As a biology major in undergrad, people would often ask me if I intended to pursue medicine as my future career. I never hesitated to tell them no. It wasn’t for me: The years of training, the debt, the delayed income, the prospect of matching to a location that was unfavorable for me, the lack of control over my own schedule. Not to mention the pressure of caring for patients at their sickest or the mental weight of knowing my decisions could directly impact their health. Though I found my purpose, I deeply admired those who chose to pursue medicine, but it didn’t fit the goals I had or the lifestyle I wanted for myself.
And then I met my future husband. He was entering year three of eight in an M.D.-Ph.D. program, which involves four years of medical training bisected by four years of obtaining a Ph.D. And THEN matching into a residency of who knows how many years, with the possibility of fellowship, before becoming a fully trained attending physician. And once an attending, the job often remains demanding both in time and energy, even for the less grueling specialties.
I’m not going to lie and say that I didn’t hesitate and consider if his career path was something I was willing to tie myself to for the rest of our lives. Even though I wouldn’t be the one doing the “work,” I would be the one behind the scenes managing the ripple effects of his extremely demanding schedule, his relatively low income compared to the hours, the lack of general employee benefits other industries cherish, the inability to take vacation time, and the constant flux in our routine. As he progressed from the exasperating Ph.D. years to the chaotic year of M3, bouncing among various clerkship blocks with differing schedules and expectations, to M4, where he spent a month in another state at an away rotation and another in Malawi, Africa, while balancing the stress of residency applications and interviews, through the terrifying process of The Match, to the rigors of intern year working night shifts and weekends, to the move hours away to begin residency. All the while, he was constantly preparing for and taking pivotal examinations and shelling out substantial amounts of money on licensing exams and the study materials needed to prepare for them. Now, he has the weight and responsibility of his own patients and his own clinics to devote his time to, in addition to the endless documentation, studying, the constant article writing, and the various committees he has joined to continue improving his résumé.
Obviously, I ended up married to him, so this journey was determined worthwhile in my mental calculus. That doesn’t mean it is easy, for either of us. While working full time myself, I also tend to be the one shouldering many of the chores at home and the mental load for our lives outside of work; I know his schedule better than he does most days. Which is understandable when you consider that he spends nine-plus hours at work, an hour commuting, typically five to seven hours a day studying and writing, and managing a call schedule. Clearly, not many hours are spent sleeping. As he considers fellowship, I find myself again faced with the anxiety and uncertainty of another match process that could send him anywhere in the country, recognizing that although this process remains one of the more equitable selection processes, there is an inherent and intense lack of agency. On top of that, I try to support his education as much as I can from the sidelines, reading and editing his papers or quizzing him using his notes and flashcards. I cannot imagine how we would manage as a dual-physician household or if he entered a specialty such as surgery.
His profession weighs on him too, in many ways. There is, of course, the constant need to prepare for and see patients, study for exams, write and submit and revise and submit articles in an endless cycle. Plus, the intangible stressors of wondering if he is doing enough, if he is making a good impression, if he is caring for his patients in the ways they need while also caring for himself and his own mental and physical well-being. I know he feels guilt over missing weddings and parties and other events, and it is hard for people outside this career to understand why he cannot just “take the day off.” He feels guilt over his more modest income over the last decade, over his frequent absence at home and his fatigue when he does get back, and the extra burden on me to keep our lives running smoothly while sacrificing quality time and vacations and date nights with my best friend. Now that we are expecting our first child in a few months, it is clear that his anxiety about managing his workload and reaching his maximum potential career-wise, while also being a present father and husband, is making it difficult for him to be truly excited about this next step in our lives.
So, what makes all of this worth it? To my husband, medicine is not a job. It is a calling. It sounds cheesy and cliché, but that is truly how he feels. He wakes up every day motivated and excited to work. He thrives on the positive feedback from patients and colleagues. While he comes home tired, he also comes home happy. He feels like he is fulfilling his true potential, making a difference in the lives of his patients, and bettering the department and community around him. He spent years studying while awaiting this moment. What more could you want for someone that you love? His ambition often scares me, but it also inspires me and impresses me. I am unendingly proud of how hard he works and how much he cares while still putting in the effort to be a great partner. I am proud of myself, too, for holding down the fort at home while also balancing my own career in health care. I am proud of us, for facing countless obstacles and stressful experiences and coming out the other side stronger. I am proud that we are still pursuing our mutual dreams of having a family, despite the added challenges that we know it will bring to both our lives.
I am unsure if my husband will recommend medicine as a profession to our children, but I am positive he will encourage them to find careers they are passionate about, where the fulfillment gained outweighs the sacrifice. Undoubtedly, we will both certainly encourage them to choose a partner who will support their dreams, even when those dreams don’t always align exactly with their own.
Julie F. Solimine is a genetic counselor. Albert E. Zhou is a dermatology resident.
