Conference quark::human_relations-v1

    This topic is much too complex to any simple answers.  From your
    desription, it sounds like you've analyzed things pretty well,
    and are being careful about the quality of your future possible
    relationship.
    
    I only have a couple of indirect observations for you.  I am
    the son of a doctor.  In general, I could say the following
    about what it's been like being a doctor's offspring:
    
    a. yes, doctor's DO work very hard.  My father used to go out on
    house calls every night (that was back in the days that doctor's
    actually went to people's houses!), plus he was on call every
    other weekend or so.  And, since he was a pediatrician, his hours
    were relatively normal, in comparison to other stories that I've
    heard.
    
    b. It's almost impossible to adequately generalize about doctors.
    Still, there's one characteristic that almost always seems to be
    true...how the doctor reacts to it differs greatly among doctors.
    The common characteristic is that doctors are used to being in
    positions of power and status.  Basically, they are the all-knowing
    fountains of knowledge that people pay lots of money to, for them
    to work their miracles.  But, quite seriously, when someone is
    ALWAYS in a position of power, they often start to behave differently
    than other people who have a more power-balanced existence.  They
    CAN (but certainly not always) become arrogant, closed, and even
    distant when dealing with people, especially in a business environment.
    There are tons of very nice doctors out there, but there's a lot
    of them in which the continual power has warped their personal
    values or behavior somewhat.
    
    What does all this mean?  Simply that you should be very careful
    that this person really DOES provide you with the right level
    of empathy, and support for your own needs.  If there's something
    lacking in this regard now, my hunch is that it will only erode
    over time.
    

      I spent 7 years working with doctors. One of the most common
      marriage patterns is the woman puts her entire life on the
      backburner to support the medical student then resident. Then when
      the long haul is over - the wife is dumped and a new sweet young
      thing takes her place.

      Doctors as a rule (and I've known a lot) are used to having power
      and assume it as a given. They tend to be dominering and arrogant.
      Yes, there are exceptions but Marcus Welby ain't out there. One of
      the best lessons I learned in the hospital is that doctors make
      mistakes just like everybody else and they are not gods. They also
      have a very high rate of alcoholism and drug abuse because they
      think they should be gods and reality doesn't agree. No matter how
      they try, some of their patients die and that's hard to take.

      If you force the relationship to renew you may guilt him into
      starting over but eventually you'll pay for it. liesl

    A number of my non-DEC friends are physicans all have told me that
    they felt lucky to get out of med school alive and residency is
    tougher still. I have been told that the reason most of them had
    hard times in relationships during school was because of the time
    demand placed upon them. One fits the pattern described by -.1 he
    had a friend that wanted a very relaxed relationship which fit very
    well because her demand on his time was small but sex was still
    good. He also found that this shallow relationship had little to
    offer after school so dump he did and found another.
    The job will be #1 forever their love and devotion to being an MD
    is what got them thru school. How could you possibly ever expect
    them to suddenly place their life's desire in 2nd place after all
    they have been thru? I mean any physican that has his shingle has
    been thru several years of hell the program breaks a good percentage
    of future MDs the 1st few months and the drop rate stays fairly
    steady all along. It is this stress/work that one of my friends
    joke's as being the reason his rates are so high not the tuition.
    Another thing is after med school there is a never ending schedule
    of new developments,seminars,further education and other doctor
    sh%$ to deal with.
    ( on the phone with one of my MD friends now)
    Q: Bob, what do you think about what your wife should be prepared
    to deal with?
    A: lots of cold,late dinners.
    Q:is that all?
    A:to sleep alone quite often ER has me here at all hours and I never
    know how long I'll be here when called.
    Q: How much of your day is actualy devoted to your job?
    A: it's dropped off now but still 12 hours is about normal.
    
    I then went on to give a few details about the concerns of .0 to
    see if he had any remarks.
    Bob: Well he is in the thick of it right now and the going will
    not be much better for some time to come and she will continue to
    be #2 at least until residency is over.
    ME: will it get better then?
    Bob: NO, because then he will need to start getting his practice
    together.
    Me: are you ever going to get married?
    Bob: I already am, to my practice! Actually I want to if I ever
    find enough time and the right woman.
    Me: What qualities whould she have?  
    Bob: tolerance and understanding, the rest we can negotiate.
    
    
    I doubt if any of this answers your questions but the bottom line
    seems to be that if you want to always be number one in his life
    you're headed for disapointment.
    
    -j

    Some very good food for thought....

    Regarding .1 and .2:
    
    Yes, I'm aware of the "I'm God" syndrome, as is he.  In fact he's
    so aware of it that I don't *think* it's going to end up being a
    big problem, although I've been wrong before.   :-)      
    
        
    Regarding .3:
    
    I fully understand that he has to make Medical School his first
    priority.  I've always been very sensitive to this, and to the amount
    of work he has to do.  When I would visit him for the week-end,
    he would work all day Saturday and Sunday until 7 pm.  No complaint
    from me (I never expected anything else).  My problem is with him 
    being completely callous to my needs (even the ones that don't 
    take much time), and with him not being there when I really *needed* 
    him, and he could easily have helped.  This has actually happened 
    only two or three times in the past year, but they were significant 
    to me, as I gave him all of the time and energy I could.
    
    I guess that I don't mind being second in the day-to-day of what
    he has to do.  I really do admire him for his ability to handle
    it all.  It's just that he's done some really unpleasant things,
    (e.g. not wanting to bring me to the doctor when I was *very* sick
    and there was nobody else to, because he didn't want to take the 
    time away from studying).  I mean, that's extreme!!  He's really 
    a sweet, giving, caring guy, or he was when I met him anyway!  I 
    know that Medical School has altered his personality - what I wonder 
    is if I can expect these behavior patterns to pretty much stay around 
    given the stress of residency, and then a practice.  If I can, then
    I want out now!!
    
    I've always thought that I was the type who could handle this situation
    fairly well.  I think that I have up until recently.  I know that
    being involved with a Med student/doctor implies sacrifice.  I guess
    that things have come to a head now, and so I'm taking a closer
    look at just what is involved with this sacrifice.  The next step
    will be to decide if I can deal with it.
    
    
    - Sarah

     Sarah,

	  A very good friend of mine that I've known since high school is a
     pediatric endicrinologist.  Now that she's finally ready to take her
     boards, and enter into "normal" practice, I have some hope that she'll
     be able to keep an SO for longer than a year or three.  She's leaving
     her current SO, who followed her to her current job from her last job,
     because he will not follow her to her next job.  She is 36.

	  You have found out that medical students have no time for
     anything other than school.  Residents have even less time -- my
     friend often worked 100 hours a week, and from time to time 150 hours
     a week, when she was a resident.  (And, yes, I am aware that there are
     only 168 hours in a week.)  I think it unrealistic to expect _any_
     consideration out of a resident on a personal level -- they have _no_
     _time_, and they have such needs.  Especially during their tour of the
     ER, residents get to have patients bleed and die as they're working on
     them -- sometimes three and four a day, sometimes only one or two a
     month.  And out in the wards, it's traditional to give death watches
     to residents.  I got my share of 3 AM telephone calls, and I was just
     a good friend, 500 miles away -- everyone closer, emotionally or
     geographically, had burned out.

	  And, yes, the practice comes first to my friend.  Of course it
     does -- she has been training for this for fifteen years now.  She has
     had THOU SHALT HELP THE PATIENT AT ANY COST TO YOURSELF beaten into
     her for fifteen years.  There are people who are going to _die_ if she
     isn't there for them.  It does not make sense to her to make her
     patients die so she can have the time to help her SO through his
     latest crisis.

	  Coming out of medical school into residency is major change.
     Coming out of residency into a fellowship (for the specialty) is a
     major change.  Going into practice is a major change.  Many lesser
     changes have a reputation of destroying relationships -- having
     children, getting married, deaths in the family, moving, and so forth.
     It may be possible for a couple to stay together through the whole
     process of someone becoming a doctor, but I've never seen it.  And
     neither has my friend, who next month will take her specialty boards,
     and the month after that will leave her SO of three years.

	  Good luck.

			       Brian Hetrick

Such a shame that the current medical professional system doesn't allow doctors
time to be people and puts them through such !@#$%^.  Why do we need our
doctors to be gods?  The medical field is a mess, with nurses and technicians
not allowed to do work that they certainly are capable of doing, with the
work and *responsibility* instead piled on the doctors.

Such a pity when they could be trained for what they know at half the time,
expense and grief if the training process didn't have to be a weeding out
process.  And the medical care we recieve would also be at half the cost
if we didn't demand the impossible from them, and sue their asses off when
they fail.

What amazes me is that there are still people willing to go through this !@#$%
for the $$$$, the status, and the power!  But I guess, that's just that I
can't imagine putting myself through that.

Jim. 

    
    Actually Jim, I doubt that there are as many med students in it
    for the money, status, and power as there used to be.  It just isn't
    worth all the crap they put you through anymore.  Medicine doesnt
    necessarily guarantee tons and tons of money the way it used to.  
    It guarantees a comfortable living if you make it, but there are 
    much easier ways to get rich (as many of the med students I've 
    talked to realize).
    
    It seems to be something they're driven to.  Whether it's that they
    have a subconscious need to be in this position of power, or if
    it's just "their calling."
    
    The man I was seeing has never wanted to be anything else.  He
    knows other doctors - many of them have said that if they could do 
    it all over again, they wouldn't go into medicine.  He just couldn't
    see himself doing anything else, even though he knows all of the
    garbage that's in store for him.
    
    I wanted to be a doctor at one time as well, but decided that it
    just wasn't worth it to me (I have this funny desire to eventually
    have a family and actually spend time with them).  I really think
    that my friend (as I'll call him) is a wonderful, giving person,
    who will be a truly outstanding doctor.  He's in this because he
    cares about people, and is only interested in a specialty that allows
    him to work with people (as opposed to bodies - there's a big
    difference).  If I could make it with any future doctor, it would
    probably be this guy - or so I thought until the last few months
    went by.  Perhaps it remains to be seen.
    
    
    - Sarah
    

    As soon as I saw this topic, I thought of a friend of mine who is married
    to a medical student.  I asked her to write a bit about her experiences
    to share with you.  Here are her comments:
    
 				   *****
My SO and I had been living together for six months when he was 
accepted into medical school.  He began to distance himself in many 
ways until finally everything that belonged to him was moved to a 
friend's house.  He felt that he needed to separate himself from 
anything that might hold him back.  

Once he started medical school, he became very lonely and 
discovered that he still needed me in his life.  During his first 
year he became so depressed and overwhelmed by everything that 
he had to take an emergency leave and come home.  He was tired, 
thin, and mentally exhausted.

During the first few years of medical school, the students 
operate in survival mode.  The hours of study are long, and there 
is so much to learn that they can't believe it's humanly possible 
to get it all into their brains.  They need love desperately, but 
they don't have the time, or the psychic energy to put into a 
relationship.  It's hard not to be resentful if you feel used 
or taken advantage of.  

My husband and I were married two years ago.  We were together 
during his third and fourth year of clinical rotations.  I 
learned how to leave him alone when he needed to study, and he 
learned how to pay attention to me when I needed him.

We are now facing a sub-internship and then 3 years of a 
residency.  There will be lots of nights on call.  There will be 
lots of missed birthdays and anniversarys, and Christmases 
celebrated three days late.  It doesn't matter.  If there is good 
stuff in the relationship, the time together will be good.

I decided a long time ago that I would rather be married to a 
man that was doing what he wanted to do, than have an unhappy man 
around all the time.  I wouldn't change him, or one single thing 
we have gone through, because it has brought us that much closer 
together.

                                                         

    Lots of negative stuff here!  I'm no expert on Doctors, but I have
    observed a couple of them who have managed to extract themselves from
    the horrible grind which it can become.  One of them works in an
    emergency room in a large hospital, regular 40 hours a week on a
    salary (with all the paperwork handled by the hospital - a plus).
    The other became disenchanted with a very "successful" practice
    as a pediatrician.  He went off to work as a college physician,
    again salaried with regular hours.
    
    	There is currently a big shift towards HMOs around here
    (Northeast), with one of the results being that doctors are
    setting up their practices in large groups where the load is
    shared, and the hours can be more "normal".  It all depends upon
    what YOU want to do.  Just because you are a doctor is not an excuse
    for having no life of your own!  I know just as many young, striving
    DECcies who choose to work terribly long hours.  It's a personal
    thing, not necessarily related to becoming or being a doctor.  I
    do admit that the process of becoming a doctor is still so severe
    that it is more likely that those choosing that profession are
    more likely to work long hours, but this is NOT necessarily so.
    
    	The key question to ask is, "What IS the goal?"  Is this
    striving doctor going into research and dead set upon winning a
    nobel prize?  Or is he going to be content to work 40 hours per
    week in an HMO or in an emergency room?  Is s/he satisfied with
    a salary, or does s/he want to become a millionnaire by age 35?
    As with many things, you need to find the right questions to
    ask!  As I am fond of telling my kids (and myself), life is full
    of choices...
    
    Dave E
    

    
    	I've sat here and read the basenote and all of the responses
    up to now.  I nromally don't like to give advice that could help
    or hinder a person's future life unless I feel I really know what
    I'm saying.  this is one time I feel I might have an answer.
    
    	Sarah,
    		You of all people know what is really comming down here
    and I admire your openess.  I know DECcies that work LONG hours;
    I'm one of them and yes I have a terminal that I own at home.  I
    just recently transferred to another job because of spending too
    much time in my old one.  I'm in Telecommunications.  I beleive
    that what you must do is to review with your boyfriend what is giong
    on and find out what is in his head as well.  Get down into the
    gutter eand ask those real hadr questions to him and see what kinds
    of answers he's got as well.  If he's into his work that deep then
    maybe he doesn't "see" what's going on.  If he does then maybe what
    is going to happen is to accept what is going on or change it. 
    The final real decision is yours and to some extent his.  No one
    is going to make those decisions for you.  My wife has said on many
    occasions that I am a workaholic and I get immersed into a problem
    and the whole world can blow up and I'd never know it.  It's at
    that point that I have to haul back and reasses what's giong on.
    My wife sees it but I have to do it.  Maybe at this point your
    boyfriend has to assess what he wants to; but if you don't talk
    about it with him then nothing is going to change.  Reasses whats
    going on in your life and his life, but try to do it with him before
    you really make that final decision.  The choice belongs to the
    both of you; not just you
    

    <A rephrased version Note 759.11 by MRMIKE::ROSEN, which I deleted >

    Anybody who would go through the S*#& involved in becoming a doctor
    has probably made their career a priority in their life.  You need to
    evaluate if you can live with that.  Also, if the stress of med school
    has put a severe strain on your relationship, and it's just starting to
    get tough on the long road to doctoring, you need to evaluate what the
    future holds for that relationship.

    My brother is a successful surgeon.  He is happily married and has
    been for 8 years.  However, he married a nurse and she knew exactly
    what she was getting into.  He has 3 kids who do recognize him as Dad.
    He works 12 hours/day,  4 1/2 days a week, is on call one night
    a week and every other weekend and has office hours every 3rd Saturday.
    He has made it clear with his practice that the rest of the time is his
    own to spend with the family (excepting emergencies).  However, it did 
    take 12 hard years after graduating from med school to get to where
    he could set his own hours.

    The following is a synopsis of what is involved in becoming a doctor
    based on my interpretation of my brother's experiences.  I have
    tried to include the major stress factors in the story, but have
    probably left out a few.  Read on and evaluate if you want this
    kind of relationship and if your relationship can withstand it.
    
    It starts as an undergraduate, where you have to work very hard in
    a competative Pre-Med type major to have good enough grades to make it
    to Med. school.  If you're successful at that, there are 4 years
    of grueling med school to get through.  And it's not like you can
    let up knowing you're about to graduate because you still have to
    compete for a slot as an intern and of course there are more graduates
    than interships.  Okay, assume you're lucky and you get a good
    intership, you have your diploma and a $50-100K debt for med school
    costs.
    
    Now the going gets tough.  As an intern, you're the lowest
    of the low - 3 nights a week with ER duty, graveyard shifts, constantly
    on call.  I never understood how people could function with so little
    sleep, not the mention the fact that I wouldn't want them working
    on me.  After a year of this, you've kind of forgotten what sleep
    is like anyhow, but at least your internship is over.  But, don't assume
    that having an internship guarentees a residency because it doesn't.
    There are fewer openings for residences than interns.  Life eases
    up a bit with the residency which can last from 2-5 years depending
    on the type of doctor.  Now you only have to work 80 hours/week,
    1-2 nights in ER (emergency room) and every other weekend.  The
    longer you're a resident (more seniority) the better the schedule
    gets, but the longer you've been out of school, so the more time
    you have to spend keeping up on new things in the field.
    A subtle point that alot of people don't realize is the pressure that
    some people feel from having and wanting to get rid of their debts.
    Residents only make about $20-30K/year and med school ain't cheep.

    The next hurdle after residency is finding a practice.  For most
    types of doctors, you can't just go start one because the necessary
    equipment is too expensive, so you have to find one to join.
    Typically, you work on the staff of a private practice for 2-3 years and
    if you work out, they will invite you to join the practice.  After
    3 years if you haven't been invited to join, it's time to find a
    new practice.  (Things are different for HMO's.)  So while you're in
    this practice you again have the lowest seniority, so the worst
    on call, etc. hours and you're also kind of on probation trying
    to make a good impression so you'll be invited to join the practice.
    You also still have a responsibility to provide emergency on call
    service to the hospital's ER.  And don't forget the courses, reading,
    etc. to keep current in the field.  At least you're finally making
    good money and can start to pay off your loans.  But of course,
    while you're trying to impress your practice, and live a normal
    life, you have to start studying for the medical board exams.  You
    know...the one's that only 20% pass the first time.  So what's the
    big deal about taking it over anyhow?  Tell that to your boss...
    
    Finally, you get invited to join the practice.  This means buying
    a share of it.  If, for example, you're the 4th partner, you're 
    cost to join is 1/4 of the assets.  This includes the x-ray machines,
    office equip, examinatin benches, possibly building space, etc...
    grand prize price tag of $100-250K and you still probably haven't paid
    off your med school loans.  And it isn't over yet, because now you're
    one of the bosses and you have policy issues, board meeting and other
    stuff to deal with in addition to your every day duties.  For example,
    A practice with 4 partners probably has a total staff of about 30
    people, so there is alot to deal with.
    
    And what about those every day duties.  There is alot of stress
    and responsibility with being a doctor.  The decisions you make
    will effect the patient's future and possible their life, and if you
    screw up...see you in court.
    
    
    DISCLAIMER: Please don't flame to me about the high cost of medical
    care.  I am not trying to justify this, nor do I agree with the
    process involved in becoming a doctor.  I'm just relating the facts
    about the life of a doctor and how they relate to the stress that
    doctors are under.