I've written this over and over again in my mind at least a hundred times. But to be perfectly honest I was too scared to ever put the words on paper. I know that most wont understand what I'm talking a
bout and others will brush it off thinking "oh but it will pay off in the end". A phrase I have grown to loath.
So I guess I need to start off by stating that my husband is a doctor. I use that term very lightly and often avoid it all together. There is something about being married to a doctor that gives people the wrong idea. That is probably why I prefer to say- "My husband recently finished medical school". "He is in medical 'training'". "Oh yes my husband works at the hospital as an intern". For some reason I feel like those statements paint a more accurate, if vague description of our lives.
Before I became in engaged with my husband I had no experience with the medical field. I say that because in my time beside him I have learned a large portion of medical students and doctors alike come from families with other medical personnel. I come from a family of teachers, artists, and blue collar american made dreamers. Not necessarily high wage earners but some of the happiest and kindest folks around. My husband comes from a family of engineers and academics. Brilliant people with advanced degrees working hard to improve the world.
During our courtship he would talk about his dream of helping people. Traveling the world providing services and trainings, otherwise unaccessible to so many. He spent a summer in Honduras helping a charity that worked to improve eyesight and was quickly won over by the miracle of ophthalmology. His pure desires to bless others and be a force of good in this world made me his biggest cheerleader. Medicine was the perfect match for him and to be honest the idea of being married to a doctor to do humanitarian work around the world beside me sounded great!
He studied hard and was accepted to a remarkable medical school in a city I always dreamed of living in just 6 months into our marriage. I remember it was a few weeks before christmas when he played the voicemail from the school offering him a spot. We cried from joy and I felt a rush of relief knowing he was on the path and in 4 short years he would be a real MD. HA! How little we knew. That first round of interviews was one of many to come.
His time in medical school was outstanding! He learned and grew in ways we didn't know possible. And his love for medicine continued. But the reality of the sacrifice for a career in medicine was only starting to sink in. I remember the first few weeks learning about medical school loans I laughed. Yes I laughed. Interest, which was not low, would begin to accrue immediately. After doing all of the math, considering our desire to have a child during that time, and cost of living we ended up taking out around $300,000 for our 4 years of training. Yes some programs are cheaper and some cities are cheaper but for the quality of experience received we wouldn't trade the school or city. At this point I should clarify that we were living in NYC, and no it is not cheap. Sadly, and I mean this very seriously- like I cried for a week about this- his school did not offer subsidized housing for anyone with children. Wanting to have a baby we had to find other options for our time there.
Nervous about the high costs and loans we applied (yes "we" as we shared the essay writing and application filling duties) to as many scholarships as we could find. Comically we were denied all but one- a scholarship for Latinos in medicine. This is funny because if you saw my strawberry blonde husband with the most Welsh last name possible you would know without a doubt that he was not latino. But with a CV full of work in central and south america or heard him speak some of the most elegant spoken Spanish to be uttered by a white boy from Southern Illinois maybe, if you never saw his face, you would give him the benefit of the doubt that he was at least a little Latino. The scholarship was certainly a blessing but at only $5,000 it was just one drop in the bucket. As my husband met with financial aid officers explaining our situation (not dependent on parents, one of six children, wife works full time to support us, baby on the way) none of it mattered. Those government created forms that asked how much the parents of the medical student make are all that matter. Who cares if those parents aren't paying our costs, or if they happen to have other dependents to care for. It appeared that his parents, at least on paper, had enough money to afford his schooling, never mind you retirement or anything else.
As the working and supporting spouse my information was not asked for anywhere on the form and not accepted by the officer. Oh and our decision to have a child- a life choice that would have no bearing on financial aid. It was after these heart breaking meetings that I started to realize the financial sacrifice of being a doctor. And to be honest things started to make a lot of sense. Like why most of his classmates came from families of doctors. How they were able to afford to spend more on alcoholic beverages in one week than we spent on groceries for a month. Or how some of his classmates confessed to a problem taking taxis everywhere knowing that it cost a lot for a person with no income. Especially a person paying the equivalent of a middle income for school. Ok. Ok, yes I know all grad school is expensive, or at least most. I received my masters degree while he finished school, and I did that with a child and while working. It took me a little longer but I had options. In medical school your schedule changes monthly with new rotations and studying takes any free time you may have so a job for the majority of med students is not an option!
I cannot write this without saying I was blessed with a wonderful job that helped us cover rent and food and other living costs while we attended school. A job I could take my child to. Really it is the only way we did it. We learned how to find amazing deals and free activities all over our city and enjoyed every thing it had to offer but as interview season rolled around again I learned that once more as a medical "trainee" there are no freebies. The board exams, practice tests, study materials, the interviews (close to 20), every flight, hotel, car rental associated was coming from our thinly lined pockets. Our friends in business were shocked to learn programs didn't fly him out for interviews. That is when I realized how little most people know about this process. Residency programs are competitive especially in smaller fields like ophthalmology. We were quickly taught to be grateful for the opportunity to interview at so many schools and not to complain about the costs associated. Yet in the back of my mind I couldn't help but think this system is flawed. How many brilliant minds are choosing not to persue medicine simply because of the cost? Some students wont apply to top rated programs because of associated living or relocation costs. Is this why the classes are filled with students whose parents have been down this road and are willing to back them? I am not saying parents should pay for their children's graduate studies- not at all. But can we look to find ways to encourage those whose parents aren't?
By the time he finished medical school I was a few months shy of 30 and my husband was 28. You can imagine my excitement at no longer living the "student" life. He would have a salary! A salary!!!!!! As my peers are busy buying homes and discussing career changes, I'm sitting over here ecstatic about finally having income! haha. Well it is easy to say that my joy quickly fell when I learned that loan payments were due and the interest already accrued was almost as much as his entire salary. Oh. And that glorious income. It would be less than 60K and that wouldn't really change for the following four years. $60,000 is nothing to mock. It was a livable salary in this country. But after 20 years of education you would expect a little more. Regardless we moved forward with a smile, forced at times but still there.
Entering intern year I was prepped by many about how this would be the start of the real struggle. I laughed it off thinking- hey at least he is getting paid. hahaha. Once again how naive I was. Financially loan payments had to be made, even though those payments are only lightly scratching the interest owed. Oh well. Not a big deal right? As the rotations across general medicine went from ICU to ER, Surgery, Internal Medicine I learned what working 80 hrs a week really looks like in a family. In NYC we had banker friends and lawyer friends who worked all day and night. I pitied their poor wives and children who never saw them. But in the end they had promotions, and bonuses - sometimes the size our our entire annual salary! They would comment on feeling poor when the bonus at the end of the year was less than $20,000 and I would go home and cry thinking that these young couples, many in their early or mid 20s felt poor while my humble income was supporting my family at a stage of life I didn't expect to be comparing myself to others financially.
One day I foolishly calculated my husbands hourly wage based on his paychecks and the hours he clocked that month- lets just say that you should never do that in medicine. It is depressing. Lets just say a local fast food joint recently had a sign advertising a better wage.
Alas, I would be amiss if I only talked money. To be honest money comes and goes and the happiness in our marriage and the love in our home is simply not dependent on it. Or so I keep telling myself. But what is hard is trying to support a man who is mentally, emotionally and physically exhausted. Working 6 days a week is hard. And when a good day is a 12 hour shift and a long day is 30 hours straight, you can imagine that the one day off is spent resting. Oh if only that was the case. With a 2 year old and 8 month pregnant wife the day off is the day to get things done, to read books and play dolls with the 2 year old who cries when she doesn't get to see him for a while.
How do you support your spouse who that morning had to tell someone they have an aggressive form of cancer and might not live to see another year? Who had to deal with a family irate because of the condition of a loved one. Who performed CPR on a patient for 45 minutes only in the end to realize there was nothing more they could do. How do I express my frustrations of lost keys, toddler tantrums and feeling overwhelmed with the world when he has come home carrying those burdens? My husband actually rarely tells me about these things. He comes home with a smile on his face every day, ready to help and love us.
People have commented on my daughters lack of night time routine but if there is any chance she can see him why not let her stay up till 9?! And God bless him, he even puts our daughter to bed at night when he can and then feels bad when he falls asleep next to her crib. He works tirelessly. He works passionately. And then every day he rises way before the sun and puts on his coats and scarves to ride his bike back to the hospital to do it all again. He never complains about letting me use the car. He says he likes the exercise. But in the rain and snow I have to question his honesty.
We miss him.
The short time we get with him is precious but not without stress of studying for another board exam, or worry that he is not doing enough research to get into a fellowship program. Oh and don't get me started on away electives or holidays. We only have 5.5 more years of this lifestyle. (4 years residency + 2 years fellowship) But hey- it will pay off right?! Yes when we finally finish fellowship we will accept a job somewhere in the country and continue to live as students in a small rental for a few more years as we pay off the loans. But it is worth it in the end right?! I mean doctors make a ton of money right?! With the way medicine is changing and insurance is a constant mess right now. In my humble opinion I think there should be more incentives to get the best of the best into medical schools-- low cost or even tuition free. And then pay residents and fellows well enough that they can support a family. And then pay Attending Physicians a nice salary- nothing extreme but some thing that reflects the years of training. Moderation sounds pretty good right?
All I can say is I am grateful he is in this for the right reasons. Countless times he has reminded me that regardless of salary, he will be a doctor. Not to hold the title. Not because he looks dashing in a white coat. Not because of the associated respect. But because to him the purpose of his life is to bless the lives of others and through medicine he hopes he can do that.
So next time you hear someone say that doctors make too much money, or catch yourself making assumptions about the lifestyle of a medical practitioner- pause. And maybe ask yourself if you would be willing to delay financial stability well into your 40s to spend long days at a hospital caring for strangers in some of the most discouraging circumstances known to man. And please remember the sacrifice they and their families have made so that on Christmas morning when your child is taken to the ER with a broken bone or illness someone is there with the proper training to make sure they will be taken care of.
