Everyone knows that medical school and residency are stressful for young physicians. The AMA Alliance knows that the training years can be just as challenging for the physician's spouse. Our new blog offers resources to provide specific support for partners of physicians in training, as well as assistance in finding an Alliance in your area.

We know that support for the family of medicine is most comforting when it is provided by the family of medicine.

To learn more about the Young Member Connection please view our first blog entry here.

Monday, April 27, 2009

Avoiding the Pitfalls of Medical Marriage

A recent article in AMA Alliance Today explores common pitfalls in medical marriages and how to avoid them. Click here to read the article.

Friday, April 10, 2009

Book Review: Doctors Cry Too by Frank H. Boehm, M.D.

Hi all: I apologize for not posting last week's book review on this site. To keep you up to date, here is this week's review.


Frank H. Boehm is an obstetrician/gynecologist who writes a twice monthly op-ed in the Tennessean newspaper, entitled Healing Words, about the life lessons he has experienced as a doctor. His articles became so popular he decided to write a book that is a compilation of his favorite and most popular pieces. The result was the book Doctors Cry Too.

Organization. The format of the book and Boehm’s straightforward, simple language makes Doctors Cry Too a very pleasant and easy read. The book is organized into various topics, including medicine and religion, the end of life, and personal stories. Within each topic there are a number of essays, each of which spans an average of 2 pages in length.

Its easy format and short stories allow you to choose whether you want to read the book cover to cover (which I actually did in the span of 2 nights) or read an essay at your leisure. The stories don’t build upon each other so you can read the essays out of order.

Topic. In Boehm's words, his book consists of "stories that deal with the emotional and personal issues surrounding health care and physicians." His book is best described as a Chicken Soup for the Soul written by an obstetrician. For that reason, I recommend this book to obstetricians and to mothers. I recommend this book to mothers as opposed to parents in general because of the personal experiences a mother goes through during pregnancy.

Pros and Cons. It was refreshingly nice to read Bohem’s personal stories about his children. It is extremely evident that he loves his children dearly and he has a happy marriage with his wife Julie. This is another reason the book is like Chicken Soup for the Soul—you get a glimpse into the mind (and heart) of a compassionate, loving father and husband who cares deeply for his family and his patients. You feel good to reading such nice thoughts from an accomplished physician. The book also gave me a sense of hope because Bohem has achieved a wonderful balance between personal and professional life that many physicians strive to achieve. It makes me feel like it can be done.

However, I must admit that I was disappointed with Bohem’s inability to delve deeper into controversial issues. For example, at one point he comments on a woman who died because of an illegal, inadequately performed abortion before Roe v. Wade was decided. He focuses on the woman’s death and its impact on him, but he briefly mentions the need for a change in the law so that deaths like this would not happen. Of course, abortion is an extremely controversial issue and one that Bohem couldn’t quickly delve into. Also, the purpose of his story is to demonstrate the impact this patient had on his life. But I am one who is always interested in delving into the difficult stuff and somehow making sense of conflict. For that reason I sometimes felt the book was a bit superficial.

That being said, the book certainly accomplishes its underlying goal. It gives a reader a glimpse into the heart of a loving, caring physician. It helps patients see that doctors, who may seem like they don’t care, do in fact cry because of the compassion they feel for their patients.

Photo from Dr. Boehm's website.

Wednesday, April 8, 2009

Why study medicine?

An article from Student Doctor Network (SDN) explores the question of why pre-medical students decide to pursue medicine. A survey conducted by SDN reveals that "89% listed either a desire to help others, a genuine interest in the sciences, or personal exposure to medicine as the impetus for their decision" rather than financial gain. Click here to read the article.

Tuesday, April 7, 2009

Medical Students & Residents - Transitioning to Practice

Any transition, be it from college to the work world, or the common transitioning between jobs, can be difficult. But most transitions happen fairly quickly, in a matter of a couple months, compared to that of the medical transition. Transitioning in the medical profession is a way of life, whether it be from student to internship, internship to residency, or residency into a fellowship, specialty or private practice. The family of medicine is always there to support their physicians in training and make the transitions as smooth as possible.

To read the rest of this article, click on the "Transitioning to Practice" title link.

Thursday, April 2, 2009

Medical Marriage

I love Thursday nights. And I love Thursday nights even more since the invention of the DVR. We finish all the tucking and praying and reading and singing and last-minute drinks of water, and we field all of the ingenious stalling techniques and finally go downstairs around 8:30. Grey’s Anatomy is already a ½ hour in, which means with a DVR, we can start watching it from the beginning and fast forward through the commercials.

I don’t know if you’ve ever watched a medical drama with an actual physician, but in order to do so, you must establish rules.

Rule #1: No talking.

Michael often comments, “That wouldn’t really happen…” or “Uh, notsomuch…” while I’m trying to hear Bailey’s witty comeback or George’s self-deprecating whine. But - again - thanks to the DVR, we can rewind. Then, of course, we re-establish Rule #1. Let’s just happily suspend reality and watch the stinkin’ show. Please.

I loved last week’s episode. McDreamy and Dark&Twisty finally get engaged. But here’s what I loved the most: he was able to get back on his feet and be who he is meant to be simply because she had faith in him to do it.

I’ve stumbled across several blogs this week written by wives of physicians – mostly medical students and residents. On one hand, I love reading their stories and so appreciate their sharing the struggles they have. On the other hand, my stomach turns because I have been there, and I know how excruciating it can be.

I’ve thought a lot this week about what I have learned over the last thirteen years as a medical spouse. We married at the end of Michael’s Christmas break during his first year of medical school. Had the wedding on Friday night, and he was back in class on Tuesday morning. Those two crazy kids had no clue what they were getting into.

What have I learned? Well, first let me say that I’m still learning and coping and adjusting. Each year brings new challenges to his career and to our family, and finding the delicate balance between the two is a constant challenge. The good news for us and for others in a medical marriage, particularly those like us who got in at the beginning, is that it does get better. SO much better! If your marriage can survive med school and internship and residency and fellowship, then the rest will seem so easy in comparison. You will have survived the worst.

But if I could go back and talk to that insanely na├»ve 22 year old bride, here’s what I would tell her:

Hope for the best, expect the worst. This was my mantra through residency. It’s all about expectations. If he is on-call, expect him to be gone all night. Expect to eat dinner alone, to pick up the kids from practice, to put them all to bed by yourself, to clean up the kitchen by yourself, to spend the evening with a book or the DVR instead of your husband. If he’s not called in, celebrate and move through the evening/weekend with him. But his being with you should always be Plan B. It may sound cynical, but it is survival.

Take the small amounts of time you have and focus solely on each other. Some days, this may consist of a single phone call in between surgical cases. Even if that is all you get, be all there. Listen. Communicate. Laugh. Say “I love you.” If you get more than that, be thankful, and be all there. Make the most of what you have.

Make friends. This can be a tricky one, but I cannot give it enough weight. You absolutely must have friends who are also medical spouses. No one else in the world is going to completely understand what you are going through – not even your own family. That kind of support breathes life and sustains you like nothing else.

I met my best friend in the world during residency training. Both of our husbands were ophthalmology residents, and our kids were born within months of each other; they too became the best of friends. Neither of us had family within 800 miles, so we were family to each other for three years. We live on opposite ends of the country now (which we all hate), but we are still as close to each other as we were during residency, and every summer we take a family vacation together. No one else understands my life like she does. Which leads me to the second point about friends:

Be careful to whom you complain. As the wife of an ophthalmologist, I can’t complain about my life to the wife of a general surgeon. At the same time, it’s going to be a little difficult for me to empathize with the wife of a dermatologist (I probably could, but I haven’t had to yet. I’m just speculating.) Along the same vein, I have to be careful about what I say to my non-medical friends. During Michael’s first year of medical school, I was talking to my good friend from high school and whining about how Michael was gone all the time (oh, my word – really? I had no clue!), and she was genuinely worried about us. She thought we were on the verge of divorce. “Oh, no,” I assured her, “this is just what we do.” Again, no one else is going to understand your life like another medical spouse, particularly one in the same field of specialization.

Non-medical friends and family are going to make assumptions about your life. Even during training when your life is the most stressful and your bank account is the most depleted, other people are going to assume that because your husband has “Dr.” in front of his name, your life must be a cake walk. Many times while Michael was in training, I found myself having to explain the entire training process to our non-medical friends and defining words like STEP I, Match Day, internship, boards, and even residency. I remember one instance during medical school explaining to a friend that no, he is not able to work and go to school at the same time.

Now that Michael finished training and is now in practice, we still find ourselves defending our life and battling assumptions. On more than one occasion, I’ve overheard husbands tell their wives (who are usually wanting to buy x, y or z), “I’m not Michael Hunt. I’m not a doctor.” – as if we don’t have a care in the world about our finances. Believe it or not, we still get to the end of the month and wonder where it all went. (And don’t even get me started on taxes and malpractice insurance and disability and the debt that doctors take on during their training while their friends are out making a healthy salary.) It’s not that simple. So you have to grow a thick skin and learn to ignore it. You know what is true, and what other people wrongly assume about your life doesn’t matter. (I keep telling myself that – I’ll let you know when it sinks in.) My wise old aunt gave me this sage advice: “What other people think about you is none of your business.” Just remember that these assumptions are born out of ignorance – I don’t say that spitefully, but truthfully. The non-medical world has no clue how it all works. We know only because we are submersed in it.

Take care of yourself. Whether you work full-time during your husband’s training or stay home raising your kids (or some combination of both), you have to be careful not to lose yourself as “Dr. ____’s wife.” A good friend of mine from residency advised not to put your own gifts and talents aside, but to work with your husband and find a way “for both people to fit into the marriage so that one person isn't sucking up all in the air in the room. We, too, need to breathe.” During training, this is extremely difficult. Your life is revolving around your husband and his career. You probably left your family, friends, and job to move somewhere you never thought you would live (after matching, we said, “you just don’t grow up thinking ‘someday I’m going to move to Iowa!’”), and once you’re there, you are alone. Your time together revolves around his work schedule, you have no money to pursue your own dreams, and if you have kids, you spend much of your time caring for them alone. Somehow, in the midst of all that, you need to nurture your own spirit and do the things you love to do. Take care of the person your husband first fell in love with. Finding that balance during training is complicated, and it will look different for each one of us, but talk with your husband and find a way to make it happen. If you have kids, I would highly recommend finding room in your meager budget for a Parents Day Out program or preschool. If that’s not possible, work out a kid-swap with a fellow doctor’s wife so you can each have time to yourselves. Either way, the break from your kids will feed your soul and allow you a little time to take care of yourself.

Respect. I’ve saved the most important one for last. This is HUGE. My lack of respect for my husband and his career has shredded our marriage on more than one occasion, but particularly during his first year of residency. We went into our marriage with the conviction that divorce would never, ever be an option – but let me tell you, if it were, we would have gone there. It was that bad, and it was (mostly) my fault.

Let me again assure you that I am not at all devaluing us as women and wives. Each of us has gifts and contributions that are essential. We are each uniquely gifted to bring hope and healing to the world, and we should do so with every opportunity we are given.

Having said that, let’s talk about our physician husbands, particularly those in training. As we are all aware (but probably not to the full extent), they are under incredible pressure. The career they have chosen places someone’s life and health in their often incapable hands. If they screw up, somebody else’s very life is altered. That is a huge burden for anyone to bear. Medical training is rightfully brutal because of the magnitude of this burden they are choosing to take on. During training, our husbands are grilled, yelled at, and belittled. They are expected to know their stuff, which is why they work for 14 hours a day and then come home (if they come home) and study for another 2-3 hours. If they don’t know their stuff, they will suffer, and their patients will suffer. Once they have completed training and go into practice, they aren’t subjected to the yelling and criticism (at least by their attendings - some patients and their families aren’t always so gracious), but the pressure only intensifies.

This puts us, as their wives, in a precarious yet very powerful position. We love them. We value our marriages. We want to spend time with them. But they have chosen a very demanding career that requires more time and energy than they have, and we hold the power to make them better.

Which brings us back to McDreamy and Dark&Twisty. He could be the surgeon he needed to be because the one woman he loves the most has empowered him to be so. We, as wives, need to believe in our husbands. We need to be understanding – even when we don’t like it – of their long hours and limited family time. We need to give them a safe place to come home to after being run through the garbage disposal all day. They need to hear, “Thank you for working so hard for our family” and “You are going to be an incredible (doctor/specialist).” They need to hear, “I am so proud of you.” They need to know that they are heroes at home, even if they are peons at the hospital. They are working their butts off in order to learn how to save someone’s life. They need – and deserve – our respect.*

Yes, we have every right to complain about not seeing them and being a “single” parent. Yes, their careers put an extra burden on us as their wives. But for the sake of our marriages and our own happiness, we must learn to put aside our “rights.” We must lovingly and effectively communicate our frustrations while still affirming their value and appreciating what they do and how hard they work.

Medical marriages are extraordinarily difficult, and although far from “normal,” this life is all we know. I have learned in thirteen years of medical marriage that you can, in fact, have a loving, fulfilling, vibrant marriage. It takes more work and tears and effort than you ever thought you were capable of, and it never will be easy. But remind yourself of this: you are an amazing, strong, gifted woman, and your husband could never be the physician that he is and will become without you.


*Love and Respect, by Dr. Emerson Eggrichs, is a great resource for learning ways to show our husbands respect and how they will in turn respond lovingly.