on marriage and medicine

IMG_0515Mark is in the last year of his medical training.  He leaves Monday for a year of pediatric electrophysiology in Toronto.  We’ll join him there at the end of the summer.

We have been apart quite a bit over the last eleven years of our medical journey (note the pronoun our–it’s well deserved). Henry was born the day after Mark graduated from medical school.  While I recovered, Mark drove with my dad from Oregon to Vermont to begin his pediatric residency.  During those three years, Mark did a month-long away rotation in California, and spent countless weekends and nights away from us at the hospital.

I gave birth to Gracie in Vermont, then between residency and fellowship in Utah we spent a summer apart again, and repeated the medical toil for three more years of endless nights and weekends apart.

Medical marriages are given an extra difficult hand.  Mark and I were married for three years before he started medical school, and yet our solid beginning did not prepare us for the pressure of tests, board exams, 100+ hours of work each week, and last, but definitely not least, little pay.  Granted, residents and fellows make a starting salary of around $50,000, which is roughly the average American’s pay; however, residents begin making this salary after earning advanced, doctoral degrees.  Not to mention the fact that they are earning less than minimum wage per hour.  Yes, this is true.

The real rub, however, is the antiquated (although at no point acceptable), hierarchical, hazing-based system.  You can think of it as the “I went through it, so you have to go through it, too” mindset.  I will never forget the day Mark came home from his first clinical rotation in medical school.  He said to me, defeated, “I’m not supposed to ask questions.”  “What do you mean?” I asked.  “Well,” he said. “The attending physician said ‘medical students are meant to be seen not heard.'”  It took him at least an hour to convince me he wasn’t joking.  This scolding was not an anomaly.  My inquisitive, curious, and spirited husband was repeatedly quashed in his earnestness time after time after time, until, he stopped.  He stopped asking questions.  He stopped wondering why.  His light went out.

I am not being melodramatic here.  Mark went from a bass rocking, squash playing, rock climbing, book reading, avidly snowboarding, and unabashedly joyful man, to a tired, hollow shell.  And it all happened so terrifyingly quickly I nearly lost my bearings as well.

The thing about medicine is that it’s scary.  And this is totally understandable.  People are sick; kids are dying; and there are doctors who are supposed to fix everything while wearing white coats that shout “Hey! I’m in charge and I know what I’m doing!”  A lot of super smart people go into medicine because it’s either what their parents did or they have ambitious and altruistic interests.  I think most of us agree at this point that it’s not for the money.  There are indeed much easier ways to make a lot of money.  In medicine though these super smart people who mostly have no real world experience (because they are in school forever) haven’t worked out who they are, what they believe, or why they’re in this business to begin with.  Enter:  INSECURITY.

Mark is not insecure.  Or at least, he wasn’t.  He asked a lot of questions in medical school because he genuinely wanted to know answers.  He likes to understand things.  But, a lot of people in medicine don’t like being asked questions because when you’re dealing with life and death, and academia, you get scared, and anxious, and those feelings beget defensiveness and, sometimes, anger.

Amidst this unhealthy cycle of needing to learn but being afraid to ask questions, Mark’s psyche took a huge hit.  And at the time I didn’t know what to do.  So, we started to fight.  And then, we were mostly silent.

In March of 2011 I went away to a wonderful resort in Arizona with my sister.  I left Portland knowing that Mark was in a very, very bad place.  I thought maybe the break would help him regroup.  While I was gone,  Mark saw a therapist, and I started to feel like something awful was going to happen.  When I said goodbye to my sister at the airport I clung to her and cried.  I didn’t want her to leave and I didn’t want to go back home.

When I arrived at the airport, Mark was there to pick me up.  We didn’t speak the entire car ride home.  When we arrived home he told me he was leaving.  And he left.

We were apart for exactly two weeks. During this time we saw a marriage therapist, a man named Michael.  He took us on a sliding pay scale because we were broke, and then he saved our marriage.  He told us it was worth saving, and incidentally later told us that he had never said that to a couple before.  He also never charged us a dime.

I learned during our sessions with Michael that while I was hiking and swimming in Tucson, Mark’s therapist had told him to leave me.  I still do not understand the brashness of her direction, but I believe that if she had said, you should just tie a noose around your neck, he would have.  Perhaps she thought our marriage was over, or that by leaving me he could actually process his life.  I’ll never understand, but I don’t blame her for what happened.

In Michael’s dusty, book-filled office with layers of antique rugs and cluttered rock specimens, Mark and I relearned how to talk.  How to see each other anew.

This is what I know about my Mark.  His is the fiercest love.  He can read every expression, every glance.  He believes in me with every bone in his body.  And his every action, his every word, is good and true and real.

This post is not about therapists, or even medicine, but it is about navigating the world when you are scared and vulnerable.  It is an extremely difficult thing to do.

And here’s the craziest part of all.  We’re pretty damn happy.  We’re entering the final stretch, and Mark loves what he does.  We’ve got a little debt, Mark’s bald, and I’ve got some killer wrinkles; and TWO beautiful children, and a favorite saying:  We’re killin’ it at this life thing!!! High five.

2 thoughts on “on marriage and medicine

  1. Hi Aggie, thank you so much for sharing this! As you so astutely pointed out, in medicine we are taught to give every part of ourselves to the job, often with no support in return especially during the grueling years of training. During residency I didn’t even notice when I stopped enjoying the things I used to love, that I would cry for no reason, that couldn’t get out of bed until my friends and husband made me see a psychiatrist. Dr. Papsun saved me and I am forever grateful. Sylvia Plath described depression as a bell jar and it felt that way for me, except I didn’t notice it until the jar lifted and suddenly all the color, noise, excitement, and joy of the world rushed in again. I was shocked that I had forgotten what life was supposed to be. The partners that we have in life are essential to surviving medicine and to maintain our souls while doing it. You and Mark are such incredible people, thanks for sharing what your journey has been like. As a doctor and a part of a double doctor marriage, this has inspired me and I am sure will do the same for many others! I miss you both! Love, Parimal

    Liked by 1 person

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