My wife is six weeks away from completing a Peds residency.  It's hard for me to think of a favorite thing about residency that doesn't make me sound selfish.  I guess my favorite "unselfish" thing has been seeing her grow and gain so much confidence as a physician, garnering the respect and praise of her classmates, attendings, administrators and nurses.  She's really a star in her program, and that makes me very proud.  On the selfish side (ugh, this sounds awful)...I really have enjoyed having time to myself when she  is either on call or asleep.  It's not a very romantic idea, but I think one thing that can actually hurt a marriage is the pressure some couples feel to spend all of their free time together.  We used to feel that way too, but having this enforced solitude has taught me that I can recharge and be a better husband if I have the personal time.  The downside is that she has not gotten that time, as she's always at work.  When she does come home, I've usually been alone long enough, so I won't leave her alone and end up smothering her!  Of course I can't wait to have her around more often (believe me!) but we need to find a way for us both to keep having that healthy private time, too.

The hardest thing has been how the long hours, heavy workload and pressure of responsibility have drained her of her emotions.  She has become less communicative, more moody, and less tolerant of small irritations.  I often feel like I'm in the stereotypical woman's role of wanting to talk about feelings and relationship issues, when she would rather just turn off her tired brain and watch TV.  I'm already an overly sensitive, moody person myself, so sometimes this combo makes for a bad, bad time.  I am always mistaking her silences for signs that she's mad about something I did or said and is not telling me, but I usually find out that she's only frowning because she's already dreading getting up for work the next day.  On those rare months when she gets some vacation, it takes her a good week to get back to her old self--laughing, gardening, being happy.  Then she starts to think about vacation being over in a couple of days and she gets depressed and moody again.

To people starting out, I would say, make sure you both talk in detail about your feelings, fears, priorities and everything BEFORE internship begins.  Not just all of the "I love you and I'll always be here" stuff, which is improtant, of course, but also really set aside the time to have a loving, supportive talk (or two or three) about how you'll both meet the challenges ahead.  My wife and I did this and it helped me greatly.  Some of the things we said back then still echo in my head now.  For example, she told me that no matter what happened or how residency might change her attitude, I would always be her first priority even if it might not always seem that way on the outside.  And I told her I would remember that so she wouldn't later have to focus her energy on constantly reassuring me.  That's just one small example.  In reality, these ideals break down slightly, but I'm still glad we discussed everything ahead of time.  Once residency starts, it becomes harder and harder to have a converstion about any of this without feelings getting hurt, or to even find time and energy to work on these issues.  By then, you'll have to learn to accept a greatly reduced amount of emotional feedback form your spouse, so laying the foundation early on is really important.

If I could change one thing about the medical training years, I would have more carefully chosen the first place to live when we moved here for residency.  The comfort level of the place you come home to at night has SO much to do with your overall attitude.  Our first place was an apartment in what turned out be be the worst area we could have chosen; the commute to the hospital was awful and we were way out in the suburbs, while almost everyone else we met lived in the city closer to the hospital and to all of the fun stuff.  This made us feel very remote and left out.  To top it all off, we went through a series of increasingly loud and obnoxious neighbors.  Before we first moved here, we just didn't do enough homework to learn the good places to live, and the resulting frustration and even depression made things harder than they should have been.  Imagine your spouse is post call and hasn't slept in almost two days...it takes you both an hour to drive home in heavy traffic, then you have to sweep soiled kittly litter off the patio that the neighbors upstairs spilled through the cracks in their deck, and when you finally make it to bed, you wake up every 20 minutes from 11pm to 3am due to a loud party from the apartment below despite calling the police twice.  THEN see how emotionally supportive and understanding you both are.  True story...not fun.  But I don't want to end on a bad note, so I should say that we recently bought a house in the city, and despite some difficulties with ants and woodpeckers, have been infinitely emotionally healthier and happier.  So, just make sure your home environment is as calm and restful a place as it can be so you and your spouse can come home and get rejuventated rather than more stressed out--you'll both be a lot saner in the long run!
Surviving Residency as A Male Spouse 
by Christopher B.
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