of my pregnancies were high risk, resulting in one preemie and 2 long bedrest episodes. Two of our babies required extended NICU stays and surgeries during that time, too. Since we had no family supports nearby, dh took a family medical leave of absence from the surgical program to help me out with our last pregnancy there (10 weeks of bedrest and later 2 surgeries for the baby). It was the first time other than on vacations when he was able to sing his toddlers to sleep at night and take them to the park and attend preschool events and reconnect with our religious community (that had always been a significant part of his life) and give me his focussed and awake time and attention----not to mention actually doing some housework and cooking for the first time since starting the program.

He was a different man than the one who had left medical school, so hopeful and looking for hard and interesting surgical cases and for his skills and knowledge and endurance to be tested to the max. He no longer needed that adrenalin rush or to push himself to his limits. He had always been very interested in radiology and very much enjoyed looking at the films with the radiologists before doing his surgeries. In the past, he had found some things on the films that the radiologists had missed, even----as he discovered he had a keen eye and intuitive abilities in this specialty and greatly related to the radiologists. He left surgery, before our 3rd child was a few weeks old and has never gone back since. While he sometimes misses the thrills of the surgical experience--------the actual practice of surgery during a residency and beyond-----are often far from thrilling........and often at the expense of everything else that is dear in one's life. I know couples/families who made it through........and there are some on this website as well who are managing alright........but it is not for someone who wants more balance in their lives and some degree of flexibility in their lifestyle choices. It is EXTREMELY hard to go through a surgery residency and maintain a healthy/strong family, especially if you already have 4 kids. It is EXTREMELY hard on EVERY family member who lives this lifestyle---overall. It can be done. But my best advise to you would be to very strongly help him consider all of his options and realize that surgery is not as thrilling or glamorous when you are on a Q-2 call schedule and up all night, starving, getting cramps in your hands from holding instruments for hours and have to wait 3 more hours until you can get a chance to pee, before heading back into the OR for more fun......not remembering when the last time it was you had more than a few minutes to speak with your spouse before falling fast asleep midconversation.

[peggyfromwastate]

Dear Peggy,

but it is not for someone who wants more balance in their lives and some degree of flexibility in their lifestyle choices.

I think that this fits my husband. He really does want balance and he wants to be a "good dad". I think he is a bit optimistic about surgery! He thinks he can have it all!!! We're having discussions, but he's out of it right now coming off of working 36 hrs...

He really confuses me b/c he doesn't dislike IM, even though he gets tired of all the hypertension, etc. and he actually really likes pulmonology but doesn't know if he could stand going through 4 yrs of IM followed by a podunk assigment until he could "qualify" for a military subspecialty fellowship (they kind of have to wait in line...).

He didn't like Psych and he wasn't crazy about FM, but he liked the variety at least.

I think he could be happy with EM or with IM, if he would just give it a try! Tonight I told him that if he goes into ortho, his kids will most likely really really resent him by the time he gets out (just in time to be deployed) (actually I said that they would hate him... probably an exaggeration...) and that made him think a little bit!!! We shall see...

I really appreciate all of your opinions!!!

Thank you so much!!!

[PrincessFiona]

Re: Recalling an old joke...

You could tell him there will be sex in the house at 7pm every night, whether or not he's there.

That ought to make the decision easier. :>

Woohooo...I think I'm moving to YOUR house! :> Will Sven be there?

kris

[peggyfromwastate]

Anyway, so now he is set on ENT b/c it is much more family friendly and it is still surgery. It has been a whirlwind... ENT basically means one bad year (surgical intern) followed by 4 decent years (I guess the residents here at Walter Reed generally work about 60-70 hrs per week) and then it should be really nice after that...

I almost feel guilty about him going into ENT, even though he says it is interesting, because that's not his "true love". Maybe I have a martyr complex... Anyway, when I look at him objectively I think he'll be happy with ENT, and I know he'll be much happier to be home more than ortho would allow. So I'm happy with ENT, he says he is happy with ENT, now he just has to get into the program.

[houseelf]

Peggy,

Now that I've calmed from my "Surgery Jihad" I want to give you a little more rational insight. If he is o.k. with ENT, I would strongly suggest encouraging it. Again, if your hubby can be happy doing ANYTHING at all besides surgery, he should do it. Seriously, your kids will have known a life with dad and thus a life without dad will be a.... challenge. It's funny because I used to think being alone with an infant as a new mom was hard because I was struggling with the pressures of marriage, parenting, surgery residency, etc.. Now, I think I'm better equiped to deal with all of the above, (REALLY) but it is harder because I have to rally for my kid and do my best to not screw him up (anymore than I probably will anyway).

To summarize , surg sucks for the spouse. Unfortunately, my last post centered too much on this facet. To give a more complete accounting, it SUCKS balls for the Surgeon too. Really. DH used to ride his bike, read about history, play darts and take in beers with the boys. No more. Sadly, he has gained 30 pounds, has one male friend outside of the residency (which I introduced him to), rarely does anything just for fun, never goes to church or even ordinary places like the grocery store. Basically his life is fairly one dimensional because that is what this path takes.

As far as the kids go, you know them best. Kids' reality is whatever we make it. You could uproot them and take them to a grass hut in Botswana and they'd cope with the adventure far better than the adults. On the other hand, there WILL be missed Christmas mornings, missed birthday parties, ER visits without one of their parents, absences from major school and religious functions, and just general down time with the surgeon parent. Even if the surg. resident *really* makes this his or her goal, the kids come second to the needs of the service. Each human being only has so much to give.

Perhaps the military is different. Maybe they have sorted this out better. Although it is unpleasant, any would be surgery family needs to hear from those who have BTDT in no uncertain terms what they are possibly up against. I hate sounding "victimized" because there is so much good in my life. However, this set of circumstances didn't arise because of some random, tragic event like a 747 slamming into the WTC, a freak fall from a horse rendering him incapable of participating fully in the family, a drug addiction, or even a messy divorce. We deal with the far reaching ramifications of this choice every day because this is his greatest passion in life. It is a very, very delicate dance to negotiate and I want to give as much fair warning as possible to those who are considering this path.

Kelly

Anyway, so now he is set on ENT b/c it is much more family friendly and it is still surgery. It has been a whirlwind... ENT basically means one bad year (surgical intern) followed by 4 decent years (I guess the residents here at Walter Reed generally work about 60-70 hrs per week) and then it should be really nice after that...

I almost feel guilty about him going into ENT, even though he says it is interesting, because that's not his "true love". Maybe I have a martyr complex... Anyway, when I look at him objectively I think he'll be happy with ENT, and I know he'll be much happier to be home more than ortho would allow. So I'm happy with ENT, he says he is happy with ENT, now he just has to get into the program.

So my suggestion worked, huh?

Don't doubt the power, says this future ophthalmologist.

[Flynn]

Sending you a big, supportive, sigh and a YIPPEE ENT!!!!!!!!

WOOO HOOOO!!!!! A "reasonable" choice. !!!

[smiley]

I was interested to see that same article about divorce rates come up. Someone really needs to do a good one so people have some reasonable statistics to look at. This article only applies to men who went to JH about 50yrs ago!
Johns Hopkins Precursors Study is a longitudinal cohort study of 1118 persons who entered the Johns Hopkins University School of Medicine from 1944 through 1960.
New England Journal of Medicine 1997: 336:800-803
Divorce rates based on specialty:
Psych: 51%
Surgery: 33%
IM: 24%
Peds: 22%

My opinion is that everyone who isn't single should choose a residency with family friendly hours. There are plenty of them out there. I think that a job can never be as meaningful as your family or friends, so don't let it get in the way of your true priorities. Just my 2 cents.

[pstone]

As an Architect that quit his job to stay at home with the children, I have a different persepctive. I "love" architecture, but "love" family more. I was doing what made me happy, and being a SAHD is clearly different, less and more fullfilling at the same time.

So I am not sure I buy the "do what makes you happy at the expense of family" and my wife chose anesthesia and it is still a hard time making it though residency.

When you are on your death bed, no one wishes they had worked more. Will your kids know who you are or just know you are a doctor?

[Flynn]

Well said Peter....there are so MANY more important things than YOUR JOB.

Also, along the ENT is a "reasonable" choice -- let me add that ONLY if you aren't on call at a level 1 Trauma center....that would be a HARD life.

[Gwendolyn]

When you are on your death bed, no one wishes they had worked more. Will your kids know who you are or just know you are a doctor?

Almost word for word, that was our ohilosophy in choosing ophtho. DH might have "loved" another specialty more, but it would not replace time lost with his family.

[peggyfromwastate]

Now he's looking into Urology too.... :argue:

[Gwendolyn]

You guys will figure it out. DH fell into the trap that you are just supposed to know where you fit and then you should go get it. I think it is that way for many people, but it is not that way for most...especially if you are trying to take a family into account. We spent a lot of time talking about many possibilities. Good Luck

[KCwife]

Now he's looking into Urology too.... :argue:

If it is any consolation urologists are supposed to be "happy surgeons".