How's Your Marriage, Doctor?

This month, I want to talk about loveand the medical marriage. Dr. KarlMenninger, one of the giants ofAmerican psychiatry, wrote that lovecures people—both the ones who giveit and the ones who receive it. I thinkthat his words speak to us as physiciansand spouses. I notice that physicianswho seem the happiest in love havebeen able to most successfully integratetheir responsibilities of work andof intimate relationships at home,which is no easy task.

MEDICAL CHARACTER ARMOR

Many of us in medicine are woundedhealers. Because of early trauma andloss during our developmental years(eg, family breakup, death or sicknessof a parent, physical or emotionalabuse, a major geographical move,etc), we may have difficulty finding—and more often sustaining—maturelove in our intimate relationships.

Medical school gives ascendancy toscience, intellectualization, and rationalism.It can devalue emotion and theimportance of love in the hearts of itsstudents. The culture of medicine demandsobjectivity and clinical neutralityin its practitioners. In many physicians,this character armor becomeshypertrophied. It's carried from theworkplace into the home. Giving andreceiving love in the medical marriagebecomes a challenge.

The following is an example. Dr.Glen, a 44-year-old thoracic surgeon,consulted with me about 4 weeks afterhis wife left. He did not see it coming.She, on the other hand, argued thatshe had been trying to tell him foryears that she was very unhappy, lonely,and bored in the marriage. Heworked long hours and had a lot ofmedically related interests outside ofhis clinical work. She said that he neverlistened to her unhappy pleas forchange or her wish for him to accompanyher to marital therapy. A fewmonths before she left Dr. Glen, shemet another man at work and started arelationship with him.

SUPPRESSED EMOTIONS

Dr. Glen was intensely mourning theloss of his wife. He told me about anincident that occurred in the operatingroom the previous week. Suddenly, awave of sorrow came over him and hiseyes filled with tears—a classic featureof grief when someone loses someonedear to them. When one of the nursesasked if he was okay, he replied, "Yes, Ithink I've developed some kind of allergyto this new disinfectant they'reusing in the hospital."

It passed. When he was recountingthis story in my office, he said to methat he wished he could blurt out tothe whole surgical team: "My eyes arelike this because I can't stop crying. Mywife is gone; my heart is broken."Reflecting on the thought, Dr. Glenthen said, "But how acceptable is thatin the middle of a lung resection?"

This is an example of lost love in themedical marriage: how the demands ofsick patients and one doctor's love ofhis work blinded him to another kindof love—that of his spouse. It also illustrateshow tough it is to have a normalgrief reaction and still do your job—especially if you're a surgeon.

Michael F. Myers, a clinical

professor in the Department

of Psychiatry at

the University of British

Columbia in Vancouver,

Canada, is the author of

Doctors' Marriages: A Look

at the Problems and Their Solutions (Plenum

Pub Corp; 1994) and How's Your Marriage?:

A Book for Men and Women (American

Psychiatric Press; 1998). He is the past president

of the Canadian Psychiatric Association,

and welcomes questions or comments

at myers@telus.net.