The Cost of Two Medical Careers

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Welcome back to the Direct Well-Being Podcast. I'm your host, Dr. Anders Apgar, and with me tonight, I have a very special guest to me, and hopefully you'll feel the same way. But if you really don't really care. This is my wife, Dr. Jacqueline Apgar. Dr.

Apgar is a board-certified OBGYN and the mother of four children. Thanks for joining me, Jackie. Sure. What we're digging into is very personal, so, I think it substantiates what we're trying to do with the podcast, but also trying to help other people out. You know, what happens to a marriage and a family when both parents devote their lives to medicine?

What happens if one of them finally steps away? we've got that experience as well. And hopefully, this will not only help two physician families, but also as, I stepped away a little bit, it'll help one physician families as well. we'll certainly delve into that, and delve into that stuff too.

But my wife and I are both OBGYNs. She's been practicing for twenty-two years, and I've been in it for twenty-six. And for most of our marriage, medicine was not simply what we did, it [00:01:00] dominated our home. It determined who was available, who missed dinner, who handled the runny nose, the scalp laceration, the broken wrist, the kidney stone, the carpool, and whose exhaustion had to wait.

And I think Jackie will verify that those were all true events in our household Missing the school bus was not an option. It affected our marriage, it affected our children, it affected how we spent money, how desperately we needed childcare, and how we tried to compensate for the times we weren't home.

Two years ago, I stepped away. I stepped away from clinical practice and moved into a more administrative role, and I still see patients every week, but I walked away from the operating room and the delivery room and the calls, the OB calls, at least. My wife stayed, and perhaps the most uncomfortable thing I've learned since then is how quickly I began to forget what it feels like to be the person still carrying the pager, the patients, the call schedule, and the responsibility of being an OBGYN.

So tonight we're gonna talk honestly about what medicine gave to our family what it demanded in return, and why my wife is still doing [00:02:00] it and why I stopped, and whether the life we built with a dual physician income ultimately gave us freedom or made it impossible to leave.

So again, Jackie, thank you for being here.

Sure.

We have a lot of emotional ground to cover but let's begin with the very obvious question and just let it rip. What did, having two OBGYN careers actually do to our marriage? What did it do to our home?

Well, I mean, I would say it's relatively a disaster.

A happy disaster, right? I think there was a lot of good that came from it, right? we understood each other at the end of the day. We didn't have to explain the kind of day we had. We just could allude to it , And we understood, what we were going through.

At the same time, we carried the burden of both of us coming home with, difficult days, traumatic calls. And sometimes that was not just double the trouble, but more exponential. So I think it was difficult for the kids to have both of us coming home with that, shouldering that burden.

[00:03:00] I often said it was people that didn't marry into medicine were smarter than us. but their partners did not understand what they came home with. So it's been an interesting journey.

we will certainly have listeners that are OBGYNs and cardiologists. We have got a couple ER docs out there too. Do you think there was something more difficult, less difficult, or specific to OBGYN?

I don't know any different, right? I'm an OBGYN.I happen to think it's the best profession.

No offense to the cardiologists out there, I think they're brilliant. I wasn't good at cardiology.I love the ER folks, but I wasn't good at that either. I think it's the best profession for me, and that's all that I understand. I married an OBGYN, and that is all I ever knew. So, obviously we have friends that are in other fields, and we can sort of see the pros and cons of, being an intensivist or being a primary care doctor.

I couldn't do what they do, so I can't [00:04:00] speak to what they go through. we have similar stories, you know, similar traumas and burdens that they carry home, and it's nice to talk to them about it because they understand. But they all say to us that we have the worst call schedule, that we are the interns for the rest of our life, right?

we are working the hours that we used to work in residency forever, and that's something that we didn't realize when we got into this. I truly believe there's n-not a better profession. I couldn't do anything else. I love my job. I love the idea of taking care of women through all stages of their life and, helping them through teenage, years and then watching them get married and have kids and delivering their kids.

And there's not a better profession. But, when you strip that down, it's really challenging. It's the happiest field and the most traumatic field. It should always be happy, and when it's not, it's really not. So I think you and I carried that burden a [00:05:00] lot. And I don't think we did a really good job of shielding our kids from watching us go through all of that.

And I think we definitely placed some undue burden on our kids just by talking shop, so to speak, all the time at home.

Yeah.

Intentionally or unintentionally kids hear everything. So they could hear what we were talking about, whether or not we were Trying to be in private and taking phone calls from patients, in the cars and answering, you know, some serious questions from patients on speakerphone.

And, lead kids to hear more than you might expect them to hear or they pay attention. Didn't matter if they had their headphones on, they were paying attention to what we were hearing. So I'm not sure we did that correctly. I think we probably could have shielded them a bit more.

But they are well-versed in a lot of things at this point.

I think it's a really good word you use, shielding them. I don't know how you do that really effectively without distancing yourself from the [00:06:00] kids. I think that's really hard. But I think the other thing that comes to mind is when we did have those phone calls in the cars, we literally had to apply HIPAA to those kids.

You may hear some names, you may hear some medical stuff. You may not say a thing, even if you recognize the names or the voices. and we do. We take care of some people in the neighborhood, and that neighborhood, the community, and the surrounding area such that when we go out to dinner, people notice who we are and the kids too, and, if you notice somebody and you've heard them before, you've heard any medicine, you have to...

We had to apply HIPAA to them. Poor kids.

Did having a physician spouse make you feel understood? Or did it sometimes mean that neither of us had anything left to give when we came home?

I think for me it was a team effort. I always felt much more supported when you were back in the clinical field when we worked alongside each other at the hospital, and I knew it wasn't often, but if I got into trouble or there was a particularly difficult surgery, there was always other physicians I could call, but [00:07:00] you were always my go-to.

So It was always your support system was right there next to you. Not having to explain, why your call was so terrible or why your day was so difficult, or even the little wins here and there It was nice to not have to explain it all.

At the same time, it did get old. I mean, we found that very early on manipulating our call schedules. Well, if you're on call on Monday, I know you're gonna be exhausted Tuesday, but now I'm on call, and so post call you're gonna have three kids under the age of four, to deal with that night post call.

I remember manipulating call schedules and thinking, I can't take call that night, or I have to move that call or I just know it's not gonna go, not gonna go well this week. where do you stack your calls so that one person doesn't always have to be on, carpool and childcare and who's getting up with the kids in the middle of the night on those post call days.

Calls were [00:08:00] hard enough to schedule so that we had somebody in the house at all times. But, the post call days were equally. And as we got further into our careers and the anxiety of, you know, being on call, even the pre-call days became challenging, but we couldn't both be anxious or exhausted all the time.

It wasn't fair to the kids.

but again, we probably passed that burden on to them more than we intended to.

Yeah.

So yeah, I don't know the answer to that. there are some days that I wish that there was only one of us in medicine. It would've been a lot easier on the kids. And then there's other days that that's all they knew too.

it was interesting once you left the clinical realm, it became very different. even your understanding of what happens back in the day. It did take you a while to start to ease off the pedal a little bit.

But once you did, it became more challenging to explain to you why I was running late, why I got home later than I want to, why I'm doing the charts until midnight. It's [00:09:00] different. your mental load is very different now.

Yeah. I distinctly remember you answering a phone call or a text here and there, and like, "You used to do this, remember?

Idiot." Parentheses idiot. Although you were too sweet to call me that. At least not to my face. But yeah, You definitely said that on the phone, where you're like, "You know where I am. You know exactly what I'm doing. You know I'm stuck. There's a postpartum hemorrhage. There's something going on."

the other thing that came of interest, I think, was people often asked us how did we operate together, and I think we did a really good job of separating the house and the operating room. And I think when we got in there when we called each other in, right? It didn't matter what was going on at home.

We're very professional. The personal life never bled over into the operating room. and to your point, I really like the fact that, you know, when we did get there the great part about operating beside you, being your assistant, was that I did know kind of what you were thinking, what your next [00:10:00] step was.

We had a good tune, and we had a good rhythm going back and forth 'cause we didn't necessarily have to know what each other was saying, 'cause we knew what each other was thinking because we talked about surgery, privately at home, and what scared us and what made us feel good and what made us feel talented or, what skills we needed or what bleeders we had to attend to first.

I think we did a really good job with that.

And to be fair, there was a handful of times over the years that we did that, but it's having a dance partner. you know who's leading and what's gonna happen next. So it was comfortable. But, overall, I think we were able to work side by side and be very professional in the meantime.

Yeah. Did you ever think that medicine was like the third person in our marriage?

Good question. no, because it's just an entity and medicine is our whole life. It still is. it still affects everything we do. I have friends that are outside of medicine, that it doesn't define them.[00:11:00]

This becomes, as much as I'm, maybe not popular, but a wife and a mother first to my patients when I'm at work, I'm only a doctor.

I do sometimes let in some personal information for my patients that I've seen for a long time. they know that, you know, sort of where the kids are. Mostly they ask about them because, they watched me be pregnant with each one of them and they were often, especially the ones that were pregnant at the same time, they have similar age kids, and they followed our kids and, some of these folks who let in on some of this personal information.

So they know that but at work, I'm a doctor. and at home I try and be a parent, but the reality is it becomes a part of you. I can't undo medicine from who I am. I try but I can't undo it. we think in medical terms. We think in everything that we do, everything, I have to think of the job and how it's gonna affect my [00:12:00] job. Everything that I do at work I know is gonna affect our home life. Everything that happens it does affect me, and I bring it home with me, and, the kids can tell. Now that they're older , They can tell. they get it. They don't always know exactly what's going on, but they know.

they know that they have somebody to do their homework with at night because I'll be up doing my charts. They know. They ask on the regular basis, "How far are you behind in your labs?" They know that affects me. So they are astute. so no, in terms of the marriage, it is part of it.

I don't know what it's like to not have that be in, I don't wanna say in the way, but like part of our relationship. We didn't know each other before medicine and, I don't know what it would be like to not be married to medicine, which is kind of depressing. If you remember, especially when we were younger, we didn't wanna be friends with other doctors.

Yeah.

We hated that. We [00:13:00] wanted to just be normal people. And because doctors are boring and doctors only talk about medicine but I think you and I have evolved over the years to knowing that we do have some friends now that are in medicine.

Yeah.

And I think we very much gravitated towards that because some of our other very, very, very good friends still don't understand-

Yeah

what we do. They still don't understand what we take home. they still don't understand the hours that we work. Not necessarily for compensation purposes, but just because that's what we do, right?

Yeah.

So,

A lot of our parents are guilty of the same thing. they still ask, "Wait a minute.

Uh, so if you're on call, Are you working the next day? what's that mean?" I mean, this is 26 years later. 22 years, 26 years later, they're, they still can't contemplate it. It's interesting . And I think we gravitated toward those people because we had similar languages and similar stresses.

did we actually talk about the pressure that we were under? Or do we always assume that [00:14:00] the other person knew because we practice the same specialty or we practice in medicine? Did we do that well?

No, and sometimes you're just tired.

Sometimes I don't wanna hear it. I mean, that's the downside of being married to medicine. Yeah. Sometimes I'm not having a bad day. and I had a decent day. And vice versa. I'm sure that you could say the same, but if you're asking me the question, there's some days that I have come home and i-it wasn't a bad day.

Maybe somebody said thank you for something. Maybe I saw a patient that I have been seeing forever and they said something nice to me, or maybe they got , the kids', you know, th-those Christmas cards we get from patients that send us the Christmas cards every year and their kids are now, 15, 18, 20, whatever and like you had a win.

You had a g- a day like where there was no catastrophes and the wheels didn't fall off during clinic and, deliveries happened and you got out on time and, I come home and there's Grouch Head over there like, "Oh, I had a terrible day." and some days you just don't...[00:15:00]

Which is terrible. Like it's no different than any other marriage, but when you're married to medicine, you are married to those ups and downs too. And so while I very much understood and while you very much understand when I'm just not having a good medicine day, some days you just don't wanna have to, do that.

Some days I didn't wanna listen to your pager go off in the middle of the night 'cause I had been on call the night before. Some days it would just got old. It was just constant. and yet I can't imagine, if you didn't understand what we had been doing. So-

Yeah

I don't know that there's a good answer there. I don't know that I'd wanna be married to a doctor if I weren't a doctor. I have a lot of respect for partners that are not in medicine. I have a lot of respect for those people. They share disproportionate burden, I think, of the household.

I think you're right. I couldn't agree more. But I'll have you know that's Dr. Grouch Head to you, not just Grouch Head. But, you touched on a really good point too. When both of us came home [00:16:00] depleted, whose exhaustion was allowed to matter?

for us, I think it was really What we needed, right? how do you fill your cup again? and we're different people. I mean, we're just different people, and that's okay. I filled my cup again by diving into the home life.

I filled my cup... I still do. I'd rather stay up and make sure the kids' uniforms are clean or, that the homework is done or do the schedule for carpooling or whatever that is. Make sure that the next birthday party is planned. that is where I could gain some control back in my life.

you can speak to your own, but that didn't necessarily...

think sometimes you needed to be more separate. you needed to just have some downtime, some non-stimulation time. I could sit in the middle of the kids, and even if it was yelling at them to brush their teeth, it still gave me grounding. It put me back where I [00:17:00] wanted to be, where I felt like I missed out, or the guilt that I wasn't home the night before, or that I, missed the little one waking up in the middle of the night and I wasn't there for it.

That was not okay for me. But that's where I came back to fill my cup, and I think it's different for everybody. So it's the exhaustion. if I can stay up all night for other people, if I can stay at work too late for other people, then I can go to the next baseball game.

I can make sure I break my neck to get to the end of the volleyball game or whatever it is because that's what I need. But that's me. Where does that begs the question, which probably is somewhere in your little sheet over here of what we're gonna talk about. It begs the question, where do you put yourself?

Like, if you put your career first, your family tied for first, at what point is there anything left for yourself? [00:18:00] And that's something that I'm not good at.

No, I think it's extremely difficult. That's why we're here. These questions are hard. I don't know that there's necessarily answers, but at the very least, others who may be in our shoes or may be at the beginning of their careers doing the same thing we are will have someone to feel like they're not completely ridiculous or off base for, 'cause we had those nights where we just, "What are we doing?

What are we doing to our kids?" and remember what we used to say, which was, "If I can stay late for my patients, I can stay up for my family too." And that you hope that home is a place of recovery and not always a place of unfinished work. And we blurred those lines, because we had to.

everybody talks about pajama time and labs that aren't done and phone calls that aren't done, and there's always call. And that's why specifically for OBGYN, I feel like, there was always the next phone call. All it took was one page, and the entire night could change, which I think is different from other specialties.

Well, it's no different than in the office, though. I think every specialty has that moment where you think you're walking into something and you get completely [00:19:00] derailed. And the second that you see that patient, the second that it gets derailed, you know you're staying up finishing your charts late that night.

You know you're not getting out on time. You know you're not gonna make it potentially to that pickup that you thought you were gonna make it to. and what was different for us is I couldn't always pick up the phone and call you and say, "I can't make it. You need to go," because you were not available.

Or you could be available, And that's the uncertainty. I think it's the uncertainty. Having two people in medicine for us was always the uncertainty, which, wasn't great for the kids, but that's where we elected to the best I thought for the kids would be, other than one or both of us leaving medicine, which I didn't feel like was an option for what we wanted to do, was to then make sure we had people around us that, could really help support the kids, right?

We don't have any family, obviously, in the area. We were sort of floating on our own, but we built our own village and I think the kids [00:20:00] very much benefited from that.

Yeah.

and we were very lucky to do it, right?

Well, I think that's another cost of medicine. That's the whole title of this whole thing, which was we afforded, we made a nanny part of our budget as well as we could.

and it was very important to us, to have that person be a constant not just coming and going. And we had a couple nannies, and then we found our forever nanny. And money doesn't buy that. It was very good luck but we were very lucky But I used to say, and I know you remember, I used to say know, "Either we're gonna spend this money, or I can leave my job.

I cannot feel good about anything I'm doing unless the kids are in a good place."

Right.

it's not fair. They didn't choose medicine. For us, with our hours and our unpredictability, I didn't want our kids to be the last ones at daycare or the first ones there, the last ones picked up.

I didn't want to be [00:21:00] scrambling because we couldn't leave. There were just times we couldn't leave.

Yeah.

Many times. And try as we might, like, if you're in the middle of an emergency, you're not leaving to pick up your kids. And I wouldn't have our kids doing that. So it was always my mantra, we're gonna have to pay for what we need.

even, you know, our parents, they don't live close by, but that was never an option even if they lived around the corner. For us, it was not an option. I wanted our parents to be grandparents and not be the disciplinarians and not be the ones that had to say no to all the things, with their friends or living their retirement life so that they could raise our kids because we were too busy, and that was just not gonna be an option for us.

So we've devoted a large portion of our income to making sure that the kids felt very, well taken care of. , so that was, our financial [00:22:00] wellbeing. Quite frankly, I could care less about. if we got money in the bank and our kids are not well taken care of, I'd rather...

As much as I like doing what I do, and I really have enjoyed my career, I really still do like doing what I do, I would leave it in a heartbeat if I thought it, the kids or the household were not okay. That's where my allegiance lies.

Well, and to be fair and transparent we made that decision not because of money.

We made that decision because you made the same sacrifices to become a physician as I did. and although you were tasked with being pregnant and having the kids and going through that physiologically as well as psychologically you deserved, I think, to be in the medical workforce if that was the decision you wanna make.

I think that's the conversation we had. And, you know, we both had the same medical degree. we practiced the same specialty. But it doesn't necessarily mean that medicine or even family life asks the same thing of us. and let's be clear, female physicians, and we're the best test case, I think, for this.

Female physicians who do the same thing as male physicians [00:23:00] still take on more of the burden at home. And so, did you feel expected to be a full-time physician at work and still carry that full-time responsibility at home?

I feel that my patients deserve a full-time physician. I have to have boundaries, and I'm not great with those, but they deserve a full-time physician, not someone who plays doctor, you know, nine to five and, then plays mommy outside I have to worry about my patients.

I do. I'm sorry that it's probably not a popular probably not healthy, but I have to. I sleep with one eye open when I'm worrying about a patient, and that's not the patient's fault. But I think as a physician, I think most of us, do have, really we care about our patients. We really care about them.

despite what's out there these days on the internet that doctors are just in it for the money and, we're obviously have ulterior motives and everything. That's not how I feel. I feel like we're really in this, and at the end of the day, we care about our patients, so I have to be a full-time [00:24:00] doctor and, that's okay.

But the kids don't need to deal with it. And at home, I really want to be fully at home. I want to be. but I can't ignore phone calls, and I can't ignore pages, and even days that I'm off or that I'm not on call, I still have to run a business, and I still have to answer emergencies.

if my partners, my colleagues need something, I need to answer that. So did I feel that I had to do more at home? I don't know that's a fair question to you because I am not in a good place if the house is not in order. We've had this conversation, right? So if the house is not in order, if the kids are not good, if the laundry's not done, I'm not okay, right?

I would feel better staying up and getting that done. I think where, and I will speak for you just to remind you of the conversation is if our finances are not in order, you're not okay, right? I could care [00:25:00] less, what's in our bank account, so to speak. ... But if the carpool schedule's not done on Sunday night, I can't go to bed.

Yeah. So it's a self-imposed burden. There's been times where, and it's a control issue probably, right? There's times when you say, "What can I do to help?" But somebody has to be that default parent, that somebody has to be. There was an article written years ago about the default parent. And it talked about you know that somebody has to be that default parent because when somebody doesn't get picked up from soccer practice, they have to call a parent.

And that default parent is the one that they call first. And that's okay. but somebody has to do it. In our case, it wasn't the default stay-at-home parent or the default nine-to-five work from home, work remotely, always available parent. So just by definition one of us had to be the first phone call.

Mm-hmm.

And I'm not okay if the kids are not okay.

Yeah.

I remember the kid getting phone calls from our nanny saying, "Oh, so and so has a fever. she needs to go to the [00:26:00] doctor," And you would say, "Oh, do you want me to take her?"

And I remember saying to you on at least one occasion, "That's great if you wanna come. I'll meet you there because I'm gonna be there too." Because I can't let go of that control when it comes to the kids. That was on me. So, yeah. I think over the years we've evolved.

Let me interrupt you there.

that's a really good point. So how much of that was societal pressure on being a mom and a female physician, and how much of that do you feel like was personal? I don't wanna say self-imposed, but how much of that was this is the way you wanna-- You've been very good about describing how you wanted to handle it, love the transparency here.

But how much of that on you or on all of your female colleagues, how much of that is, imposed by society?

it's good question. I just feel like any working mom. I think that society has evolved that I know you feel the pressure of being an [00:27:00] involved father, right? Like, it's not cool to just come home and pat the kids on the head after dinner and, that's your involvement.

Clearly you're much more involved. You coach the kids. you know, you carpool the kids. You do lots of things. I think women can be a little judgy. right? Like we're supposed to be able to do it all.

Yeah.

We're supposed to be, a big, powerful, professional person and well-educated and because we can.

I mean, there's nothing wrong with, higher education. There's nothing wrong with having a great job and a profession and all that stuff. and it doesn't even have to be in medicine. We have good friends who's, are, very successful in business and, other endeavors and that's great.

But on the flip side, you go into you know, the Halloween party at the kids' school, and there's definitely side glances. "Well, you weren't here for the last party." And there's judging. there can be some judgy people out there, and I took it all in very [00:28:00] personally. Even friends that would allude to the fact that our nanny would do-- "Oh, it must be so nice to have that nanny.

She probably does a lot of things for you." As though I didn't do anything in the house.

Yeah.

As though I came home and, had my nails done when I got home. I don't know what they thought I was doing, "It must be so nice for you. They alluded to the fact that they worked so much harder because they were the homeroom teacher or something for kindergarten, and it would just felt very judgy-

A lot of the times, not super supportive. Yeah. Backhanded supportive, I think would be good I was very happy for these folks that they could have the life that they wanna live.their role is they wanted to be at home with the kids or they Just happened to have more time, and they're probably more organized than I am.

I am not super organized, but dang, we both went to as many things as we possibly could-

Yeah ...

at all times, and that was the only thing that matters. And as the kids get older, I think that's what [00:29:00] they remember. They remember us showing up. Yeah. Just show up. When I talk to my younger colleagues with with younger kids in their household, unsolicited advice I give them all the time is just show up.

Just be there. Cancel that, four or five patients and get to the Christmas sing-along. Things that the kids actually don't remember or they don't make a big deal that you broke your neck to get there. Later on they do remember. Yeah.

and that made all the difference for our kids, just showing up.

You did a great job with that. Were there things that you stopped asking me to do because it just felt easier to handle them yourself?

Yeah. it just was easier. But, I believe that marriage it's not a 50/50 thing, right? Marriage is more of a, 100%, right? If you're gonna make the marriage work, not that this is a marital advice thing, but in our world, I think everything our lives have is accentuated by medicine.

Everything is, the highs, the [00:30:00] lows the routine things, everything's accentuated. Everything feels a lot more difficult than a lot of our friends because of the medicine.

and I think marriage is much more of 100%. It's gotta add up to 100. And there are some days that we're very 50/50, and there's some things that it's probably me 75 and you 25, and there's-- vice versa.

But at the end of the day, it's gotta add up to 100 or else it's not gonna work. At the end of the day, it has to be, for me, about the kids and about our sanity, right? When it was time for you to get out of medicine, you're-- it was time. you're not out of medicine, but when it was time to get out of the extremes of medicine, it was time.

And during those times, yeah, it was probably me 90 and you 10 for a lot of things because your mental load could handle only that. And then there are times now where you're, have more reserve, than [00:31:00] I do. And, I think, the percentages have changed on certain occasions.

And I think what you've touched on basically is what burnout looks like in the home, and maybe we should talk about that a little bit more at some point.

But where did I fail to see what you were carrying?

I don't know if you failed. It was just a priority thing, and I can't make your priorities be the same as mine. That's not fair. as I said, my priorities and my sense of wellbeing was always in how is the household doing, right? And that doesn't speak a lot to me taking care of myself.

People say, "Well, what do you do for yourself? When do you go to the gym? when do you go out with your friends?" And for many, many, many years, the answer was never. But my sense of wellbeing was coming home, making it home for bedtime, making it to the Halloween parade that lasted six minutes and the kids didn't even notice I was there, at [00:32:00] school.

just my sense of wellbeing was the kids going to make their lunch, and they realized that I had gotten the Nutella that they had asked for, you know. Because every time they said, "You forgot this," or, "You didn't have that," or, "I was supposed to bring a snack and you didn't have it for me," and we were running out at 10 o'clock at night to get this stuff, that was a failure for me.

And so my sense of wellbeing is still knowing that everything's okay with the family. and to me, yeah, the kids are older now, so we have it much more flexible. We're not passing the baton of childcare, getting home and trying to get the nanny home or racing home on call so that I could get home so that you could leave for surgery w-was incredibly stressful.

And so I've used to just fill in those gaps with having the nanny come earlier or you know, just rearranging my schedule [00:33:00] or whatever. I don't think you failed You didn't have the same needs that I did. I needed it to be smooth for the kids. I needed the kids not to feel the burden that they were in the way of me getting to work on time or figuring out how we were gonna get to the grocery store or when the laundry was gonna get done.

I needed that. So did you see that? I don't know. I don't know that was as important to you because if the kids didn't have the snack for the soccer game, it was gonna be fine for you. Like it wasn't quite as stressful, I don't think, for you 'cause at the end of the day, who cares about snack at a soccer game?

But it was important to me.

Well, you've done a fabulous job of not throwing me under the bus with that question, but what would feeling seen or supported have looked like at that time? Or if you could more generalize it to any female physician who's trying to get her partner to kinda dig in a little bit for more or do more things, how [00:34:00] do they approach their partner

I have a lot of female physician colleagues who are much Better at verbalizing to their partners,

I need you to do grocery shopping this week. The kids have a birthday party to go to, and I need you to get this gift." I spend a lot of time organizing for our nanny. I spent inordinate amount of time that was a sore point for me because my friends thought that must be nice that your nanny went and got birthday presents for this birthday party that you have to go to.

But what they didn't realize is that I organized that list, and I knew what she was gonna get, there's a lot of organization that goes into just getting things done, even if you're outsourcing it. I spent a lot of time just filling in the gaps.

And I don't know. I think if I had to do it over again, which I probably could never do I would say try and be honest and upfront. But we had challenges. [00:35:00] I knew that adding that burden to you was probably not where you needed to be. You hit that burnout button a lot earlier than I did, and I think just adding that burden to you

I think that was the cost of having two in medicine, right? I couldn't do that to you. it was not gonna be successful. And, you know, figuring out what's for dinner. Oh, I know what you could do. You could tell me what you want for dinner. Because I don't mind making the dinner, but the burden of picking out the stupid meal is super annoying.

So when I call or when I text and I say, "What do you want for dinner?" "I don't know. I don't care," doesn't help me, right? So that burden, just decision fatigue just help me get to the next step. I'll do the work. Just help me get to the next step. So I think telling someone's-- one's partner, like, "This is what I need.

I need you to not be upset that I'm up doing charts until midnight, 'cause I don't wanna be doing them either. It's not that I don't wanna go to bed, it's [00:36:00] that I can't. Because if I don't do these charts tonight, then I'm staying late tomorrow. And I need someone to decide what's for dinner. I will make the dinner, but s- not every day can I decide what's for dinner.

I need to make sure that when I put things on the calendar That everyone looks at the calendar because that doesn't always happen, right? So, the organization is there, but if nobody pays attention to the organization... But I also thought that I don't wanna be that person that tells everybody what to do and where to go.

So, that would probably be the only thing when I do say, "This is what I need for help,"

You don't wanna have to say it twice

Yeah. I gotcha. Well, we could default to lobster and steak if you want to next time we ask that question- ... and I will answer it fast enough. No, appreciate it. Personally, I think we're not all the way through it, but I think we did a really good job. I think, we came out of the other [00:37:00] end, and we're still together.

Divorce rates are pretty high among physicians, particularly OBGYN physicians. I remember there was some particular residencies that we knew when we were very young that were very proud of their 100, 100% divorce rate. I've been divorced, in medicine as well, and you know that, and the listeners are gonna know it too.

As those stories go on and we share these things, Being transparent and sharing our own stories will hopefully help others. But I think it made us better off. But, what about you? Did medicine make us a stronger team, or did it just make us pretty good at surviving, and we just have a foxhole marriage?

That's a long foxhole. I think we're beyond the foxhole part.

You always have the best answers ...

again, I don't know what it would be like to be married to somebody who isn't in medicine. I don't know. I can fantasize about it, but I don't know that they would understand me.

I carry everything with me everywhere I go. So, I think it would probably be odd being married to meif you weren't in medicine. I think it would probably be at some point. Again, I have a lot of respect for people. I don't [00:38:00] know if I'm jealous of them or I feel sorry for them. For folks that don't have partners that are in medicine, I don't know how they do it.

I don't know how they separate. And I take care of patients that are married to physicians and I've heard stories about, you know, I've had one woman say to me, "I get it. I know he's tired. He's a surgeon, and I get it. I know. But he always gets to be more tired than me.

He always gets to be the person that's more tired. And, like, sometimes I'm just not having a good day, even though I'm a stay-at-home mom. Some days I wanna be the one that's tired, but I never get to be that person." And it hit home for me, and I'm very cognizant of that with the kids. The kids, they're up, they're studying , They're working hard, they're doing sports, they're getting up early.

hustling. They're good kids. Despite us, they're really good kids. And I think we both fight, sometimes successfully and sometimes not successfully, to not pull the I'm more tired than you [00:39:00] card, I work harder than you card. Because we do. We work stupid hours, and we take a lot of the burden of our patients and our administrative roles and everything home with us.

That doesn't make us right, and it doesn't make them work any less it doesn't make them not as hardworking as us. And same with our friends that are not in medicine or in different fields of medicine. Everybody works really hard. There's a lot of hardworking people out there. We think that we work the hardest

And we do have a long hours. But you know, we also have really great perks to our job. Not necessarily financially, but, like, some really good things that are going on, or else I wouldn't still be in it.

Yeah. Those are really good answers. The close of each episode, what I try and do is ask the the guest, what one action item would you like to take-- you like listeners to take home from this?

What one thing could someone, [00:40:00] especially a female physicians who are listening to this or female residents that maybe are starting, what one action item would you have them take with them to prolong their careers?

I think one or two would be you have to figure out what, I used the term before, but what fills your cup?

What's right for you? Don't listen. There's so much out there on the internet, I think it means to be very supportive, like Facebook groups for female physicians and some of them take what is good for you and leave the rest. There's a lot of competitiveness even within our own fields, even within medicine.

Well, I'm a great doctor, but I also am the room mother and I'm this person, I'm that. Nobody is living your life. Nobody. I'm sure there are other, OBGYNs married to another OBGYN with four kids and two dogs and, you know, like I'm sure there are other people out there.

They're still not me and you. They're still not us. they're [00:41:00] not in our marriage. They don't know what works. I'm sure there are people that would even listen to this and go, "What the heck? She should have had him do more. That's not right." I don't care. I hope people enjoy the podcast, but I don't care.

This is what worked for us. This is what works for our marriage. This is what works for our family. And so I think if I gave myself an action item, it would be, give yourself some grace and don't forget about yourself. You have to be honest. What fills my cup?

What fills my cup is the kids and our marriage going well, right? I need a date night every once in a while. And you and I know it, we don't put it as high up on the priority list as we do, but we can tell every once in a while we just need to, even if it's just taking a walk or grabbing dinner or hitting the golf ball poorly for 45 minutes or something.

That's what is works for us and for the kids. Sometimes I just need to be with the kids. I just [00:42:00] need to make sure that we have a, some kind of time with one, two, three individually, separately. That's what works for me. But I had to figure that out. I was told on the internet that I, don't forget about working out.

I was told, on the internet about you read all these things. Don't forget to work out. Don't forget to go out with your friends. Don't... And many years like I just didn't go out with my friends as much unless we were with the kids. But that was then and now I can find time to do things with them.

But be kind to yourself, right? figure out what's best for you and not for the people on the internet who are telling you what to do. Figure out what's best for you and for your marriage and what works for you and your family because at the end of the day, that, that's who you have to live with.

And if getting out of medicine, quite frankly, doesn't, is what you have to do, then do it. But figure out what you need. I still wanna be in medicine. If [00:43:00] I had to leave it, I would. If my family needed me, I would go but I think just finding what I need for myself, has been the hardest part of the journey, I think

Well said.

Don't think I can say it anymore . Thanks for being a part of our podcast. I think we've got a lot more to talk about than the cost of two medical careers, and I think we'll handle that on a separate episode. So thanks for being here. I love you, babe.

Love you too.

Transcripts are lightly edited for readability and may contain minor errors.